Racial Diversity in Health Care Workforce Leads to Improved Outcomes in Minority Populations

FOR IMMEDIATE RELEASE: Tuesday, January 19, 2021

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Janelle Davis
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Racial Diversity in Health Care Workforce Leads to Improved
Outcomes in Minority Populations

WASHINGTON, DC — It is well documented that most people prefer to receive their health care from clinicians with whom they share common traits, most notably race. New research from the Robert Graham Center examines the role of patient-clinician racial concordance as it relates to communication, patient satisfaction, health outcomes and health expenditures.

The research article, entitled “Patient-physician Racial Concordance Associated With Improved Health Care Use and Lower Health Care Expenditures in Minority Populations,” was published in the January 2021 issue of the Journal of Racial and Ethnic Health Disparities.

“Overall, our study findings are consistent with previous studies that showed minority populations were more likely to prefer or have a race-concordant clinician,” writes Anuradha Jetty, MPH, and her colleagues. “Examining the association of patient-clinician racial concordance on patient-clinician communication, patient satisfaction, and health outcomes may provide insight into the role that interpersonal dynamics play in the development of racial health disparities.”

The primary purpose of the research was to examine the use of health care services and expenditures by patients across different racial groups if having a racially concordant physician impacts their health care use and spending. The researchers also aimed to gain a better understanding of which socio-demographic factors were associated with an increased likelihood of having a racially concordant clinician.

Key findings include:

• Asians and Hispanics who were foreign-born, spoke English less fluently, and were publicly insured had increased likelihood of seeing a clinician of their own race.
• Patient-clinician racial concordance is associated with lower emergency department use for Asian and Hispanic patients.
• Patient-clinician racial concordance is associated with lower rates of hospitalization for Hispanic patients.
• Patient-clinician racial concordance is associated with lower total health care expenditures for Asian, Hispanic and Black patients.
• Despite lower total health expenditures found in the non-Hispanic Black concordant dyads, there was no reduced odds of emergency department visits or hospitalizations for this concordant group compared to non-Hispanic Black respondents seen by race discordant clinicians.
• Having race concordant clinicians did not lead to increased use of services, such as primary care visits and receipt of screening tests for cervical, breast and colorectal cancers, in any of the populations studied.

“These study findings add to a body of similar evidence supporting the initial hypothesis that improved communication from racial concordance leads to an improved and therefore more effective therapeutic relationship. In addition, having an established, ongoing relationship with a racially concordant clinician as a usual source of care, particularly in minority populations, may reduce health care expenditures. Whether this is due to enhanced disease prevention, improved disease management, improved patient counseling, or simply less health care utilization warrants future study.”

While this study has some limitations, it offers important indicators for areas that need improvement within health care delivery and medical education to achieve cultural understanding. Addressing these underlying contributory factors to racial health disparities will likely facilitate improvement in these disparities in the United States.

The study authors advocate improving access to medical professions for underrepresented minorities in medicine as well as expanding existing training in medical school and graduate medical education curricula on race, cultural humility, structural competency and anti-racism.

“Having a racially-concordant physician as a usual source of care promotes appropriate utilization of health care services and improves patient outcomes beyond patient satisfaction and communication,” Jetty said. “However, the variation in outcomes seen here indicates that racial concordance is important in some groups and in some settings, depending on the needs and preferences of each racial and ethnic group.”