In the United States, we know that long-standing systemic health and social inequities increase the likelihood of poor outcomes or death for members of racial and ethnic minority groups. For example, Black babies are more likely to die before their first birthday, and Black women are more likely to die from childbirth-related causes than their white counterparts. The COVID-19 pandemic has also underscored the fact that economic and social circumstances, social determinants of health (SDOH), and maldistribution of resources contribute significantly to health inequity.

Many of the more tangible and measurable factors driving inequity could be addressed through a heightened national political commitment to achieving a better balance in health-related budgetary and organizational reforms. But some of the factors are less easy to see and measure – yet are perhaps just as challenging. Distrust and poor communication related to racial and cultural differences pervade the health system and frustrate many efforts to reach the goal of good and equitable care for all in America. All too often, Black patients and other minorities are spoken to rather than talked with; the result is less-effective interactions, less empathy and acknowledgment of concerns, and ultimately, worse outcomes.

Poor communication is a failing of the health system, not of patients. A good health system engages fairly and respectfully with everyone who seeks care, and it recognizes that its patients and plan enrollees come with a range of previous experiences with the health care system, as well as different literacy levels, language fluency, and cultural norms. It is the responsibility of system managers, and front-line providers, to ensure that everything from examination room interactions to provider training is guided by good communication techniques. But while health managers will usually say they recognize the importance of good communication, there remain profound barriers to introducing and implementing the techniques needed to achieve better outcomes and equity.

Read the full article about poor communication and health inequities by Stuart M Butler and Nehath Sheriff at Brookings.