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Diversity in Health Care Providers Helps Patients Feel More Included

Many people take it for granted that when they visit a doctor’s office, stop at a pharmacy or go to the dentist, at least some of the staff members will look like them. For some patients, it may not matter much whether health providers resemble them by race, ethnicity or sexual orientation. But for others, diversity (or lack of) could determine whether they seek or shun the health care system.

Read on as experts describe the consequences of the diversity gap among health care providers, researchers and leaders — and how greater inclusiveness is better for patients.

[See: 14 Things You Didn’t Know About Nurses.]

Lagging Life Expectancy

With persistently shorter life spans, black Americans are at a disadvantage, according to statistics from the Centers for Disease Control and Prevention. A breakdown by race and ethnicity from the Kaiser Family Foundation showed that in 2009, African-Americans had a life expectancy of about 74.5 years compared to nearly 79 years for whites, almost 83 years for Latinos and a high of 86.5 years for Asian-Americans.

Boosting the diversity of providers in the U.S. health care industry could be a tool for bridging the gap from shortest to longest life spans, says Dr. Douglas Garland Jr., trained as a health scientist and also a board member for the Association of Black Health Professionals, a recently formed interest and advocacy group.

The group’s mission is to increase the use of black doctors, pharmacists, dentists, nurses and others who work directly with patients. In addition to more recruitment and hiring of clinicians, the ABHP is advocating for employers such as hospital systems, both public and private, health agencies and pharmacy chains to expand black presence and build more diversity in leadership positions.

A recent study conducted by the association looked for a connection between states with a higher proportion of black Americans working in the health care industry and higher life expectancy trends. The early study suggests a correlation, Garland says, although the study does not show cause and effect.

Doctors, Nurses and Leaders Who Look Like Me

From a patient’s immediate perspective, is it important to see clinicians who resemble them? “For the majority of Americans, the answer is no,” Garland says. “They should not pick a clinician who necessarily looks like them. That doesn’t have to be a prerequisite, shall we say? There are many people in American who get very great care notwithstanding the ethnicity of their clinician, be it a pharmacist, nurse, physician or any other clinical provider.”

But concerns about discrimination and mistrust of the health system exist, causing some people to avoid it altogether outside of dire emergencies. “There are Americans who are unwilling to engage in the health care system,” Garland says. “We believe that workforce diversity is one of the many tools that can help them re-engage, particularly the frequency they engage with the health care system at the appropriate time — preventively as opposed to waiting until the last minute.”

It’s not just about the hands-on providers with whom patients deal directly, but administrators and other staff members as well, Garland adds: “When patients walk into an institution and they see from top to bottom there are people who look like them, that helps promote trust and confidence in the system.”

If you want to see more diverse providers in health facilities serving your community, Garland suggests dropping a line to facility administrators and to your elected officials.

[See: How Social Workers Help Your Health.]

Mental Health Barrier

As a child psychologist, Dr. Alfiee Breland-Noble, an associate professor of psychiatry at MedStar Georgetown University Hospital, works with young people with mental health issues. In the realm of mental health professionals, Breland sees two especially salient gaps. One is the lack of diversity among those who conduct research in the treatment and prevalence of mental illness. On the clinical side, there’s a dearth of providers available to meet the needs of a diverse population.

Among teens, 11 percent have had a major depressive episode in the past year. African-American youth get less specialty care, have lower rates of treatment completion, spend less time in treatment and are less likely to get treatment specific to their mental health disorder, Breland-Noble told journalists attending a National Press Foundation conference on mental health in September.

As a federally funded researcher, Breland-Noble feels strongly about the need to increase the diversity of people who lead research along with patients involved in studies. “That’s where it starts with me,” she says in an interview. “If we’re going to have better treatment, we’ve got to have really strong research. If we’re going to have really strong research, we want it to be more generalizable. And to get there, we’ve got to bring more people into the fold. At the leadership level and in terms of who participates.”

Practitioners from any background can improve their cultural competence, says Breland-Noble, who has taught it. Cultural competence encompasses a few broad areas, she says. One is a knowledge base of different U.S. populations; for instance, the experience of Latino people depending on whether they’re of Caribbean, Central American or South American origin.

Awareness is another piece — how you view yourself in relation to other groups and your own personal experiences and biases. For African-American patients, faith is often part of the community, although it’s more significant for some than others, Breland-Noble notes. “As a provider, what is my experience and level of comfort in talking about my faith?” she says. “Am I comfortable sharing my own? Am I comfortable letting the patient share his or hers with me?”

Providers who are themselves part of a community probably have a head start relating to patients, she says. For example, an LGBTQ doctor could have personal experience coming out that another doctor might lack but could learn more about by talking to his or her colleague.

[See: 10 Reasons to See a Physician Assistant.]

“You want a diversity of perspective and a diversity of experience,” Breland-Noble says. “That’s the best for patients. Patients don’t have to have, I think, somebody who looks exactly like them. What they do have to have is someone who’s willing to understand and who has taken the time to gain enough of a skill set that they’re open to working with people who are different from them.”

More from U.S. News

8 Questions to Ask Your Pharmacist

10 Lessons From Empowered Patients

11 Things Seniors Should Look for in a Health Provider

Diversity in Health Care Providers Helps Patients Feel More Included originally appeared on usnews.com

Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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