Diversity is crucial to delivering quality care. It allows health care providers to administer thoughtful, equitable, and consistent care strategies. As the racial and ethnic demographics of the country continue to evolve toward a more diverse population, it will be increasingly imperative for nurse leaders to acknowledge, respect, and uphold diversity in their approach to care delivery.
To learn more, check out the infographic below, created by Bradley University’s online Doctor of Nursing Practice program.
By the Numbers: Cultural Diversity in Health Care
The country’s increasing diversity means that the health care industry cannot maintain the status quo. Developing strategies to meet the needs of this diverse population will be crucial to meet the goal of delivering optimal care that can improve outcomes for all patients.
U.S. Population Outlook (2020-2030)
The United States is projected to gain 18.6 million people by the end of the decade. The population itself will get older during this time frame. In 2020, 74 million people were under the age of 18, and 56.1 million people were 65 and older. By 2030, these numbers are expected to grow to 75.7 million and 73.1 million, respectively. It is estimated that the 65-plus demographic will represent 21% of the country’s population by 2030.
Shifts in Race and Ethnicity
The country’s projected to become not only older but also more diverse. In 2020, the U.S. population was 61.6% white, 18.7% Hispanic, 12.4% Black, and 6% Asian. By 2030, the U.S. population is predicted to be 55.8% white, 21.1% Hispanic, 13.8% Black, and 6.9% Asian. By 2060, the population breakdown is projected to be 44.3% white, 27.5% Hispanic, 15% Black, and 9.1% Asian. This latter projection means that white Americans would be the minority compared with the combined percentages of other populations.
Racial Disparities in Health Care
Unfortunately, large percentages of non-white Americans often fare worse than their white counterparts in terms of overall health as well as health care coverage, access, and use. Studies indicate 45% of Blacks fall into this discrepancy, as do 39% of Hispanics, 34% of American Indians and Alaska Natives, 20% of Native Hawaiians and other Pacific Islanders, and 13% of Asians.
These disparities are driven by several metrics. While health coverage, access, and use are a noticeable indicator of this disparity, health status, health outcomes, health behaviors, and social determinants of health also play prime roles.
Racial Representation in the Health Care Industry
The health care industry currently struggles with race representation. It’s a situation that’s crucial to resolve from a patient perspective. A 2020 report of pre-pandemic data found that patients were more likely to give higher approval ratings to physicians who shared their ethnicity and/or gender.
A 2021 Gallup poll asked respondents how difficult it was to find physicians of the same ethnicity. According to the poll, 57% of whites found it very easy, compared with 28% of Hispanics and 17% of Blacks. Conversely, 35% of Blacks and 24% of Hispanics found it somewhat difficult to find physicians of the same ethnicity, compared with only 8% of whites. Additionally, 18% of Blacks and 15% of Hispanics reported it was very difficult to find physicians of the same ethnicity, compared with just 5% of whites. The only consistent scenario according to the poll was the percentage of people who found it somewhat easy to find physicians of the same ethnicity (28% white, 31% Hispanic, 28% Black).
As of 2018, studies indicated that physicians were predominately white, as they represented 56.2% of the profession. The ethnic makeup of the rest of the physician population broke down as follows:
- 1% Asian
- 8% Hispanic
- 5% Black
- 7% unknown racial or ethnic origin
Promoting diversity in health care is critical because it offers several patient benefits. These advantages include a reduction in care disparities, improved and optimized care delivery, and improved access to care.
Diversity and Cultural Competence in Health Care
Cultural competence consists of attitudes, behaviors, and policies that promote equitable work in cross-cultural scenarios. Culturally competent care benefits patients and health care facilities alike.
Characteristics of a Culturally Competent Health Care Facility
Health care facilities that practice strong cultural competence recognize the crucial nature of culture. They also integrate assessments of cross-cultural relations. Additionally, they acknowledge the potential impact of cultural differences and strive to increase their cultural knowledge. Finally, they adapt their services to meet unique culture-driven needs.
Establishing a solid foundation of cultural competence yields several benefits. These benefits include improved patient safety, better communication, reduced costs, and improved patient outcomes.
Core Principles of Cultural Competence
Effective cultural competence is driven by several fundamental tenets. Some of these tenets involve establishing the concept of culture through a broad definition, understanding the value of a patient’s cultural beliefs, and acknowledging complexity in language interpretation. These tenets also involve different forms of collaboration, such as facilitating learning between providers and communities, collaborating with other agencies, and incorporating the community in defining, assessing, and addressing service-based needs. Additional tenets involve conducting staff hiring and training in a professional manner and integrating cultural competence across an institution.
Adoption of Cultural Competence Strategies
Despite the benefits, cultural competence strategies that champion diversity, equity, and inclusion have not been fully embraced. In a 2021 Relias poll, 62% of respondents said they worked for health care facilities that had such strategies. Of these facilities, 90% provided training to support those strategies, but only 40% of them made training required for managers.
How to Promote Diversity in the Workplace
Nurse leaders stand at the forefront of health care delivery and can play a key role in developing diversity strategies that can make an equitable, culturally competent approach to care delivery standard practice.
Benefits of Developing and Implementing a Diversity Strategy
Putting a solid diversity strategy in place promotes cultural competence and minimizes the risk of unconscious bias. It also strengthens the workforce community. From the patient point of view, such strategies reduce feelings of intimidation. It also optimizes patient care, which could potentially improve patient outcomes.
Strategies Nurses Can Use to Advocate for Diversity
Nurses can be diversity advocates by developing mentoring programs. They can also fight unconscious bias when it’s spotted. Additionally, they can seek ways to advocate for diversity in work interactions and broaden the definition of diversity to account for inclusion. Another strategy nurses can use involves seeking out and joining a community diversity committee.
Nurses can also strive to create a culture of diversity in the workplace. They can do so by creating an in-house diversity committee or action team. They can also develop training programs that promote cross-cultural understanding. Finally, it’s crucial for them to lead by example.
Build a More Equitable Future in Health Care
Increased diversity means better patient care. Nurse leaders can be prime movers in instilling these values within a care delivery facility to provide more consistent quality care for all and shape the future of the nation’s health care system.
American Hospital Association, “Becoming a Culturally Competent Health Care Organization”
Association of American Medical Colleges, “Diversity in Medicine: Facts and Figures 2019”
Atlanta Journal-Constitution, “How Nurses Can Help Promote Diversity in the Industry”
Centers for Disease Control and Prevention, “Cultural Competence in Health and Human Services”
Gallup, “Black Adults Have Harder Time Finding Doctor of Same Race”
Health Professions Education, “Developing Workforce Diversity in the Health Professions: A Social Justice Perspective”
JAMA Network, “Association of Racial/Ethnic and Gender Concordance Between Patients and Physicians with Patient Experience Ratings”
Journal of Patient Safety, “Hospital Cultural Competency and Attributes of Patient Safety Culture: A Study of U.S. Hospitals”
KFF, “Key Facts on Health and Health Care by Race and Ethnicity”
Relias, “How Diversity, Equity, and Inclusion Can Influence Healthcare”
SCP Health, “The Importance of Being a Culturally Competent Clinician”
The Society for Diversity, “Benefits of Having Cultural Diversity in a Healthcare Organization”
United States Census Bureau, “Demographic Turning Points for the United States: Population Projections for 2020 to 2060”
United States Census Bureau, “2020 Census Illuminates Racial and Ethnic Composition of the Country”