NMA: Certification of Health Care Providers in Cultural Competency Being Talked About

By Jean F. Gibbs

The National Medical Association (NMA), which represents the interests of more than 25,000 African-American physicians, wants to "certify" medical professionals as being "culturally competent" to treat patients of color, informs the Medical Herald  in its edition of January 2002.

"Cultural competence is not just being nice to people" Randall W. Maxey, M.D., chairman of the board of trustees of the NMA,  was quoted as saying by the the Herald. "It is also knowing from a medical and scientific standpoint how to treat the disease spectrum that is likely to be present in these individuals, based upon their ethnicity and cultural backgrounds."

A lack of cultural "sensitivity" or understanding in healthcare providers treating patients of different ethnic backgrounds has been blamed for some of the health care disparities existing currently within the different segments of the US population.  

For example, a recent survey released by the Robert Wood Johnson Foundation showed that one-fifth of Spanish-speaking Latinos living in communities with fast growing Hispanic populations reported they did not seek medical treatment due to language barriers. According to the people surveyed, language barriers make it much harder to fully explain symptoms, ask questions or to follow through with filling prescriptions.  Then trust becomes an issue, making patients less likely to believe that their physician understands their needs.

The problem gets more complicated when the cultural aspects of the patient-physician relationship are compromised. "It is the same with other races.  We want to know that all physicians who treat the black community are familiar with how to best address the health concerns of that race", said Dr. Maxey in the Herald.

Maxey, the son of a Cincinnati mortician and funeral home owner, is a nephrologist who has held leadership positions in a number of nephrology and medical associations, including chair of the NMA's Integrated Health and Managed Care Task Force and the membership committee.  He is well respected in scientific and academic circles from Washington to California to Guam and has made outstanding contributions to research regarding the prevention and treatment of renal failure, especially in cases complicated by cardiovascular disease.

The NMA has, according to Dr. Maxey, designed a course to teach cultural competence and expects medical professionals to take the time to master it to achieve the NMA's seal of approval for cultural competence.

Source: The Medical Herald (Jan. 2002)

Kidney Failure Strikes 1 in 13 African Americans

June 4, 2002

NEW YORK (Reuters Health) - Roughly three times as many black Americans as white Americans will develop kidney failure in their lifetime, according to researchers.

In their study, 7.8% of African-American women and 7.3% of African-American men, or 1 in 13 blacks, will be diagnosed with the disorder that is fatal without kidney dialysis or transplant. Less than 2% of white women and 2.5% of white men will develop the disorder, report Drs. Bryce A. Kiberd and Catherine M. Clase.

What's more, end-stage renal disease was found to cut the life expectancy of women by nearly as much as breast cancer (news - web sites). The disorder took more years off the lives of black men than did colon, rectal and prostate cancer (news - web sites), according to the analysis based on national data on rates of kidney failure for a hypothetical group of 20-year-olds.

The study did not investigate why rates of the disease are so much higher among blacks but the researchers suggest that a combination of genetics, poor health behaviors and economics is to blame.

Kiberd recommends that blacks suffering from high blood pressure and diabetes, a major cause of kidney damage, ask their doctor whether these conditions are affecting their kidneys. Reducing blood pressure and stabilizing blood glucose (sugar) can protect the kidneys from long-term damage, he notes in a prepared statement.

The findings, published in the June issue of the Journal of the American Society of Nephrology, indicate that new screening and treatment strategies need to be explored, since treating end-stage renal failure is far more expensive than the cumulative costs of treating kidney disease, the authors note.

"We suggest greater attention toward implementing existing treatment strategies and more research into novel screening strategies in the black population," Kiberd and Clase write.

They estimate that the Medicare costs of caring for patients with kidney failure will increase to more than $28 billion in 2010 from $12 billion in 1998.

SOURCE: Journal of the American Society of Nephrology 2002;13:1635.

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Study:  Disabled Blacks 43 Times Less Likely To Get Rehab Than Whites

by Jean F. Gibbs

A new study reveals that disabled African-Americans receive less vocational rehabilitation than Whites.

The vocational rehabilitation rejection rates for Whites (3.7 percent) is 43 times lower than those for Blacks (5.3 percent). Keith Wilson, an assistant  professor of rehabilitation education at Pennsylvania State University, suggests that the results are problematic, since blacks are proportionately more disabled and have more severe disabilities.

Wilson notes a factor that may cause this disproportionate rejection rate could be the high numbers of Whites (93 percent) who are vocational rehabilitation administrators and counselors.

The author of the study based his conclusions from data gathered from 22 percent respondents who were black and 78 percent who were white. Those data were collected from the rehabilitation service administration.