Disparity of Care for Minorities
BrainLine talks with Dr. Carlos Arango-Lasprilla about why cultural competency is so important when treating people with TBI.
There are a lot of healthcare disparities unfortunately in this country, especially minorities are less likely to receive rehabilitation services, such as occupational therapy, psychotherapy, speech pathology, or physical therapy. Also, I have found that minorities are more likely to be unemployed 1-4 years post injury. Minorities are more likely to-- don't receive rehabilitation services after the injury. They are more likely to have more disability 1-2 years post injury. They are far less likely to be integrated into communities. When you do studies looking at healthcare disparities in this country, especially with people with TBI, you can see that even after controlling for sociodemographic an injury characteristic, you can see that there are healthcare disparities. Minorities do worse in pretty much in almost all the areas-- in rehabilitation, employment, community integration, functional outcomes. They do worse, even after controlling for sociodemographic injury characteristics. I think there are a lot of factors that could explain these problems. One of the factors could be cultural issues. Usually, some minorities, they don't trust in doctors, and they don't want to go and receive rehabilitation therapy. There are also different beliefs and attitudes about rehabilitation. There are transportation problems, income problems, but also there are other factors that could influence these outcomes, like mistrust, also racism, and also language barriers. There are a lot of Hispanics or people from Asia that don't speak English, and when they have to receive rehabilitation services, usually there are no professionals that can provide the service to these patients in their own language.
Posted on BrainLine April 1, 2009.
Juan Carlos Arango-Lasprilla, PhD is currently a research assistant professor in the Department of Physical Medicine and Rehabilitation at Virginia Commonwealth University. He is well-known in his areas of expertise, both in the US and abroad.