Letters

Letters

Patient-centered approach to care must account for cultural sensitivity

Ike Swetlitz describes a movement that has the potential to revolutionize how the health care profession looks at and treats different races (“New lessons about race and health,” Stat, March 14). But we should consider going even further by extending this new approach to ethnicity while avoiding both biological and cultural stereotypes.

Health care is already moving in the direction of individualized care. A patient assessment should look beyond race, gender, and even age, and include such health determinants as community supports, the safety of the patient’s neighborhood, and the patient’s family structure. When possible, the assessment should be conducted by a care worker with the same ethnicity as the patient, and the individualized care plan should be delivered in a culturally sensitive way. This would lead to better adherence by the patient.

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In addition, data should be used to identify gaps in care. Our own experience provides a good lesson. We recommend that all our senior members receive a vaccine against pneumonia, but our data showed that our Chinese members were getting vaccines at half the rate of the rest of our members. We found the reason was that, as a cultural matter, elderly Chinese want a doctor’s recommendation before getting any vaccine. So instead of urging our Chinese members to get a pneumonia vaccine, we urged them to talk to their doctor about getting the vaccine.

With the United States headed toward becoming a minority-majority population, culturally sensitive, individualized care and data-driven public health interventions will become all the more important.

Wayne Lowell

President and CEO

Senior Whole Health

Cambridge

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