Harvard Medical School Associate Professor Dr. Alexander Green discusses disparities in healthcare and how his research aims to help eradicate the divide.
Dr. Alexander Green is an internist, educator, and researcher who focuses on understanding, and eliminating, racial and ethnic disparities in healthcare. He is Associate Director at the Disparities Solutions Center at Massachusetts General Hospital and Associate Professor at Harvard Medical School. He helped produce and implement a documentary film and educational project called Worlds Apart. It is currently used as a teaching resource by several hundred organizations to help health professionals better care for patients across cultural divides.
For this installment of our Faculty Spotlight series, we had a conversation with Dr. Green. He shared his ideas about how race impacts health care and his current research on culturally competent approaches to quality improvement, clinician biases as root causes of racial/ethnic disparities in health care, and cultural competence education for health professionals.
Q. You have spent a great deal of time in understanding racial and ethnic disparities in health care. What types of interventions can improve the disparities in treatment that you have seen?
A. There are so many different underlying causes and different potential solutions that it’s hard to answer this question succinctly, but I’ll give you some general categories. Education is a big one. I’ve focuses a lot of my career on teaching medical students, residents and practicing physicians and nurses about cultural competence in health care, which I’ll talk more about, but also we need to educate leaders of health care organizations to set up better systems that meet the needs of the diverse populations they serve. Another big area is data. Health care organizations typically don’t do a good job of collecting data on their patients’ backgrounds, and then using that to break down their quality measures to see who is doing well and who isn’t. Without local data on disparities, it is very hard to focus efforts on improving them. Then there are the interventions themselves. There are many, but one type that has been effective is the use of community health workers, coaches, and navigators that can help bridge barriers between patients and the health care system.
Q. What is cultural competence? How can education in this area be expanded and how does it improve health care?
A. Cultural competence is a broad concept. It basically means knowing how to interact effectively with patients from diverse cultural and ethnic backgrounds. This diversity goes beyond just ethnicity though and includes gender, age, sexual orientation, religion, and socioeconomic status. To do this well health care professionals need to be good at building trust, communicating well, in general, and through an interpreter, and ensuring that patients understand and contribute to the conversation. Cultural competence isn’t really an endpoint – it’s more of a lifelong journey of understanding and connecting with those who have a very different set of life experiences that your own. When people don’t experience culturally competent care they end up losing faith in the health care system and not getting the care they need. We are trying to expand teaching of this into all medical schools around the country and beyond and for practicing health care professionals as well.
Q. Have you used our service during your research?
A. I’ve used SabbaticalHomes.com since 2010 and have been doing this kind of research and education since 1997, so there has been a good amount of overlap and will continue to be.
Q. Your testimonial for our site read, “Our experience renting with SabbaticalHomes.com has been excellent. The people we have rented our apartment to (from all over the world) have been wonderful and have become friends that we will stay in touch in the long term.” You must find this a rewarding part of renting out your home. Can you share one particular story about one of these new friendships?
A. Sure. One couple of economists from France was staying with us when we had our first child who is now 2 years old. They are in their 60’s and didn’t have kids themselves, but really enjoyed experiencing this through being our close neighbors when we brought our little guy home from hospital. They got to know him until he was about 4 or 5 months old, came up often for dinner and to play with him, and we are still in touch and hope to visit them in France at some point. We also have good friends now with kids from both the Netherlands and Denmark and are making plans for a European tour to visit them.
Q. What is your dream sabbatical/travel destination
A. I’d love to go to Bali but not sure I’d get much work done there.
Sara Priztkat frequently corresponds with Sabbatical Homes members via our communications team. Her goal is to help you optimally use our site to find, or offer, the perfect home exchange or rental. She also enjoys writing about our members, their adventures and accomplishments.