Racial Concordance in Healthcare Can Improve Health Outcomes and Lower Costs

Thu, Sep 26, 2024 - Comments (0) - Posted by Kim Byas, PhD

Healthcare organizations and hospital systems are increasingly recognizing the vital importance of diversity, equity, inclusion, and belonging (DEIB) as core principles. These values not only promote a fair and inclusive environment but also serve as essential drivers of improved patient outcomes, trust in the healthcare system, and community well-being. At the heart of DEIB lies a powerful concept known as racial concordance. This term refers to the alignment of racial or ethnic identity between healthcare providers and their patients.

Racial concordance is the alignment of racial or ethnic identity between healthcare providers and their patients.

This blog explores the imperative of DEIB in healthcare, focusing on how racial concordance enhances the quality of care, impacts structural efficiency, and reduces health disparities. Citing real-world examples of healthcare organizations making strides in these areas, the work of fostering DEIB is critical to a healthier population.

DEIB as a Foundation for Healthier Communities

DEIB in healthcare goes beyond checking boxes or meeting quotas; it is about creating a system where every patient — regardless of their background — feels recognized and respected in the process of receiving care. A diverse workforce that mirrors the community it serves ensures that healthcare providers understand and respond to cultural nuances. This fosters trust and comfort. Equity, in turn, demands that every patient has access to high-quality care tailored to their unique needs while inclusion ensures that all voices — both patients and providers — are heard and valued.

A sense of belonging is especially important in healthcare. It refers to creating an emotional connection where both patients and staff feel that they are integral to the healthcare community. In any healthcare setting, fostering belonging means the creation of policies that support diversity while building a culture where these values are lived daily.

Racial Concordance: Why It Matters

Racial concordance is a critical aspect of DEIB that significantly impacts patient outcomes. Research has shown that patients who are treated by healthcare providers of the same skin melanation or ethnicity report better satisfaction, more effective communication, and greater trust in the healthcare system. These factors lead to improved adherence to treatment plans and, ultimately, better health outcomes. The concept of racial concordance recognizes that a shared cultural or experiential background can help bridge communication gaps, alleviate mistrust, and reduce the likelihood of misdiagnosis or inappropriate treatment.

African American patients who are treated by African American clinicians have higher levels of satisfaction and are more likely to adhere to recommended treatments.

For example, studies indicate that African American patients who are treated by African American clinicians have higher levels of satisfaction and are more likely to adhere to recommended treatments. This underscores the importance of increasing diversity in the healthcare workforce to improve health outcomes — particularly for historically marginalized populations.

A study conducted in Florida found that racial concordance between African American mothers and African American physicians significantly reduced maternal mortality rates. When African American women were treated by African American physicians, there were fewer complications during childbirth and lower maternal mortality rates compared to those treated by non-African American physicians. This improvement was attributed to better communication, increased trust, and a deeper understanding of cultural nuances between patients and healthcare providers.

Real-World Examples of Racial Concordance in Healthcare Organizations and Hospital Systems

The following healthcare organizations illustrate the value of racial concordance that fosters diversity within their staff and that impact patient care, organizational efficiency, and equity.

1. Cleveland Clinic: Cleveland Clinic made significant strides in addressing racial disparities in healthcare by emphasizing DEIB and racial concordance. The health system developed initiatives to increase the number of healthcare professionals from underrepresented groups. By fostering racial concordance, Cleveland Clinic improved patient satisfaction and reduced disparities in managing chronic diseases such as cardiovascular disease and diabetes. This initiative is linked to a decrease in emergency department visits and hospital readmissions among minority patients.

2. Massachusetts General Hospital: Massachusetts General Hospital (MGH) has made significant strides in DEIB by fostering racial concordance through recruitment and retention programs aimed at increasing the number of underrepresented minorities in healthcare roles. In 2021, MGH’s DEIB initiatives were associated with improved health outcomes for minority populations—including a decrease in disparities related to cancer treatment and cardiovascular care. MGH reported that racial concordance improved communication and trust between patients and providers and led to better adherence to treatment plans.

3. Montefiore Medical Center: Located in the Bronx, New York, Montefiore Medical Center serves a highly diverse community. Montefiore has prioritized racial concordance in its recruitment and training programs—particularly for African American and Hispanic healthcare providers. By aligning its workforce with the community it serves, the medical center has successfully improved trust and adherence to treatment plans among minority populations for chronic conditions such as diabetes and hypertension. These efforts reduced hospital readmissions and improved overall health outcomes for marginalized communities.

4. NYU Langone Health: In 2022, NYU Langone Health launched an initiative focused on increasing racial concordance between healthcare providers and the communities they serve. This initiative led to a more diverse workforce and improved health outcomes for underrepresented populations. A study conducted in 2022 demonstrated that increasing racial concordance resulted in improved patient-provider communication, higher rates of patient engagement, and better management of chronic conditions such as diabetes and hypertension among African American patients.

5. UCLA Health: UCLA Health has incorporated DEIB into its strategic goals by focusing on recruiting and retaining healthcare professionals from diverse racial and ethnic backgrounds. These efforts have resulted in improved patient engagement—especially among minority groups—and have positively impacted health outcomes in areas such as mental health and chronic disease management.

6. University of Pennsylvania Health System (Penn Medicine): Penn Medicine has implemented a racial concordance strategy in its primary care settings, focusing on improving preventive care and chronic disease management among Black patients. This approach has resulted in better health outcomes and greater patient trust, highlighting the positive effects of aligning healthcare providers with the communities they serve.

7. Veterans Health Administration: The Veterans Health Administration (VHA) has focused on racial concordance in mental health services. Research shows that Black veterans are more likely to seek mental healthcare and adhere to treatment when matched with providers of the same race. This focus on racial concordance has resulted in improved mental health outcomes for veterans of color and thereby illustrating the positive impact of DEIB initiatives.

Addressing Health Disparities Through DEIB

The health disparities faced by marginalized groups — including African American, Hispanic, and Native American populations — are profound and deeply rooted in systemic inequities. These groups suffer disproportionately from chronic conditions such as cardiovascular disease, diabetes, and maternal mortality. Social determinants of health, such as economic instability, lack of education, and limited access to healthcare, exacerbate these disparities.

Healthcare organizations and hospital systems organizations that focus on DEIB are better equipped to address these challenges by understanding the unique needs of their communities and developing targeted interventions. Cultural competency training, recruitment of diverse healthcare providers, and community-based health programs are effective strategies for reducing disparities and improving health outcomes.

Building Equity in Care Delivery

Achieving equity in healthcare means moving beyond equal treatment to tailor care to the specific needs of individuals. Healthcare organizations and hospital systems organizations must develop models of care that account for the social, economic, and environmental factors influencing health. Community-based programs, such as mobile clinics, telehealth services, and community health centers, are effective tools for improving access to care in underserved areas.

By focusing on equity in care delivery, healthcare organizations can build trust with communities that have historically faced discrimination or neglect. Ultimately, doing this important and sometimes challenging work improves health outcomes and reduces disparities.

Treating everyone the same overlooks the unique challenges faced by marginalized populations.

Overcoming Barriers to DEIB in Healthcare Organizations and Hospital Systems

Despite the clear benefits of DEIB, healthcare organizations often face barriers in implementing these initiatives. Resistance to change, entrenched biases, and limited resources can hinder progress. Moreover, political and ideological opposition to DEIB programs has emerged in recent years with some critics arguing that these initiatives detract from providing equal care to all patients. Equality, however, does not necessarily mean equity. Treating everyone the same overlooks the unique challenges faced by marginalized populations. By focusing on equity and racial concordance, healthcare organizations can ensure that every patient has an equal opportunity to achieve optimal health outcomes.

DEIB and Racial Concordance Reduce Healthcare Costs

Hospitals that focus on DEIB and racial concordance can significantly reduce healthcare costs by improving patient outcomes, enhancing efficiency, and decreasing readmissions. One powerful impact of DEIB is cost reductions achieved through better alignment between healthcare providers and patients. DEIB and racial concordance have shown to foster trust, improve communication, and enhance treatment adherence. These powerful results help to reduce costly medical errors, unnecessary tests, and repeat visits.

Hospitals that invest in DEIB initiatives tend to have higher staff retention rates and lower turnover.

For example, a study by the American Economic Review highlighted that racial concordance between African American patients and African American doctors led to improved health outcomes. Such reductions in long-term costs are associated with managing chronic diseases that disproportionately affect minority populations. Furthermore, hospitals that invest in DEIB initiatives tend to have higher staff retention rates and lower turnover, which directly reduces the costs of recruitment, training, and onboarding. Additionally, hospitals with a focus on DEIB are more likely to engage in community-based health initiatives that help reduce emergency department visits and hospital readmissions by providing accessible, preventive care.

Moving Forward: A Commitment to DEIB and Racial Concordance

The path forward for healthcare organizations is clear: DEIB and racial concordance are not just ethical imperatives but strategic priorities for improving health outcomes, reducing disparities, and enhancing organizational efficiency. By investing in diverse workforces, cultural competency training, and community-based programs, healthcare organizations can create systems that are fair, equitable, compassionate, and inclusive.

As healthcare organizations continue to navigate the complexities of today’s world, their commitment to DEIB and racial concordance will determine their ability to meet the needs of their communities and foster a healthier and a more just society for all.