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June 7, 2013 OHA Director's messages on the web
To: All OHA employees
From: Bruce Goldberg, M.D., Director

What we know affects what we do

"Of all the forms of inequality, injustice in health care is the most shocking and inhumane." ~Martin Luther King, Jr.

To truly transform our health system, we must set the expectation that everyone receives high-quality care that is patient-centered. That means creating a culture where health disparities are unacceptable. To do that, we need clear information about who we are serving in the health system and whether we are doing so in a culturally competent way. That is why I am pleased about two bills headed to Governor Kitzhaber’s desk for his signature.

House Bill 2134 creates a uniform standard for demographic data collected by both OHA and DHS. That includes the vital statistics unit in public health, Oregon Health Plan and DHS clients, and grant recipients for our agencies.

Today the way we gather data from our clients and the general population – about people’s ethnicity, race, language preference and disabilities – is inconsistent and insufficient. And that’s a problem. For instance, Chinese, Korean, and Hmong populations could have very different health beliefs, cultural practices, languages, and health needs. The "Asian" category masks that. Caucasian Americans could have different needs and practices from people who identify as Eastern European. "White" is too broad to be meaningful. And African Americans have different language, nationality, and cultures from people who identify as African, but too many of our forms don’t allow for that differentiation.

Accurate data collection will increase our understanding of different populations so that we can do a better job serving them.

House Bill 2611 requires the 21 health boards that license health professionals to report to OHA how many of those professionals are taking cultural competency trainings every two years. This includes nurses, doctors, chiropractors, massage therapists and home care workers.

The Legislature also gives medical boards the right to include cultural competency education as a prerequisite for licensure.

Let's remember that cultural competency is about much more than reducing language barriers. Generalizations and misinterpretations of cultural practices can increase costs and reduce the quality of care people receive. Two people who grew up in Oregon speaking English could still come from different cultures with different understandings of health and disease, health practices, and customs. Patients who come from a culture that doesn’t question authority, for example, may be hesitant to have open communication with a provider, creating huge barriers to good care.

I want to thank everyone at OHA who worked with diverse stakeholders across the state on the passage of these bills, particularly Tricia Tillman, her team in the Office of Equity and Inclusion, and the members of the Race, Ethnicity and Language (REaL) Data Leadership Workgroup. These bills are an important step forward to creating a health system that truly serves everyone in our state. While none of us is individually responsible for creating health disparities, we all have an important role and responsibility for eliminating them.

OHA on the web