In other countries, there are increasingly more people who are obese.
Adults have a higher prevalence of obesity than their teenager counterparts, even though obesity affects people from all walks of life. A recent study published in the American Journal of Clinical Nutrition found that there is not only a lack of racial diversity among healthcare professionals who treat obese patients but also a lack of systematic tracking of the racial makeup of the field. Here are some examples of how and why increased representation could benefit more Americans' health.
The ability of a practitioner to establish a rapport with a patient can have a positive impact on health outcomes regardless of the illness state or concern in question. Given the history of how some communities have been treated by the medical profession as a whole and the perceived risks of obtaining medical care in the first place, experts say representation and cultural mirroring are especially crucial when it comes to treating BIPOC communities.
“Being treated by someone who shares the same ethnic, cultural, and racial background allows a patient to feel seen and understood," says Alice Figueroa, MPH, RDN, chef, and author. "Historically, many BIPOC communities have a distrust of the healthcare system establishment. Although our population is becoming more diverse, most doctors, dietitians, nurses, physical therapists identify as white, and BIPOC health professionals are underrepresented in every sector of the healthcare industry."
According to Figueroa, it's critical for the healthcare system to train medical staff members to deliver culturally-humble care while also working to help BIPOC medical professionals who are working today and in the future. This viewpoint is shared by Ashley Carter, RD, LDN, and Jasmine Westbrooks, MS, RD, LDN of Eatwell Exchange, Inc.
“There’s a different dialogue that occurs when your healthcare provider is able to relate to you and that opens the door for effective problem-solving," Carter says. "Equitable healthcare will provide a higher retention rate amongst minorities thus reducing health disparities in the long run.”
Beyond concerns about equitable, competent care, Figueroa and the dietitians of EatWell Exchange Inc. also voice concerns about the criteria and methods used to classify obesity, in addition to the lack of diversity among healthcare professionals who treat obese patients.
“With regards to obesity treatment, I believe that our current medical system uses poor or insufficient tools to assess a person’s health,” Figueroa says. “BMI is a measure that was developed using a white, male population and was not initially intended to become a health marker."4
She claims that a sample of the world population that includes women and BIPOC was not included to develop the current BMI equation. She suggests that as a result, it might not be the best indicator upon which to make health judgments.
"l firmly believe that a person can be healthy at any size, regardless of their BMI and weight," Figueroa says.
Both Carter and Westbrook feel that treating patients with a weight loss-focused approach is dismissive and fails to address or recognize the main reason they are looking for assistance. Obesity interventions shouldn't be thought of as a one-size-fits-all idea. According to Carter and Westbrook, culturally competent care for obese patients entails that medical personnel have considered the patient's race/ethnicity, socioeconomic situation, food insecurity, cultural customs, and lifestyles throughout therapy.
“Specifically for patients diagnosed with obesity, healthcare professionals should educate themselves on obesity as it relates to an individual culture to accurately assess that patient’s health needs," Carter says. "If a patient enters your office with health concerns that aren’t directly related to their weight status, the first response shouldn’t be discussing their BMI and recommending they lose weight."
According to the study published in the American Journal of Clinical Nutrition, having a more diverse medical field is important since it will lead to greater research on ethnic groups that are typically underrepresented. Figueroa points out that the task is more complicated than simply employing a workforce that is more diverse in the healthcare industry.
“It is key for RDs to construct partnerships with BIPOC people and groups that champion antiracism initiatives and provide representation, support, and space that champions empowerment for people from diverse backgrounds," she says. “Ignoring the existence of systemic racism within health organizations only worsens the problem, stunts organizational growth, and delays progress, justice, and equity."
According to Figueroa, it's critical to support the growth of BIPOC dietetic students, interns, and new professionals through mentoring, financial support for scholarships, and training initiatives that increase access to and affordability of dietetics education.
"Equitable healthcare will provide a higher retention rate amongst minorities thus reducing health disparities in the long run," Carter and Westbrook say. "How do we increase diversity in the healthcare system? We challenge the discrimination, lack of promotion and job opportunities, and other obstacles minorities face in the healthcare workforce. As a result, we will begin to see increased engagement and more satisfying interactions between minorities and their healthcare providers.”
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