Big challenges create big opportunities, and 2020 has offered both in spades. Perhaps only true innovators would see opportunity in the struggle for racial justice and wrangling a pandemic. Telehealth stepped in to meet the demand for remote care options as providers figured out the new normal. At the same time, the virus laid bare racial health disparities and flagrant inequality in the healthcare system.

Combining the two is the goal of a handful of digital health start-ups. Using technology, these start-ups connect patients with culturally competent providers, often from the same background. As healthcare and the nation grapple with an overdue conversation on equality, there are digital innovators are already working to bridge the gap.

There are still many who question that there is a gap to be filled. This highlights the importance of understanding what ‘culturally competent care’ is, and why the diversity of the healthcare workforce is so important.

What does ‘culturally competent care’ mean?

Culturally competent care is healthcare optimized for a wide range of cultural and ethnic backgrounds. It is care that takes into account cultural beliefs, taboos, traditions, language and history.

But it is more than being aware of culture, race, and ethnicity. It also means ensuring equitable outcomes, not allowing minority patients to fall through the cracks, and ensuring optimal treatment, and COVID-19 highlighted racial and ethnic health disparities.

One analysis found that the COVID-19 related death rate among African Americans was twice that of White people. Age-adjusted hospitalizations were roughly five times higher for Black, Hispanic, and American Indian/Native Alaskan people than for White people. This follows a well-documented trend of racial health disparities. For example, African American women with breast cancer 67% more likely to die than white women. In addition, African American infant mortality rate is 2.5 times greater than that of white infants.

Why is it important for healthcare to be culturally competent?

According to the U.S. Census Bureau, people identifying as White, not Hispanic or Latino currently make up 60% of the population. 

Four out of ten Americans classify themselves as Black or African American, Hispanic or Latino, American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander, or two or more races. By mid-century, that number is expected to rise to five in ten Americans.

To provide the best possible care, the U.S. needs adequate diversity among healthcare providers. Diversity of providers helps both patients and practitioners as they are being trained and work with diverse populations. There is increasing evidence that racial and ethnic concordance between patient and provider leads to better outcomes. For example, African American men seeing African American doctors were shown to be more likely to receive preventive services than those who did not see an African-American doctor.

Where is the healthcare industry in terms of diversity right now?

In two words: woefully understaffed.

While African Americans make up 13% of the US population, only 4% of physicians, 9% of nurses, 3% of dentists, and 5% of pharmacists are African American. People who identify as Hispanic or Latino make up 18% of the US population, but only 5% of doctors, 3% of nurses, 4% of dentists, and 3% of pharmacists.

Four new start-ups embracing the opportunity offered by digital health:

Digital health has become an accepted part of care due to COVID-19. It also removes the expectation that patients be in the same room as their provider. Digital health options increase access for people living in rural areas where reaching healthcare providers is a challenge. Internet access is still a barrier for some. However, digital health still opens opportunities to bring culturally competent care to the patient’s fingertips.

Founded by women of color, the following four startups leverage digital technology to create more access to culturally competent care.

Candlelit

Candlelit connects women at risk for perinatal mood and anxiety disorders with culturally-competent licensed therapists. It was founded by journalist Lauren Elliott after she experienced depressive symptoms following the birth of her son. 

Candlelit’s mission is to destigmatize and demystify mental healthcare for Black and multicultural families. The organization offers free mental health screening, affordable same and next-day consults, a virtual community, and a personalized care plan. Services are available for women with or without insurance.

Culture Care

Dr. Monique Smith, MD, MSc, DLSHTM, and Dr. Joy Cooper, MD, MSc, DLHTM, founded California-based Culture Care. The company’s goal is to connect patients of color with physicians of color. Women of color die from preventable diseases like cervical cancer at a significantly higher rate than White women. Increasing cultural connection between women and their providers could save many lives.

Health In Her Hue

Founded by Ashlee Wisdom, MPH, Health in Her Hue is a digital platform connecting Black women to culturally competent healthcare providers. The platform tackles topics ranging from self-care as a Black, female professional, to the best skincare for dark skin. It also provides health information and content supporting the lived experiences of Black women.

Poppy Seed Health

Simone Taitt founded Poppy Seed Health with a goal of helping women of color navigate pregnancy and the postpartum period. Black and Native American women are two to three times more likely to die from pregnancy-related causes. The latest tragic example is the death of 26 year-old Sha-Asia Washington at a hospital in Brooklyn, New York.

Poppy Seed Health offers pregnant women on-demand text support from doulas, midwives, and nurses. They also offer educational webinars for new and expecting mothers.

Technology is a start…

Digital health technology is certainly a start to addressing the need for culturally competent care. COVID-19 made telehealth a permanent part of the healthcare experience. It eliminated the need for patients and providers to be in the same location. Even though technology opens a door to more diverse healthcare providers, there is still a need to attract and retain more diversity in the healthcare workforce. 

Hopefully startups like these will make healthcare more welcoming for people of color, which may inspire future nurses and doctors.