Implicit Bias in MN Healthcare – LGBTQ and BIPOC

It is undeniable that the American medical system has long been influenced by racism and homophobia. African Americans and Indigenous people have spent generations suffering harm at the hands of medical professionals, from experimental surgery to forced sterilization. The LGBTQ+ community has struggled with medical care in different ways- mainly for recognition, either of our identities or of the illnesses that disproportionately affect our community. Though healthcare today has improved, this legacy of prejudice is not one soon forgotten. 

According to data from the Center for American Progress in 2018, 8% of LGBT respondents delayed or refused to seek medical attention for fear of discrimination. The National Center for Transgender Equality found that in 2016, 23% of transgender respondents said they too did not seek out care due to concerns that they would be subject to mistreatment based on their gender identity.  A 2020 survey, also by the Center of American Progress, highlighted the many levels of discrimination felt daily by Black LGBTQ+ people. In healthcare alone, 15% of respondents reported negative or discriminatory behavior from a doctor or health care provider, 14% reported the need to teach their own doctor about their sexual orientation in order to receive appropriate care, and 7% reported that doctors had refused to see them based on their sexual orientation. 

Fortunately, there are people and institutions who are working toward a more inclusive future. Allina Health- a non-profit organization with 12 hospitals and over 90 clinics across Minnesota and Wisconsin – is working to foster trust among these communities, as well as addressing some of ways in which they have been underserved. I spoke with Allina Health’s Director of Health Equity and Community, Vivian Aungwom to discuss their plan to address these concerns. 

“I would say that Covid and sort of the racial reckoning that really happened…and just the greater awareness of disparities and intersectionality has really accelerated our approach.” Director Aungwom has been working for Allina Health for nearly a decade and has been a big part of the effort to first identify, and then to tackle health care disparities in the BIPOC and LGBTQ+ communities. 

“So, when we look at healthcare disparities,” Aungwom explains, “Access to care, experience with care and the eventual outcomes, we have a lot of data. For many years we’ve collected Race, Ethnicity and Language data. So, we’ve collected the data, right? And I would say in the last maybe three, four years really started to get comfortable, or start to step into like, what do we do with this data? How do we look for the disparities? What are we going to do about it? That is a shift, and it’s uncomfortable, but part of my role is to really move us beyond just admiring the problem.” 

Once the data shows the problem, Aungwom and her team work with the appropriate parties to address it- whether it be a matter of education, resources, or even a language barrier. But the work isn’t just about engaging with the community- it’s also about doing the work to change from the inside. 

“We have collaborated with many community organizations to do some internal education, do some consulting, on how we can create a more inclusive environment. Not only just physically but also just how we make people feel… My approach to this work really centers on making sure that the work we’re doing is useful and impactful, and the only way we can do that is to co-create.”

  This also includes input from all levels.  For example, last year several Allina Health hospitals flew Pride flags- an idea that was initially put forth by an employee. 

            “That was huge. That was such a bold step in the sense that it is not only an internal sign of inclusion and welcoming, but also to our broader community. We know that words and things like this…you have to be consistent. We even heard from our employees…that was an example of, an employee brought up the idea and we delivered. And I think that’s part of how you begin to build trust, but also maintain trust and have people feel heard.” 

Where plenty of companies and institutions see the flying of a Pride flag as the beginning and end of their contribution to the LGBTQ+ community, Aungwom sees the gesture as a promise for the future. 

“We have a lot of work to do, but…I would say from the very top of our organization, we’re really dedicated to this work. And dedicated to having the hard conversations internally and continue to call each other out. Where we need to push ourselves more, sit with the discomfort. But, also ultimately making sure that we’re standing by our main goal of just making sure that we are caring for everyone well.”