The Importance of Diversity and Inclusion in Healthcare Settings: Benefits for Healthcare Workers and Patients

Abstract

Health is a basic human right, as outlined in the World Health Organization constitution. The benefits of health are defined in its preamble as “not merely the absence of disease or infirmity, but the best attainable state of physical, mental, and social well-being”. Despite these principles, marginalized groups are less likely to reap the health benefits of these ideals and experience poorer mental and physical health outcomes compared to more privileged groups of the same societies. Health inequities are defined as “differences in health which are unnecessary and avoidable but are also considered unfair and unjust”. Those who have different cultural backgrounds and speak languages other than English are more likely to be disadvantaged and judged inappropriately by existing health and healthcare systems, a double disadvantage costing individuals to pay a hidden price for their cultural safety in terms of health outcomes. While various campaigns assist in raising awareness of these injustices, attention should also be given to those who are historically induced to experience worse health consequences because of socially determined physical conditions As recognized in the Ottawa Charter for Health Promotion, there is a causal cycle between disadvantages due to the social determinants of health and the poor health outcomes. Those who have poor health are limited in terms of education and work opportunities. This in turn leads to an ever-increasing gap in income and wealth levels, with the consumption of unhealthy food and the use of harmful substances and energy-density food and obesity, and reduces the physical capacity for paying the price of better health. Corresponding to the deleterious actions in all dimensions, individual and community productivity is reduced, which can lead to unskilled and low-income jobs and limited access to healthcare services. Unable to pay health insurance, some people do not access health services when needed, leading to premature death, disability, and loss of dignity. Such healthcare services may not be inclusive of diverse populations, including hard-to-reach groups with a temporary visa. The costs of non-inclusive practices in healthcare in the country are clear and can contribute to avoidable health inequities. Given the awareness of such adverse consequences, there has been a change in approach to the 1980s and 1990 to review the provision of healthcare, and rather focus on health promotion and prevention strategies more broadly. Healthcare practice becomes more active in the management plan and includes legislation, policy, and practice regardless of health. Sweden is a pioneer in this revolutionary shift, implementing “inclusive health and safety measures” based on the Ottawa Charter action areas including public policy, community coalitions, and services needed to make healthier choices easier for citizens. Since then, awareness of health inequities has generated inclusive and person-/patient-centered healthcare practices rooted in socio-ecological and life-course approaches tailored to individual identities, beliefs, and needs. However, despite several decades of implementation of such principles, inequities in health and healthcare are still a serious matter in most countries.