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• Institutional racism is experiences in places of higher education, where Black, Latin and Native American aspiring clinicians face discrimination that makes achieving advance education harder • All people, regardless of differences or similarities, should be served with excellence and dignity, respecting the value and needs of each person. • Providence staff have similarities and differences within our organization, just like we have with our members — this is an asset. • Ensure that programs, policies and practices recognize and reflect the diversity of our membership. • Workforce diversity is an important factor to improving patient outcomes because having a provider who understands you and your experience increases patient experience. • Literature has shown that especially with Black patients, satisfaction and communication are improve with patient-provider race concordance • Cultural health beliefs affect the way members view health, illness and death. • Dignity should be given to members' beliefs, experiences and values as it relates to their health. • Some cultures consider discussion of impending death to be inappropriate and insensitive. • At end-of-life, some patients may rely heavily on medical care, some rely on faith and spirituality, and others rely on both. Health Disparities and Inequities of the LGBTQIA+ Community • LGBTQ+ youth are more than four times as likely to attempt suicide than their peers • Transgender and nonbinary youth were 2 to 2.5 times as likely to experience depressive symptoms, seriously consider suicide, and attempt suicide compared to their cisgender LGBTQIA peers • Transgender and nonbinary youth who reported gender identity acceptance from adults and peers had significantly lower odds of attempting suicide in the past year • Transgender people are also more likely to attempt suicide as a result of this and other stressors: 4.6% lifetime suicide attempt rate among general population, 42 – 46% among transgender and gender diverse population. • LGBTQIA+ patients face significant community and family discrimination, which contributes to these disparities. Discrimination of LGBTQIA+ patients: • 22% of transgender patients avoided or postponed seeking needed medical care because of disrespect or discrimination from health care staff • 41% of LGBTQ people who lived in a non-metro area said it would be "very difficult" or "not possible" to find the same type of service at a different hospital • 29% of transgender patients surveyed said a doctor or other health care provider refused to see them because of their actual or perceived gender identity Provider Education Training Manual 37 |

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