GENERAL | May 16, 2022

How to Promote Health Equity with Patient Decision Aids

Reading Time: 3 minutes

Clinician and patient hold hands. Patient decision aids are a useful tool to promote healthcare equity
Reading Time: 3 minutes

Patients should never feel they have received suboptimal care or were treated differently because of their race, ethnicity, or socioeconomic status. However, healthcare disparities are an ongoing reality for minority and underserved communities throughout the United States.

Findings from a 2019 report from the American Cancer Society revealed that although the overall cancer death rate declined by 27 percent from 1991 to 2016, socioeconomic disparities in cancer mortality actually widened. The COVID-19 pandemic further illuminated the problem, with minority and low-income populations suffering disproportionate levels of infection and death.

While there is no single measure that will eliminate health disparities, the use of patient decision aids as part of the shared decision making-process can help diminish health inequalities in meaningful ways:

Building trust

For individuals in minority and low-income groups, a pervasive mistrust of the healthcare system exists because of a history of bias and unethical treatment. That mistrust has only grown due to issues with inequitable access to quality care.

Trust is paramount in provider-patient relationships. Sensing bias or being “talked down to” evokes a response of mistrust and feelings of being excluded from the medical decision-making process. This in turn can adversely affect access to individualized, quality care. Using patient-centric decision support tools can help marginalized patients feel like they are partners in the process and cultivate trust in their provider and the healthcare system.


Removing implicit bias

Implicit bias is defined as bias or prejudice resulting from “the tendency to process information or unconscious associations and feelings, even when these are contrary to one’s conscious or declared beliefs.”

Research shows that implicit bias may perpetuate healthcare disparities among vulnerable patients. Provider biases and assumptions can impact which information is shared and how options are presented. Additionally, patients may feel that the health information presented is not representative or applicable to them.

Providers can eliminate implicit bias by introducing patient decision aids that are inclusive and help structure the conversation around discovering that patient’s individual values, concerns, and goals for medical treatment.


Incorporating language and cultural differences

People from different cultural and religious backgrounds may have different values, beliefs about health and illness, and approaches to communication and decision making. It is crucial to recognize the cultural factors that may influence medical decision making.

Differences in language also impact access to healthcare and shared decision making. According to American Community Survey data, there are at least 380 languages spoken in the United States, making it one of the most linguistically diverse countries in the world.

Research shows that patients with limited English proficiency are at risk for suboptimal care and rehospitalizations. By utilizing patient decision aids that address cultural and linguistic diversity, providers can engage in shared decision making and promote health equity.


Boosting medical decision-making confidence

Of the approximately 87 million of Americans who struggle with low health literacy, racial and ethnic minorities are disproportionately affected. Low health literacy limits access to healthcare and inhibits the ability of patients to confidently communicate with their providers and engage in shared decision making.

Supplementing conversations with decision aids can improve patients’ confidence in the process if these educational resources facilitate comprehension. Decision support materials that use plain language and present information at accessible reading, numeracy, and health literacy levels can empower patients to engage confidently in shared decision making, ultimately decreasing health disparities.


Choosing patient decision aids that foster health equity

Patient decision aids should support shared decision making by providing detailed, balanced, evidence-based information about treatment options. Marginalized patient populations benefit from a patient-centered approach to shared decision making.

To foster health equity, healthcare providers and systems must understand the diversity of their patient populations and choose decision aids that best serve the diverse communication needs of their patients.


ACP Decisions is the leading provider of certified patient decision aids that support serious illness shared decision making. Our extensive video library is:

  • Evidence-based
  • Linguistically diverse, with over 400 videos across 20+ languages
  • Culturally and racially inclusive
  • Professionally developed to eliminate implicit bias
  • Designed at a broadly accessible health literacy level
  • Constantly growing to meet our healthcare partners’ needs

Reach out today to learn how your healthcare organization can utilize our video-based patient decision aids to reduce health disparities and drive health equity – empowering all patients to engage in medical decision making.

For more information on selecting and using patient decision aids, read these articles from the ACP Decisions blog:   


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