We’ve been talking recently about Medical Anthropology’s role and impact on improving global healthcare systems. Today we will share three additional observed examples, looking through the lens of Diversity, Equity & Inclusion (DE&I). These studies emphasize the importance of integrating DE&I initiatives into the core of healthcare institutions to enhance health outcomes.

It is widely known that DE&I initiatives aim to improve healthcare efficiency, address health inequalities, and achieve health equity for all, regardless of social factors. With up to 80% of health outcomes attributed to social determinants, it is crucial to examine how healthcare systems perpetuate disparities.

Diversity: Culture as Accessibility

Diversity in healthcare involves recognizing cultural differences in symptom expression. Some of our studies involving depression and anxiety show misdiagnosis due to language barriers and short consultations, but a greater challenge is ensuring HCPs understand diverse cultural meanings of illness.

For example, some Asian cultures express depression as physical pain, very often as a stomachache. A doctor may miss diagnosing depression if they only interpret symptoms within their own cultural context and don’t understand somatization.

Somatization in Asian cultures

It's crucial to apply an introspective lens to both patients and HCPs, as culture shapes everyone.

Equity: Lack of Inclusion as Structural Violence

Limited healthcare access due to socioeconomic status, gender, or orientation delays diagnosis, treatment, and worsens disease impact.

A study showed that a woman's autoimmune condition was exacerbated by her life circumstances (physically demanding job, role as a single mother); another found that cancer patients in Spain resorted to extreme measures to receive timely care (changing their address to switch for a well-known public hospital).

Discrimination also affects healthcare access, especially for LGBTQ+ individuals, leading to lower screening rates and inadequate sexual education.

DE&I efforts can help alleviate structural barriers, reducing structural violence and improving health outcomes for disadvantaged populations.

The DE&I funnel

Inclusion: What Can We Do?

DE&I efforts should prioritize social justice and revolutionize healthcare for improved outcomes for all.

A Piece of Pie advocates for incorporating patients' narratives as qualitative evidence, enabling HCPs to provide holistic guidance by:

A) uncovering cultural expressions of symptoms,

B) understanding social variables' impact on quality of life,

C) referring disadvantaged patients to social services, and

D) diversifying the healthcare workforce.

Join us as partners for the cause of transforming healthcare into a human-centric reality.


[1] Braveman P, Gruskin S. Defining equity in health. J Epidemiol Community Health. 2003 Apr;57(4):254-8. doi: 10.1136/jech.57.4.254. PMID: 12646539; PMCID: PMC1732430.
[2] Braveman P, Gottlieb L. The social determinants of health: it's time to consider the causes of the causes. Public Health Rep. 2014 Jan-Feb;129 Suppl 2(Suppl 2):19-31. doi: 10.1177/00333549141291S206. PMID: 24385661; PMCID: PMC3863696.
[3] Kleinman, Arthur M. “Depression, Somatization and the ‘New Cross-Cultural Psychiatry.’” Social Science & Medicine (1967), vol. 11, no. 1, Jan. 1977, pp. 3–9. DOI.org (Crossref), https://doi.org/10.1016/0037-7856(77)90138-X.
[4] Matthews AK, et al. Disparities in Pap Test Use Among Sexual Minority Women: The Role of Provider Recommendations. J Womens Health (Larchmt). 2016;25(12):1269-1275. doi:10.1089/jwh.2015.5413
[5] Farmer PE, Nizeye B, Stulac S, Keshavjee S. Structural violence and clinical medicine. PLoS Med. 2006 Oct;3(10):e449. doi: 10.1371/journal.pmed.0030449. PMID: 17076568; PMCID: PMC1621099.