By: Kat Gruschow, Policy Fellow

When the trailer for Disney’s live-action remake of The Little Mermaid was released in September, heartwarming reaction videos showing Black children overjoyed to see Ariel played by a Black actress spread across the internet. The star, Halle Bailey, even tweeted a compilation of the videos and said their reactions “mean the world to me.” 

Representation in the media matters to how all people, especially children, see themselves and their place in the world. And, unlike the trend-focused cycles of social media, which fixate on isolated events like Bailey’s casting, establishing full representation in entertainment is a continuous effort against racist backlash and content with the status quo.

The story is similar in health care.

Representation also deeply matters. Health care providers who look like and have similar experiences to the communities they serve help alleviate health disparities. Black and brown providers practice in underserved communities more than their white counterparts and minority patients are more likely to select preventative care services and report higher levels of satisfaction and better quality of care when their provider is racially concordant. A representative health care workforce is an important step towards health equity and developing culturally responsive networks. 

Culturally responsive networks expand upon cultural competence. Rather than simply recognizing that diverse communities have different access barriers and needs, culturally responsive care strives to center diverse populations and their different access barriers and needs to bridge gaps in health care access and outcomes. 

In Colorado, the need for culturally responsive care is acute. Roughly one in fourteen (6.9%) of Coloradans report needing health care that is responsive to one of their identities. This may sound like a small portion, but it means that about 388,000 Coloradans are not receiving the care they need. Individuals whose unique needs are not met are more likely to experience mistreatment in the health system and avoid further care from providers for fear of unfair treatment.

And, like attaining true representation in entertainment, fostering culturally responsive networks and a representative workforce is a continuous process. The goal will not be fully achieved overnight. One bill cannot suddenly reverse the severe underrepresentation of people of color in the health care workforce, eliminate access barriers, and establish trust in the community. 

However, advocates and legislators took the first step with HB21-1232, the Colorado Option. Folded into the legislation expanding affordable coverage access to undocumented individuals are provisions targeting health equity.

This includes stipulations that insurance carriers establish culturally responsive provider networks representing consumers’ racial, ethnic, gender identity, and sexual orientation. HB21-1232 also requires the Division of Insurance to take action–starting with stakeholder meetings to understand the experiences of underserved communities and center that feedback in the first phase of creating culturally responsive networks in Colorado. 

Central to the goal of a workforce representative of served communities is understanding what the communities, and the existing workforce, look like. Carriers will be required to collect voluntary demographic data such as race, ethnicity, sexual orientation, gender, and accessibility status on network providers and plan members so that future efforts for representation better grasp what parity looks like. It will also ensure that provider directories are more accurate, allowing consumers to select providers who understand their unique needs, such as offering appointments at accessible times, wheelchair-accessible rooms, and robust language services if they do not speak another language themselves. 

Colorado Option plans also must increase in-network access to essential community providers (ECPs). ECPs are often in low-income or geographically isolated communities and predominantly serve communities experiencing greater health disparities. Lack of trust in the medical system, rooted in ongoing and historical harm, is a barrier to health equity. Coverage of providers trusted by disadvantaged communities decreases the cost of care while enabling patients to maintain relationships with providers that understand their unique needs and background. 

Other steps towards culturally responsive care stipulated by the Colorado Option include mandatory cultural competence training for customer service employees, providers, and office staff, and bolstered language access services for non-English speakers. 

Achieving full representation of diverse voices, experiences, and people in any sector of a society founded on white supremacy is crucial. A Black actress playing a Disney princess expands the realm of what Black children believe is possible for themselves. A Latina doctor already has institutional knowledge of her community’s needs and can use her cultural connections to build trust and create healthier communities.

Representation is also an arduous goal that a single casting choice or lone bill won’t ensure. 

Continued advocate feedback on questions and challenges establishing culturally responsive networks is necessary for us to realize the long-term vision of health equity. While celebrating the gains of  HB21-1232 and its first open enrollment period beginning next month, we invite you to join us in continuing to push for a more diverse and responsive workforce to advance health equity in our state and beyond.

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