corner
hret disparities toolkit
a toolkit for collecting race, ethnicity, and primary language information from patients
(This page was designed to be printer-friendly)
< Return to last page   |  Toolkit Home
corner
spacer spacer spacer
 

Please note: Not all links are displayed in this printer-friendly layout. To view and print the links, you will need to click on them below or on the previous page.

How to Ask the Questions

We recommend that health care organizations/health plans provide a rationale for why they are asking patients/enrollees for information about their demographic and communications background. Suggested wording for the rationale is:

"We want to make sure that all our patients get the best care possible. We would like you to tell us your racial/ethnic background so that we can review the treatment that all patients receive and make sure that everyone gets the highest quality of care."

We have found that people feel comfortable responding to the question about race/ethnicity/sex/primary language/disability status, but they sometimes have their own questions, wish for additional clarity, or perhaps prefer to not answer the question at all.

The following link to a response matrix (PPT) provides real world examples of questions people have asked as well as suggested responses. This response matrix is not all inclusive. You may encounter different scenarios, and you may not hear any concerns from patients after asking these questions. The response matrix serves as a tool for you and your staff, and it is excellent for facilitating dialogue during training sessions.

Race/Ethnicity

    Using Broad (OMB) Categories

    "We want to make sure that all our patients get the best care possible. We would like you to tell us your racial/ethnic background so that we can review the treatment that all patients receive and make sure that everyone gets the highest quality of care."

    Ethnicity Question

    (OMB recommends asking ethnicity before race.)

    Do you consider yourself Hispanic/Latino?

    • Are you Hispanic, Latino, or Spanish origin
    • No, not of Hispanic, Latino, or Spanish origin
    • Yes, Mexican, Mexican American, Chicano†
    • Yes, Puerto Rican
    • Yes, Cuban
    • Yes, another Hispanic, Latino, or Spanish origin
    • Unavailable/Unknown
    • Declined
    • Unavailable

    Race Question
    Which category best describes your race? (One or more categories may be marked)

      • American Indian/Alaska Native
      • Asian
      • Black or African American
      • Native Hawaiian/Other Pacific Islander
      • White
      • Some other race 
      • Declined
      • Unavailable/Unknown

      Using Granular Categories

      ""We want to make sure that all our patients get the best care possible. We would like you to tell us your racial/ethnic background so that we can review the treatment that all patients receive and make sure that everyone gets the highest quality of care. I would like you to describe your race or ethnic background. You can use specific terms such as Korean, Haitian, Somali, etc"

      You can provide all or some of the granular categories based on the community you serve.

      Granular Code Set II (PPT)

      IOM Subcommittee Template of Granular Ethnicity Categories (Table E-1 in Appendix E of IOM Report)

      Sex

      What is your sex?

      • Male
      • Female
      • Declined
      • Unavailable

      Language

      1. How well do you speak English?

      • Very Well
      • Well
      • Not Well
      • Not at all
      • Declined
      • Unavailable

      2. Would you like an interpreter?

      • Yes
      • No
      • Do not know
      • Declined
      • Unavailable

      3. Do you speak a language other than English (5 years old or older)

      • Yes
      • No
      • Declined
      • Unavailable

      4. What is this language? (5 years old or older)

      • Spanish
      • Other language (identify)
      • Declined
      • Unavailable

      5. What language do you feel most comfortable speaking with your doctor or nurse?

      African languages
      American Sign
      Language
      Arabic
      Armenian
      Chinese
      English
      French
      French Creole
      German
      Greek
      Gujarathi
      Hebrew
      Hindi
      Hungarian
      Italian
      Japanese
      Korean
      Laotian
      Miao Hmong
      Cambodian
      Navajo
      Other Native North
      American languages
      Persian
      Polish
      Portuguese
      Portuguese Creole
      Russian
      Scandinavian
      languages
      Serbo-Croatian
      Spanish
      Tagalog
      Thai
      Urdu
      Vietnamese
      Yiddish
      Availability of Sign Language or other auxiliary aids or services
      Other, please specify: ___
      Do not know
      Unavailable
      Declined

      Language categories should be based on the community you serve.

        IOM Subcommittee Template of Spoken Language Categories and Coding (Table I-1 in Appendix I of IOM Report)

        6. In which language would you feel most comfortable reading medical or health care instructions?

        African languages 
        American Sign 
        Language
        Arabic 
        Armenian 
        Chinese
        English 
        French 
        French Creole 
        German 
        Greek 
        Gujarathi 
        Hebrew 
        Hindi

        Hungarian 
        Italian 
        Japanese 
        Korean 
        Laotian 
        Miao Hmong 
        Mon-Khmer Cambodian 
        Navajo 
        Other Native North 
        American languages
        Persian 
        Polish 
        Portuguese
        Portuguese Creole

        Russian 
        Scandinavian 
        languages
        Serbo-Croatian
        Spanish 
        Tagalog 
        Thai 
        Urdu 
        Vietnamese 
        Yiddish 
        Availability of Sign Language or other auxiliary aids or services
        Other, please specify: ___
        Do not know 
        Unavailable
        Declined

        7. How satisfied are you with your ability to read English?

        • Very satisfied
        • Somewhat satisfied
        • Satisfied
        • Somewhat dissatisfied
        • Very dissatisfied
        • Declined
        • Unavailable

        Disability Status
        Although some of these questions are not directly related to communication issues, they are required under the legislation of the ACA.  They also help address accommodation issues of a patient and will help you understand what specific disabilities may ultimately impact communication with the patient and how to best meet their health needs.

        1. Are you deaf or do you have serious difficulty hearing?

        • Yes
        • No
        • Declined
        • Unavailable

        2. Are you blind or do you have serious difficulty seeing, even when wearing glasses?

        • Yes
        • No
        • Declined
        • Unavailable

        3. Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions? (5 years old or older)

        • Yes
        • No
        • Declined
        • Unavailable

        4. Do you have serious difficulty walking or climbing stairs? (5 years old or older)

        • Yes
        • No
        • Declined
        • Unavailable

        5. Do you have difficulty dressing or bathing? (5 years old or older)

        • Yes
        • No
        • Declined
        • Unavailable

        4. Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor’s office or shopping?  ? (15 years old or older)

        • Yes
        • No
        • Declined
        • Unavailable

        Keep Posted!
        Sign up if you would like us to keep you informed regarding updates to the Disparities Toolkit and this web site. We will not share your information with anyone.

 
 
spacer spacer spacer
corner hret-Health Research & Educational Trust (in partnership with AHA)
< Return to last page  |  Toolkit Home
© Copyright HRET - All rights reserved.
corner
This Web site contains links to sites that are not owned or maintained by the Health Research and Educational Trust (HRET) or the American
Hospital Association (AHA). HRET and AHA are not responsible for the content of linked sites and the views expressed on non-HRET/AHA
linked sites do not necessarily reflect the views of the Health Research and Educational Trust or the American Hospital Association.