Religious Values & Healthcare Accommodations- Voices from the American Muslim Community

Background: Research has demonstrated that minority populations experience health care disparities in that they often receive a lower quality of care and face multiple barriers to care. In order to decrease disparities and increase access to care, it is important to understand the beliefs, priorities, and health care needs of communities. With an estimated seven million Muslims in the US, this ethnically and racially diverse growing population is bound together by a shared religious tradition that informs cultural values around health and healthcare. Accommodating patient values within the clinical encounter can pose cultural challenges and ethical conflicts for patients, providers, and the healthcare system. The manner in which these values are accommodated bears significance for future healthcare-seeking behaviors. To date, there has been scant empirical research performed in collaboration with American Muslim communities around such challenges. In this paper, we identify American Muslim priorities for accommodations in the healthcare system and the underlying rationale for these requests. Methods: Using a community-based participatory research design, we partnered with four community organizations in Southeast Michigan: two Islamic umbrella organizations that represent over 25 mosques, an American Muslim policy institute, and an Arab community health organization. Thirteen focus groups were conducted at area mosques sampled to include African American, Arab American and South Asian American Muslims. Qualitative content analysis utilized a framework team-based approach. Results: Participants identified three areas of priority for healthcare accommodations: (1) Gender-concordant care (2) Halal food and a (3) Distinct prayer space. Gender concordance was requested based on Islamic conceptions of modesty and privacy and expressed as strongly influencing healthcare seeking patterns. Halal food, i.e. food prepared in accordance with Islamic dietary regulations, was considered to be healthier and integral to the healing process, and an easily accommodated need due to pre-existing provisions for others. A religiously-neutral prayer space was considered important as prayer is a requirement of the Muslim faith, and participants faced multiple challenges stemming from a lack of such space in the hospital. Overall, participants identified the need for providers to be culturally competent, thus resulting in reduced stereotyping and discrimination against Muslims and improved healthcare experiences for both providers and Muslim patients. Conclusions: This study informs efforts to deliver high quality and equitable care to Muslim Americans in several ways. Understanding the values underlying these requests and the challenges stemming from lack of accommodations will inform efforts at improving cultural competence and providing culturally-sensitive healthcare.