Dr. Renee Contributes to Massage Magazine’s Special Issue on Diversity, Equity, and Inclusion

5 Ways Massage Therapists and Integrative Practitioners Can Support Diverse Communities

Michele Renee, DC, MAc, for Massage Magazine 

The coronavirus (COVID-19) pandemic exposed systemic biases in health care that have existed for centuries and brought them to the forefront of our public health system. Racial and ethnic minority groups are disproportionately affected by COVID-19 and are at a higher risk of contracting and dying from the disease. But racial inequality in health care does not start or end with COVID-19; systemic biases in generational wealth accumulation, education, employment, housing and other social barriers have all created poorer health outcomes among communities of color.

Racial minority groups are less likely to utilize complementary and integrative health care (CIH), encompassing massage therapy, chiropractic, acupuncture and Chinese Medicine, compared with non-Hispanic whites. In the study, “Racial/Ethnic Differences in the Use of Complementary and Alternative Medicine in US Adults with Moderate Mental Distress,” published in the Journal of Primary Care Community Health (2017), the authors noted, “In the patterns of CAM use among US adults, existing literature shows that racial/ethnic differences exist in CAM use.For example, non-Hispanic whites used at least 1 CAM therapy the most, followed by Asians, African/black Americans, and Hispanics. Some patterns for specific racial/ethnic groups are also known. For instance, one study reported that Hispanics were more likely to use CAM when they could not afford or have limited access to conventional medicine.

Massage therapists and integrative practitioners are aiming to provide a full range of health care options for every person in every community, but a lot of work must be done. Organizations are actively working to address issues of equity, systematic racism and unconscious bias in the field.

For example, the Alliance for Massage Therapy Education recently launched its Equity, Diversity & Inclusion Task Force to help create better representation in massage therapy education and leadership. Similarly, our team at Northwestern Health Sciences University delved into the effects of biases in health care, particularly within massage therapy and the CIH community, and defined key ways to support diverse communities:

1. Build trust. A foundational step is building trust with diverse communities. The American health care system has a long history fraught with distrust and manipulation of minority patients. As practitioners, we must listen and fully understand our patients’ concerns and take them at face value. Before beginning the massage, be mindful of one’s own biases that may slip into the therapeutic relationship and work to see goals and beliefs through the client’s eyes.

2. Elevate professionals of color. Academic institutions, private practices and professional associations should reflect their community and work to create a diverse organization. We must focus on delivering care and elevate professionals of color. This may include participating in learning opportunities and partnering with other organizations with the shared goal of social justice. By doing so, organizations may explore reviewing their history of diversity, equity and inclusion and potential instances where they have implicit biases.

Although this may prove a difficult step, recognizing history and working to create a more equal and just future is crucial. This is not just an exercise in equality. By bringing more diversity to the table, we bring the unique assets and points of view to bear on seeing issues more fully and solving problems more creatively.

3. Increase diversity in the workforce. The massage therapy practitioner community lacks diversity; only 8% of massage therapists are Black professionals, compared with 64% of practitioners being white. To increase diversity in the workforce, we must actively recruit members from communities of color to get involved and pursue careers in the profession. This helps create a more inclusive environment. It has been reported that when a Black client has a practitioner they can relate to in this way, the client immediately feels more comfortable, which ultimately leads to better outcomes.

4. Create an inclusive educational environment. Lastly, and potentially the most important, is the educational aspect, which is twofold. Educational institutions must build a welcoming and supportive environment to encourage Black and other students of color to seek professions in the massage therapy field. Curricula on disease management should reflect the Black experience, including the impact in learning materials and case studies, and explaining how massage therapy can enhance the health care experience.

By creating a more inclusive education system, we can garner the interest of more diverse physicians and as a result support a more diverse community. One concrete example of creating a more diverse and equitable learning environment is to use texts that include many colors of skin for learning about the body and physiological effects of touch, such as skin flushing and blanching.

5. Provide broader education on the benefits of massage therapy. Such benefits include reducing stress, providing headache relief, reducing muscle tension and so much more, in order to help diverse communities feel comfortable seeking this approach to health care.

According to the Journal of the American Medical Association, 75.5% of Black men and 75.7% of Black women develop hypertension by the age of 55. Massage therapy provides many benefits to those with hypertension, as it is uniquely designed to reduce stress and thereby potentially impact cardiovascular health. As we broaden our education in and on the field, we can better support every community.

Massage therapists should provide a full menu of care to every client. It is our goal to support the health and well-being of everyone. When we focus and support each patient and put more effort into reaching diverse communities and elevating leaders, then we will be one step closer to helping every community member.