Finding Culturally Competent Care for Thyroid Eye Disease

Thyroid eye disease (TED) is an autoimmune disorder that causes inflammation and damage to the muscles and fatty tissues that surround the eyes. This can cause the eyes to bulge forward, so the eyes appear to be constantly staring. It can also cause inflammation and discomfort in the eyelids. In some cases, it can cause a misalignment of the eyes, resulting in double vision or other vision problems.

TED most commonly occurs among people who have Graves’ disease, an autoimmune disorder where the immune system attacks and damages the thyroid gland. Though exact numbers are not known, it’s estimated that TED affects up to 50 percent of people with Graves’ disease in some populations.

TED, Grave’s disease, and ethnicity

The prevalence of TED varies between different populations, including people of different races and ethnicities. In the United States, the risk of TED is highest among Black Americans. Among white Americans, the prevalence is only slightly lower. While the prevalence is lowest among Asian and Hispanic Americans, TED affects many people within these populations. Studies have also found that the symptoms of TED can vary among these populations.

With Graves’ disease, research has found disparities in care among different populations—people with certain ethnic backgrounds are more likely to receive certain treatments. For example, Black Americans with Graves’ disease are more likely to be treated with surgery. Disparities in care are also well-documented in the treatment of eye conditions.

Finding culturally competent care

A person’s race, ethnicity, language, and cultural background can impact healthcare needs. Working with a healthcare provider who has the ability to recognize this impact can lead to better outcomes. For example, working with a healthcare provider who understands and respects your cultural background and values—and how your background and values may affect your decisions about healthcare. This is referred to as cultural competence.

Cultural competence is something to consider when seeking treatment for thyroid eye disease and/or Graves’ disease. These questions can help when choosing a healthcare provider to work with:

• Do you feel respected by the healthcare provider and staff?
• Do you feel your concerns are taken seriously?
• When you ask a question, are you satisfied with the answer and explanation?
• Do you feel your healthcare provider understands your answers and explanations when they ask you a question?
• Are you able to be fully honest with your healthcare provider? Are there topics that you avoid or find difficult to discuss?
• What language do you feel most comfortable communicating in during healthcare appointments?
• How does this healthcare provider compare to other providers you have worked with in the past?
• Do you feel you are benefiting from the care you are receiving?

Culturally competent care is also important to other areas of healthcare, such as primary care, dermatology, dental care, and working with specialists who treat coexisting health conditions. Grave’s disease is the underlying condition that leads to TED, and it is a lifelong condition that requires lifelong treatment. While health conditions like Graves’ disease and TED can feel all-encompassing at times, it is important to remember the other aspects of healthcare, and the healthcare providers that you will work with.