Bridging the Gap: Policy Recommendations for Advancing Muslim Patient Religious Accommodations in U.S. Healthcare
Andrew Doan, Ihsan Rizky and Aasim I. Padela, MD, MSc, FACEP, Medical College of Wisconsin, Maleeha Afreen, MS, Medical University of Lublin, and Salmah Abdulbaseer, MD, Rush University Medical Center
Background
American healthcare institutions are highly regarded for their ability to innovate with continuous advances in medical technology. However, health equity has lagged behind, with many racial, ethnic, and religious minorities being subject to healthcare disparities. For many Muslim Americans, faith remains important to daily life and can greatly modify their healthcare behaviors and decision-making. Being hospitalized often requires navigating daily or weekly prayer practices, dietary restrictions for food and medications, and modesty needs. Ensuring accommodations presents unique challenges that affect Muslim American patients, often eroding their trust and communication with healthcare providers, and ultimately compromising patient-centered care. The Muslim American Health and Spiritual Needs (MAHSN) study was launched by the Initiative on Islam and Medicine (IIM) to identify challenges faced by Muslim American patients and propose policy reforms that allow religious and spiritual inclusivity to be seen as an essential element of patient-centered care.
Methods
A x-item national survey was administered between 2019-2021 to Muslim Americans. The survey sought to assess the following: sociodemographic characteristics, religious identity and practice, hospitalization experience, availability and importance of Islamic accommodation, perceived quality and inclusivity of care. Participant recruitment focused on eight metropolitan areas with significant Muslim American populations, utilizing the help of regional recruitment teams and a cohort of national non-profit organizations to advertise. Data analysis was conducted using quantitative statistical interpretation and qualitative thematic analysis.
Results
The survey was completed by 1281 Muslim Americans who represented diverse ethnic backgrounds: South Asian (39%), Middle Eastern (37%), and African American (9%). 73% of respondents reported that having their religious needs met in the hospital was “very important.” While 92% felt comfortable identifying as Muslim in hospital settings, only 27% reported being asked about their religious identity. More than 60% of participants considered religion central to their lives and engaged in regular prayer or reading the Qur’an. 38% of participants reported that their needs were either not met well or at all during their last admission. 93% reported that access to halal food was important, yet only 17% had access to it during hospitalization, similar to experiences with other religious resources, such as neutral prayer spaces and medications free of porcine or alcohol-derived ingredients. Additionally, 82% of participants believed that access to Muslim chaplaincy services was valuable, but only 7.5% reported that such services were available to them.
Overall, 38% of participants reported that their needs were either not met well or not at all during their previous admission. Visible religiosity (β = 0.779, p < 0.05) and strong intrinsic religious commitment (β = 0.231, p < 0.05) were found to be significantly associated with higher reports of discrimination. Conversely, comfort identifying as Muslim in healthcare was associated with lower perceived discrimination (β = -0.395, p < 0.05).
Discussion
These findings highlight a substantial gap between the religious needs of Muslim patients and the availability of appropriate hospital-based accommodations, thus highlighting the need for policy changes in this area.
Policy Recommendations
The MAHSN study highlights a critical moral and institutional gap in accommodating the religious identities of Muslim patients. While most respondents desired spiritual accommodations, few found them available. Based on these findings, we propose a three-part framework for institutional reform:
1.) Practices
Recognizing religious identity and exercising the rights attributed to patients’ identities culminates in a critical factor of patient-centered care. This study reveals systemic disparities in hospital policies that fail to properly accommodate Muslim American patients. Through implementing the policy recommendations above, hospital systems can better address the needs of Muslim American patients and ensure the integration of their religious and spiritual values in healthcare, which will improve their experiences and emulate the true Prophetic spirit of care.
American healthcare institutions are highly regarded for their ability to innovate with continuous advances in medical technology. However, health equity has lagged behind, with many racial, ethnic, and religious minorities being subject to healthcare disparities. For many Muslim Americans, faith remains important to daily life and can greatly modify their healthcare behaviors and decision-making. Being hospitalized often requires navigating daily or weekly prayer practices, dietary restrictions for food and medications, and modesty needs. Ensuring accommodations presents unique challenges that affect Muslim American patients, often eroding their trust and communication with healthcare providers, and ultimately compromising patient-centered care. The Muslim American Health and Spiritual Needs (MAHSN) study was launched by the Initiative on Islam and Medicine (IIM) to identify challenges faced by Muslim American patients and propose policy reforms that allow religious and spiritual inclusivity to be seen as an essential element of patient-centered care.
Methods
A x-item national survey was administered between 2019-2021 to Muslim Americans. The survey sought to assess the following: sociodemographic characteristics, religious identity and practice, hospitalization experience, availability and importance of Islamic accommodation, perceived quality and inclusivity of care. Participant recruitment focused on eight metropolitan areas with significant Muslim American populations, utilizing the help of regional recruitment teams and a cohort of national non-profit organizations to advertise. Data analysis was conducted using quantitative statistical interpretation and qualitative thematic analysis.
Results
The survey was completed by 1281 Muslim Americans who represented diverse ethnic backgrounds: South Asian (39%), Middle Eastern (37%), and African American (9%). 73% of respondents reported that having their religious needs met in the hospital was “very important.” While 92% felt comfortable identifying as Muslim in hospital settings, only 27% reported being asked about their religious identity. More than 60% of participants considered religion central to their lives and engaged in regular prayer or reading the Qur’an. 38% of participants reported that their needs were either not met well or at all during their last admission. 93% reported that access to halal food was important, yet only 17% had access to it during hospitalization, similar to experiences with other religious resources, such as neutral prayer spaces and medications free of porcine or alcohol-derived ingredients. Additionally, 82% of participants believed that access to Muslim chaplaincy services was valuable, but only 7.5% reported that such services were available to them.
Overall, 38% of participants reported that their needs were either not met well or not at all during their previous admission. Visible religiosity (β = 0.779, p < 0.05) and strong intrinsic religious commitment (β = 0.231, p < 0.05) were found to be significantly associated with higher reports of discrimination. Conversely, comfort identifying as Muslim in healthcare was associated with lower perceived discrimination (β = -0.395, p < 0.05).
Discussion
These findings highlight a substantial gap between the religious needs of Muslim patients and the availability of appropriate hospital-based accommodations, thus highlighting the need for policy changes in this area.
Policy Recommendations
The MAHSN study highlights a critical moral and institutional gap in accommodating the religious identities of Muslim patients. While most respondents desired spiritual accommodations, few found them available. Based on these findings, we propose a three-part framework for institutional reform:
1.) Practices
- Halal Food Access: Integrate halal-certified meals into hospital nutrition services and ensure compliance through supplier partnerships and periodic audits.
- Neutral Prayer Spaces: Designate multi-faith prayer rooms accessible to patients and staff of all backgrounds.
- Availability of Faith-Based Resources: Arrange access to prayer rugs, Qur’ans, and other simple religious items to foster a respectful and inclusive clinical environment.
- Medication Transparency: Screen medications for porcine and alcohol-derived ingredients, label them appropriately, and seek out appropriate alternatives.
- Religiously Informed Training: Educate healthcare providers on how to navigate faith-based healthcare practices with cultural humility.
- Muslim Chaplaincy Expansion: Partner with national chaplaincy networks to recruit and credential Muslim chaplains, ensuring critical access to faith-specific spiritual support.
Recognizing religious identity and exercising the rights attributed to patients’ identities culminates in a critical factor of patient-centered care. This study reveals systemic disparities in hospital policies that fail to properly accommodate Muslim American patients. Through implementing the policy recommendations above, hospital systems can better address the needs of Muslim American patients and ensure the integration of their religious and spiritual values in healthcare, which will improve their experiences and emulate the true Prophetic spirit of care.