Category Archives: Racial disparities
Keon L. Gilbert, DrPH, MA, MPA, is an assistant professor in the Department of Behavioral Science & Health Education at St. Louis University's College for Public Health and Social Justice. As a Robert Wood Johnson Foundation New Connections grantee, his research focuses on the social and economic conditions structuring disparities in the health of African American males. His work seeks to identify sources of individual, cultural, and organizational social capital to promote health behaviors, and health care access and utilization, to advance and improve the health and well-being of African American males. This is part of a series of posts looking at diversity in the health care workforce.
I became a public health professional because I recognized a need to find opportunities and strategies to prevent the chronic diseases I saw silently killing African Americans in the community where I grew up. I vividly recall as a child the whispers surrounding the deaths of community members about cancer, diabetes (or sugar-diabetes, as it is commonly referred to in many communities still today), heart attacks, and strokes. I knew there was stigma and fear, but never heard of programs, interventions, or opportunities to stop these trends.
My interest in addressing these problems led me to pursue summer programs and internships during high school that allowed me to witness amputations of uncontrolled diabetic patients who had a range of clinical and social co-morbid conditions. Many of these amputees were living in poverty, they had Medicare or Medicaid, and the majority happened to be African American. This experience raised the question about prevention: How could I prevent African American men and women from having amputations? I never heard this conversation around prevention in my community. Many people seemed to accept the reality of developing these chronic conditions as a fate that could not be controlled.
I knew there had to be another way.
Time to Understand and Eliminate the Destructive Racial Disparities that Plague Our Health Care System
Gaurdia Elane Banister, RN, PhD, is executive director of the Institute for Patient Care at the Massachusetts General Hospital in Boston, and an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program. This post is part of the "Health Care in 2013" series.
Historically, it seems that we are a country that takes a step forward only to take two steps back. Consider that May will mark 59 years since our schools were desegregated, yet it required the efforts of the National Guard to allow the “Little Rock Nine” entry into Central High School three years after this declaration. In July we will mark 49 years since President Johnson signed the Civil Rights Act of 1964, one-month after which the bodies of three civil rights workers were found in shallow grave. And, of course, the 20th of this month will mark four years since we inaugurated our first African-American President of the United States, though our health care system is still woefully deficient in providing care to minority groups.
The Affordable Care Act, in many ways, addresses the grave disparities that exist in health care due to race and ethnicity. Extending coverage to the nearly 46 million uninsured Americans—more than half of whom are minorities—will address a serious need, but this act alone will not begin to resolve the larger issue at hand.
A member of the Navajo Nation, Lisa Palucci, MSN, RN, is a nurse consultant at the Centers for Medicare and Medicaid Services and a fellow with the Robert Wood Johnson Foundation Nursing and Health Policy Collaborative at the University of New Mexico. This post is part of the "Health Care in 2013" series.
As the nation trudges forward in its quest to improve health care access for all Americans, I think it is essential that we continue to make progress in decreasing the health disparities and social determinant of health gaps that continue to be ignored in mainstream health policy initiatives. Throughout the course of my PhD program at the University of New Mexico (UNM), we have had numerous opportunities to experience nursing and health policy in action by attending national conferences, meetings, and orientation programs. To my disappointment, discussion about improving health disparities and social determinants of health are seldom a topic on the agenda. This poses the question: Aren’t the health disparities and social determinants of health what got us to the point of an inequitable health care system in the first place?
Jason Corburn, PhD, MCP, is associate professor at the School Public Health & Department of City & Regional Planning, University of California, Berkeley. He is a recipient of a Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research and an RWJF Health & Society Scholar. This post is part of the "Health Care in 2013" series.
The U.S. health care system must stop treating people only to send them back into the living, working and playing conditions that are making them sick in the first place. Glaring health inequities continue to persist in our metropolitan areas – differences in life expectancy, disease and disability by racial and ethnic groups and neighborhood location. Our zip codes are often a greater predictor of our likelihood of disease, disability and early death than our genetic code. We need to shift our health care system from a focus largely on cures to preventing illness and death by improving our living, working and playing environments.
2013 must be the year we all view community development and city planning as ‘preventative medicine.’
My New Year's resolution for the U.S. health care system and population health is that there is more sustained attention to the fragile economic state of many of America’s families and households, especially as we continue to climb out of this most recent Great Recession. I say this in light of the strong empirical evidence that economic inequality continues to be inextricable linked to health disparities within our country. I also believe it is especially important at this moment in U.S. history, given the increasing calls to balance the federal budget by defunding social safety net programs— in particular those that provide social insurance to America’s most economically vulnerable populations.
A significant portion of the U.S. population is still either unemployed or underemployed. Many Americans remain deeply concerned about health care costs or the threat of financial instability due to health-related problems. The passage and implementation of the Affordable Care Act was a positive step to ensure proper health care coverage for those previously shut out of private health insurance markets, such as young adults and individuals with pre-existing health conditions. It would be naïve, however, to think that just one policy will provide the economic security U.S. households need to be productive workers and active consumers.
Comilla Sasson, MD, MS, FACEP is an attending physician at the University of Colorado Hospital and Assistant Professor in the Department of Emergency Medicine at the University of Colorado. Sasson was a Robert Wood Johnson Foundation (RWJF) Clinical Scholar at the University of Michigan from 2007 to 2010. Her latest study is published in the October 25th, 2012 issue of the New England Journal of Medicine.
Dead. How do you make someone “undead?” How, with just your two hands, can you prolong the time that paramedics have to restart a person’s heart? How can a normal, ordinary person make a difference and literally save a life?
We know that a person’s chances of surviving an out-of-hospital sudden heart arrest decreases by 10 percent for every one minute he/she does not get CPR (cardiopulmonary resuscitation). I had learned about hands-only CPR in my medical training. Hands-only CPR is where all you have to do is push hard and fast (to the tune of “Staying Alive”) at a 100 times a minute until helps arrives.
But time and time again, I cared for African-American patients in Atlanta who had laid in their families’ homes for critical minutes as their brains slowly died from a lack of blood supply from the heart. Their hearts had stopped and no one called 911. No one placed their hands on the chest and started doing hands-only CPR.
Maybe this is just Atlanta? Is it the color of a person’s skin or is the place where he or she collapses that makes the difference?
In my Robert Wood Johnson Foundation Clinical Scholars Program (RWJCSP) at the University of Michigan (2007-2010), I learned about the importance of neighborhoods in determining a person’s health. After wading through the literature, my a priori hypothesis was that having someone stop to provide CPR is completely dependent upon others; therefore, the neighborhood plays a large role in whether or not someone does CPR.
After consulting with my two RWJCSP alumni mentors, David Magid, MD, MPH, and Arthur Kellermann, MD, MPH, FACEP, the question became clear: What role does the racial and socioeconomic composition of a neighborhood have on an individual’s likelihood of receiving life-saving bystander CPR?
I Hope This Ruling Will Stimulate a Stronger Sense of Urgency to Reduce and Ultimately Eliminate Health Disparities
This post is part of a series in which Robert Wood Johnson Foundation (RWJF) leaders, scholars, grantees and alumni offer perspectives on the U.S. Supreme Court rulings on the Affordable Care Act. Janice Phillips, PhD, RN, FAAN, is associate professor, adult health and gerontological nursing at Rush University College of Nursing and an RWJF Health Policy Fellow (2010 – 2011).
I am deeply encouraged by the recent Supreme Court Health ruling on health reform. I consider this a major step toward ensuring that the countless numbers of patients, underserved communities and even personal friends who I have worked with will now have a better chance of getting the health care they deserve.
Far too many of them have suffered from chronic health conditions and related complications, in part due to a lack of preventive services and a lack of timely access to the health care they need.
My in-depth exposure to health reform occurred during my tenure as an RWJF Health Policy Fellow working in the office of Senator John D Rockefeller IV (W.Va.). It was there that I was introduced to the complexities and the comprehensive nature of the Affordable Care Act.
That experience left me to wonder how best to educate underserved communities and those who are most in need. My desire in moving forward is that communities that stand to benefit the most are educated and empowered to take full advantage of the extended coverage and protections in the Affordable Care Act.
Last week was the International Conference on Health in the African Diaspora (ICHAD), which convened experts from a variety of fields to discuss the health and social experience of African descendants in the Western hemisphere. Below, two scholars from the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College who attended the conference talk about the experience. Courtney Sinclair Thomas, BS, is a 2011 health policy fellow and doctoral student in the Department of Sociology at Vanderbilt University, and Erika Leslie, MSPH, is a 2012 health policy fellow and doctoral candidate at Vanderbilt University.
Human Capital Blog: Why did you decide to attend the International Conference on Health in the African Diaspora?
Courtney Sinclair Thomas: I decided to attend ICHAD because thus far, my research has been focused on the health of African Americans in the United States. However, I realize that the shared history of the Transatlantic slave trade unites members of the Diaspora in unique ways. I wanted to learn more about the experiences of Blacks from throughout the Diaspora so that I could gain insight into the phenomenon of "race," which has such a significant impact on our health and life chances.
HCB: Please explain the ways that being a descendant of slavery can affect individual, family and population health today.
Sinclair Thomas: Being a descendent of slavery has major impacts on health today. I am interested in social determinants of health, and the experience of slavery has left an entire race at greater risk for many health conditions. This is particularly due to increased chronic stresses, discrimination, and lower social status and access to opportunities.
Last week was the International Conference on Health in the African Diaspora (ICHAD), which convened experts from a variety of fields to discuss the health and social experience of African descendants in the Western hemisphere. Below, two scholars from the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College who attended the conference talk about the experience. Helena Dagadu, MPH, is a 2011 health policy fellow and doctoral student in the Department of Sociology at Vanderbilt University, and Tulani Washington-Plaskett, MS, is a Fall 2011 health policy scholar and second-year medical student at Meharry Medical College.
Human Capital Blog: Why did you decide to attend the International Conference on Health in the African Diaspora?
Helena Dagadu: When I met Dr. LaVeist almost two years ago, he shared his idea about ICHAD with me. As he described his vision for the conference, I knew I had to be a part of it. My research and policy interests fit directly with the spirit of ICHAD to both understand and address health disparities among people of African descent. I also attended because this was an opportunity to meet people from different disciplines and gain some insights from their respective perspectives.
An international group of scholars, policy-makers, health workers, health advocates, and journalists are convened in Baltimore, Maryland this week for the International Conference on Health in the African Diaspora (ICHAD), to discuss the health and social experience of African descendants in the Western hemisphere. The theme of ICHAD 2012 is “The Great Scattering: Solving the Puzzle of Slavery, Race, and Contemporary Health in the African Diaspora.”
This afternoon at 3:15 pm EST, @RWJF_HumanCap will be live-tweeting a presentation at ICHAD by Eleanor Fleming, PhD, DDS, of the Centers for Disease Control and Prevention, on “USA Social Determinants of Health and Health Differences between Native and Foreign-born Blacks in the United States.” Fleming is a former scholar at the Robert Wood Johnson Foundation (RWJF) Center for Health Policy at Meharry Medical College.
Click the “read more” link below to see videos from ICHAD co-sponsor Daniel L. Howard, PhD, executive director of the RWJF Center for Health Policy at Meharry Medical College, and ICHAD conference chair Thomas LaVeist, PhD, director of the Center for Health Disparities Solutions at the Johns Hopkins Bloomberg School of Public Health.