Co-written with James E.K. Hildreth, PhD, MD, president and chief executive officer of Meharry Medical College, and originally published in The Tennessean, February 2022
Black History Month is a celebratory occasion. It also provides an opportunity to look at how history has brought us to where we are, and how much we have left to do
As we reflect on this year’s national Black History Month theme of Black Health and Wellness, we must face a harsh reality.
Culturally competent care — the gaining of knowledge about diverse groups and creating specific standards and practices that result in better health outcomes for them — remains elusive for Black Americans. Tennessee is no exception.
A challenging landscape
Black Americans are at increased risk for a variety of health conditions due to societal factors like affordable housing, income, nutrition options and education. These factors contribute to conditions such as high blood pressure, heart disease and Type 2 diabetes. Black Americans are also more likely to have colorectal cancer.The list goes on and on.
In many communities, some of these conditions can be linked to obesity prevalent from childhood. An estimated 24% of Black communities are food insecure, many lacking fresh produce and protein. For many families, fast food is simply more accessible and affordable.
Nutrition affects mental health as well. Despite a higher prevalence of anxiety, depression and stress, for many Black Americans, there’s a stigma associated with seeking behavioral health services. Additional challenges like access to transportation, childcare, location and employment put mental health further in the rear-view.
It’s crucial for providers to recognize and actively implement culturally competent standards of care to help address some of the challenges and burdens Black patients carry when they seek care.
The first step for providers is to establish a safe, respectful environment for these patients. There’s a longstanding, deeply rooted mistrust of the health care system among the Black community. For decades, this system failed them because of racial biases and inequities — and in many ways, the COVID-19 pandemic has reopened old wounds, as this group has been disproportionately affected.
Providers must place a renewed focus on building trust before they can improve health. That means demonstrating intent to answer questions or determining which questions a patient may be hesitant to ask. As medical doctors ourselves, we know it can be a tightrope, but we believe if you demonstrate grace and compassion, patients will take note. They’ll also spread word to loved ones.
Becoming partners in care
We’ve learned that outside forces like natural disasters and disease outbreaks exacerbate health challenges — creating a more uneven fight to manage health. That’s why in 2020, BlueCross created the Social Vulnerabilities Index (SVI) to identify and support individuals who are at greater risk for health issues, including those in predominantly Black communities. BlueCross and Meharry Medical College, the largest private historically Black academic health sciences center in the U.S., partnered to study data from claims and assessments and address these disparities.
BlueCross health navigators now contact plan holders and educate them about community resources and affordable care options. Meharry validated our findings as predictors of health outcomes, and with this large data set, has received additional grants to continue this important work. We’ve worked together as organizations to engage with communities and providers on these issues.
Providers must consider the unseen but oftentimes overwhelming factors many Black patients are wrestling with when they step into a doctor’s office.
Remember, just taking that step could have involved overcoming numerous obstacles along the way. But by confronting these issues, you can help lead the way toward better care for all.
You can hear more about health equity and Black health and wellness from Dr. Willis and Dr. Hildreth in this Twitter Spaces conversation with April Lomax, director of diversity and inclusion at BlueCross.