Racial and ethnic disparities in health care show up in many ways, say West Michigan health care leaders:
• High rates of tuberculosis and alcoholism among American Indian men
• A low rate of health insurance for Latinos, regardless of income level
• A lack of data breaking down health care outcomes for minorities
In an Alliance for Health forum today, they called for a commitment from health care providers and business leaders to address those disparities.
“The lack of overall thrust in terms of moving ahead may speak to each of us as community stakeholders about how serious we are about this issue,” said Dr. Khan Nedd, medical director of the African American Health Institute.
Often, he said initiatives to improve health care quality achieve the greatest improvement for the majority population. Improvement occurs among minorities, but to a lesser degree -- which only widens the gap.
An awareness of inequities in health care access and quality should be “part of our DNA and our culture,” he said. As an initiative is launched, he said, “You have to find ways to build in at its foundation this issue of making sure its outcomes don’t actually perpetuate the very disparities.”
Levi Rickert, the editor of Native News Network, said health care disparities are linked to education, housing and employment. Black, Hispanic and American Indian children have higher rates of asthma, reflecting poor housing conditions.
Historical factors also are at work, he said. Diabetes rates on reservations were low before the 1920s, when government shipments of flour and lard appeared on reservations. One result was the introduction of fry bread, a high-carbohydrate, high-fat treat.
“That was not a traditional food for American Indians,” he said. “It was developed as a result of what was given to them by the federal government.”
Now, in some tribes, 70 to 80 percent have diabetes, Rickert said.
Addressing health care disparities must go beyond bilingual brochures, said Pam Satterlee, the practice leader for the Sparta Health Center, which serves migrant workers. An understanding of the language and culture is also crucial.
Because the workers are transient, it is difficult for the clinic staff to find them when they need follow-up care. When a tour of Saint Mary’s Health Care was arranged for expectant mothers, Satterlee said she was surprised how many did not know how to get to the hospital.
Martha Gonzales-Cortes, the director of the Hispanic Center of Western Michigan, said Michigan’s outreach to migrant workers lags behind other states, such as Wisconsin and Texas. That ultimately could affect everyone if a communicable disease outbreak occurs among migrant workers.
She called for more discussions of “how we reach populations that are under the radar, how we address concerns of marginalized communities and how we ramp up investment in research.”
Nedd reminded the audience that the local hospitals are community owned and encouraged individuals to help drive change.
“If you believe you want institutions to work together to solve this issue, you have to get that kind of message out,” he said.
“At the end of the day, the dollars being spent on health care comes from you.”