Sunday, September 25, 2011

Addressing Healthcare Disparities

Carolyn M. Clancy, MD, Director, AHRQ opened the Plenary Session “Addressing Health Care Disparities, Access, and Quality of Care” at the AHRQ Annual Meeting “Leading Through Innovation & Collaboration” held September 18-21, 2011 in Bethesda Maryland.

To begin the discussion, Gary R. Gunderson, D.Min, Senior Vice President for Faith & Health Division, and Director for the Center of Excellence in Faith & Health for the Methodist Le Bonheur Healthcare in Memphis Tennessee described how Memphis Tennessee is dealing with the issues.

As he reported, Memphis is the first large area north of the Delta where folks are born deep in disparities. The community has taken the first step and created a community network consisting of 376 congregations to effectively support members and their healthcare needs along with the needs in the overall community.

Susan Vega, Manager for Senior Programs at the Alvio Medical Center in Chicago explained that the non-profit Medical Center is a safety net provider for the many low-income and marginalized residents in nine targeted communities. The Center is meeting the needs of over 20,000 Spanish speaking predominantly Mexican immigrants who have fallen through the cracks of our healthcare system.”

According to Vega, Latino elders are the fastest growing segment of the population and this group of people tends to be older than the rest of the population and usually sicker. One reason is that they have done heavy work all their lives and this has resulted in not being as well as they age but in many cases, they still they tend to live longer.

As in other communities, there is a critical need for health and medical providers to be bilingual. However, this is not the case with all providers and as a result, language capabilities are uneven. As Vega summed up, “Alvio has to look not only at the individual but very often needs to work with the entire family. Sometimes the providers are dealing with three generations and since there can be language difficulties, it is not always possible to get the correct information without struggling to understanding what the patient and family are trying to say.

Herbert C. Smitherman, Jr. MD, Assistant Dean for Community and Urban Health, and Associate Professor in the Department of Medicine at Wayne State University School of Medicine, said “Social and economic policy drive disparities and eventually determines how long people will live.”

Dr. Smitherman is actively involved in working with the Detroit community and their health problems. He sees the need to connect the local population to healthcare workers, to advise the community on how they can reduce their visits to the emergency room, plus help the community with other medical issues.

Dr. Smitherman also concurs that it is very difficult to deal with language issues in a diverse community so healthcare professionals need to know several languages, but in many cases, doctors and other health workers aren’t trained in other languages so communicating is difficult. Part of the answer is to provide adequate quality medical interpretation services in the community.

Collecting the right information on populations faced with disparities in the community is very important according to Rhonda M. Johnson, MD, Medical Director for Health Equity & Quality Services at Highmark Inc., in Pittsburgh. She discussed how different states have different rules on collecting data since some states have laws or regulations that restrict a health plan from collecting data on race, and ethnicity, while other states encourage data collection—so it is a confusing issue. To add to the problem, some employers will not permit information to be submitted so the result is that only a small percent of enrollees are supplying data.