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American Medical Student Association. Take the Challenge! Student Action for Zero Health Disparities. Disparities: Infant Mortality Rates (Mothers > 20 Years of Age). Source: DHHS. Health, United States, 1998. Disparities:Cardiovascular Disease and Cancer.
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American Medical Student Association Take the Challenge! Student Action for Zero Health Disparities
Disparities: Infant Mortality Rates(Mothers > 20 Years of Age) Source: DHHS. Health, United States, 1998
Disparities:Cardiovascular Disease and Cancer • African Americans continue to have the highest mortality rates from heart disease-50% greater than whites • The death rate for cancer for African American men is approx. 50% higher than for white men Source: Kaiser Family Foundation: Key Facts on Race, Ethnicity and Medical Care,1999 Source: Health Care Rx: Access For All- The President’s Initiative on Race
Disparities: Asthma • Asthma is 26 percent more prevalent in African American children than in white children • AA children 3X more likely than whites to be hospitalized for asthma • Among 5 to 24 year olds, African Americans are 4 to 6 times more likely to die from asthma than whites Preventable? Source: CDC, American Lung Association Source: Kaiser Family Foundation: Key Facts on Race, Ethnicity and Medical Care, 1999
Biases in Medicine: Differences in Heart Surgery Rates by Race, Disease Severity, and Survival Benefit Source:Kaiser Family Foundation: Key Facts on Race, Ethnicity and Medical Care, 1999
Biases in Medicine • Recent study in NEJM (February,1999) reports landmark finding that race and sex of patients affect physician decisions about whether to refer patients with chest pain for cardiac catheterization (when controlling for clinical presentation) • 1994 GLMA survey showed 67%medical students and physicians report substandard or denial of care to gay/lesbian patients
Patient Perceptions: For the Average African American and Latino, How Big a Problem is…? ^Difficulty Getting Care Because of Race/Ethnicity *Having Enough Doctors and Providers Near Home Source: Kaiser Family Foundation Survey of Race, Ethnicity and Medical Care: Public Perceptions and Experiences, 10/99
Patient Perceptions:Experience With Being Treated Unfairly When Seeking Medical Care Because of Race/Ethnicity Source: Kaiser Family Foundation Survey of Race, Ethnicity and Medical Care: Public Perceptions and Experiences, 10/99
Physician Maldistribution Limits Access • Poor urban racial and ethnic communities are more likely to have a physician shortage • Poor urban communities with high proportions of Hispanic(H) and African Americans(AA) have only 24 physicians /100,000 people compared to 69 physicians /100,000 in similar communities with a low proportion of H and AA
US Population Forecast Source: US Bureau of the Census
Under-represented Minority Applicants and Enrollees Source: AAMC Data Warehouse, 1999
MCAT: Is this the best way to select our nation’s physicians? Source: AAMC Annual Meeting, 1998
Summarizing the Problem • Persistent racial disparities in leading health areas • Evidence of physician bias • Limited access to health services
The American Medical Student Association What can we do? • Educate • Diversify the physician workforce • Promote a supportive environment
Peer Education Brown bag lunch discussions Diversity shuffle Orientation activities Cultural Competency Curricula Teaching physicians to deliver effective medical care to people of all different backgrounds Enforce LCME standard Assess your school Partner with the Dean to improve or create curricula Student Education
Legislative Approach • Lobby in support of cultural competency curricula: H.R. 3250 –provides grants to medical schools for cultural competency curriculum development • MAC/WIM lobby day on September 22, 2000 • Letter writing campaigns • Call!
2001 AMSA National Convention Take the Challenge! Student Action For Zero Health Disparities March 28- April 1, 2001 Anaheim, California
Diversify Workforce • Recruitment Program- encouraging under-represented minority youth to pursue careers in medicine • Talk to the Dean of Admissions • Students on committee • Admissions policies
Supportive Environment There must be a supportive and healthy environment for all students: • AMSA Medical Student Bill of Rights • Peer counseling/tutoring • Adequate student affairs resources • Minority faculty as guest speakers
Coalition Building • Work With Other Interested Groups • Co-Sponsor Events with Local SNMA, Chicano Medical Student Chapter, etc. • Talk to the Minority Affairs Office at your school and help with initiatives already in place • Work with Deans/Admissions Office
Summary As our nation continues to become more diverse, it is imperative that we, as future doctors, take the challenge to eliminate disparities in health and medical education.
American Medical Student Association Take the Challenge! Student Action for Zero Health Disparities