Healthcare Matters: Providing Health Services to Diverse Populations

1. Healthcare Matters: Providing Health Services to Diverse Populations Susan Barkan & Maria Carlos Public Health – Seattle & King County Melanie Whitfield People of Color Against AIDS Network Christine Achre Beacon Therapeutic Diagnostic and Treatment Center Susan Kline Public Health – Seattle & King County

2. One Size Does Not Fit All Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments Invisible Tribes: Urban Indians and Their Health in a Changing World Overweight? Blame Your Zip Code

3. Health Disparities Are “population-specific differences in the presence of disease, health outcomes, or access to health care.” Goldberg, J., Hayes, W., and Huntley, J. "Understanding Health Disparities." Health Policy Institute of Ohio (November 2004), page 3. From http://en.wikipedia.org/wiki/Health_disparities, retrieved 2/6/08.

4. Health Disparities • Affects a population group – ethnicity, race, gender, age, sexual orientation, geographic • Inequality or Inequity • Unjust or unfair • A chain of events signified by differences in: • Environment • Access to, utilization of, and quality of care • Health status • A health outcome that deserves scrutiny Carter-Pokras, OC & Baquet, C. What is a “health disparity”? Public health reports, 2002, 117:426-434.

5. Institute of Medicine Report Inequity in healthcare is the consequence of: • patient-provider interactions -stereotypes -clinical uncertainty -prejudice held by providers • the systems of care Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care. 2003. http://www.nap.edu/openbook.php?record_id=10260&page=R1

6. Health is More Than Healthcare* • “…social conditions are as important to our health as our genes, our behaviors, and even our medical care.” • “The single strongest predictor of our health is our position on the class ladder.” • “Racism imposes an added health burden.” • “Chronic stress can be deadly.” 10 Things to Know about Health. Unnatural Causes…is inequality making us sick? www.unnaturalcauses.org/default.html

7. Eliminating Health Disparities

8. Eliminating Health Disparities

9. Healthcare Matters: Providing Healthful Living ConditionsServices to Diverse Populations Susan Barkan & Maria Carlos Public Health – Seattle & King County Melanie Whitefield People of Color Against AIDS Network Christine Achre Beacon Therapeutic Diagnostic and Treatment Center Susan Kline Public Health – Seattle & King County

10. What can advocates do? Practice preparing for health visits with clients • Know what to expect during a visit American Academy of Family Physicians http://familydoctor.org/online/famdocen/home.html American Academy of Pediatrics http://www.aap.org/parents.html MedlinePlus www.medlineplus.gov • Make a list of questions • Practice key questions/statements – “Is this the usual care people get?” Or “I don’t have permanent housing right now so making any change would be hard.” Establish care with a sole provider team – a Health Home

11. What can advocates do? Organizational Strategies • Communication with patients • Services that are available when patients are • Provider Education • Research Societal Strategies

12. www.unnaturalcauses.org/default.html

13. To Learn More About Health Disparities • Minority Health Topics Institute of Medicine of the National Academies http://www.iom.edu/CMS/18007.aspx • Innovation in Medical Education Video Library http://videos.med.wisc.edu/event.php?eventid=2 • Families USA Minority Health Initiative http://www.familiesusa.org/issues/minority-health/

14. Resources for Healthcare Providers • National Health Care for the Homeless Clinicians’ Network www.nhchc.org • Association of Clinicians for the Underserved www.clinicians.org • Homeless Resource Center www.nrchmi.samhsa.gov