Lack of Diversity in Health Care A Health Disparity

in the summer of 2013

i had the opportunity to be a part of an

internship program

that granted minority college students

exposure

to health professions that lack

diversity

this internship was a great experience

since i had the pleasure

of shadowing and learning from great

clinicians

that looked like me not only that

but we related to one another on a

different level

since we shared similar backgrounds and

similar upbringings

this opportunity was truly inspiring

because those physical therapists

helped me realize that with diligence

and determination

obtaining a doctorate degree in physical

therapy

was not unattainable

from there i learned that building

relationships

and connections with my patients was

crucial

to obtaining better outcomes and a

successful recovery

after an injury a recent surgery or

someone suffering from a neurological

condition

i especially found this to be true when

i treated patients

that were from minority groups or people

of color

often they would say to me and thank me

that they were happy to see a clinician

that looked like them

today i want to discuss how a lack of

diversity within certain healthcare

professions

is a health disparity affecting people

of color

people living in rural areas and

low-income populations

but before i get into that i want to

introduce myself

my name is dr kiana howard and i am a

licensed physical therapist

i primarily practice in outpatient

orthopedics where i treat various

diagnoses from musculoskeletal injuries

neurological conditions and people that

have undergone surgery

since i’ve been practicing i treat a

wide variety of people

from different ages races religions

people living in rural areas or people

from different socioeconomic statuses

thankfully i’ve been told by my minority

patients how they appreciate me

because they feel that their health

concerns are being properly

addressed it’s mostly known and trending

that racial minority populations are at

a higher rate

for contracting chronic health

conditions than their white counterparts

these conditions may include high blood

pressure

diabetes and cardiovascular diseases

because there is such a wide difference

between whites

and non-whites likely to contract a

chronic health condition

this is categorized as a health

disparity

a health disparity is basically health

differences between different groups of

people

some differences may include how many

people contract the disease

the severity of the disease how many

people die from it

and how many people actually have proper

access to health care to get screened

for these diseases

others may say health disparities are

linked with different factors

such as social factors economics and

environmental factors

unfortunately minority groups are more

likely to have sub-optimal care

and higher rates of poor health outcomes

than whites and some disease cases

so could the lack of diversity in

certain health care professions

also be linked to health disparities

let us turn our focus to the

demographics and look at how we are

actually being represented in certain

healthcare professions

pictured here is a graph of the united

states population

a larger portion is comprised of white

americans

at 76.3 percent followed by hispanic

latino at 18.5

and black americans at 13.4

the next image highlights physician

populations by race

similar to the u.s population graph

white americans still make up a

large portion of the medical doctors

however all minority groups except

people that identify as asian are

underrepresented in this profession

now let’s take a look at the physical

therapy profession as noted in the

previous graph white americans still

maintain a large portion of the physical

therapy population

and all minority groups except those

that identify as asian

are under-represented in physical

therapy so how do we fix this issue

how do we improve the representation of

racial ethnic minorities

in health care primarily there must be a

pipeline system

or some type of strategy in place to

ensure that disadvantaged and

underrepresented groups

are represented a lot of reasoning

behind the lack of diversity in health

care

is due to the lack of exposure of

different health care professions

to minority students for me

i was exposed to physical therapy in

latter high school

only because i had an ankle injury from

running track

but what about those students who are

not student athletes

those students whose families may not

have enough health care coverage to pay

for a physical therapy session

how will those students know about the

career or any other health care career

that is underrepresented this pipeline

model

has many levels beginning from early

childhood all the way

to the medical professional getting kids

exposed to different health care

professions

before college is important as they

think about what they want to do for a

living

the next level is the undergrad

experience which is vital for shadowing

volunteering and getting exposure into

the profession before applying to

graduate school

thereafter is the graduate admission

process which is key to having people on

these review boards advocate for people

of color

to be accepted into these programs

finally licensure preparation is also

important

this is important to ensure these

students successfully pass their

examination

and be licensed medical professionals an

example

of a successful pipeline is based on a

study

done at the ohio state university school

of medicine and the university of

california post-baccalaureate programs

these programs aim to help promising

college graduates from

disadvantaged and underrepresented

backgrounds get into and succeed in

medical school

from these efforts researchers have

found that the post-baccalar

graduates were more likely than non-post

baccalaureate graduates

to practice medicine in high poverty

communities high

latino and black communities nonetheless

research has shown

time and time again that patients from

minority groups

that are served by health care providers

that look like them

have better outcomes in another example

a study performed in oakland california

randomly

assigned black men to black and

non-black doctors to examine the demand

of preventive care from this they found

that

black males assigned to black doctors

increased their demand

for preventative care services these

services include things like getting the

flu shot

monitoring their blood pressure

monitoring their blood sugar and

monitoring their overall health

from the same study researchers also

predicted a 19

drop in the black and white male

cardiovascular mortality gap

an 8 drop in the black white male life

expectancy gap

ultimately increased racial minority

representation in health care is crucial

because diversity is associated with

positive health outcomes

these outcomes would include things like

increased access to health care for

minorities

improve patient provider communication

improve patient satisfaction

and lower morbidity and mortality rates

among minority groups

the lack of diversity in health care is

a health disparity for racial minorities

and disadvantaged groups

many health care organizations and

professional schools are addressing

these issues

but we still have a long way to go when

it comes to diversifying the system

hopefully this talk can start a

conversation and give you guys some

insight on how we need to change and

increase the need of minority health

professionals

not only to reflect the people we serve

but to positively change the trajectory

of how we treat patients and meet the

continuing needs of the overall

population

thank you

you

在 2013 年夏天,

我有机会成为实习计划的一部分,该

计划

让少数族裔大学生

接触

缺乏多样性的健康专业,

这次实习是一次很棒的经历,

因为我有幸向

看起来像的伟大临床医生学习和学习 我不仅如此,

而且我们在

不同的层面上相互联系,

因为我们有着相似的背景和

相似的成长经历,

这个机会真的很鼓舞人心,

因为那些物理治疗师

帮助我意识到,通过勤奋

和决心

获得物理

治疗博士学位并非无法

实现 在那里我了解到,

与我的患者建立关系和联系

对于

最近的手术或

患有神经系统

疾病的人受伤后获得更好的结果和成功康复至关重要。

治疗来自少数群体的患者时,我特别发现这是正确的 或

上校的人 或者

他们经常对我说并感谢我

,他们很高兴看到

今天看起来像他们

的临床

医生

低收入人群,

但在我开始之前,我想

自我介绍一下,

我的名字是 kiana howard 博士,我是一名有

执照的物理治疗师

因为我一直在练习,我治疗了

来自不同年龄、种族、宗教、

生活在农村地区的人或

来自不同社会经济地位的人

正在得到适当的

解决 少数族裔人口是众所周知和趋势的

与白人相比,他们患慢性疾病的比例更高

这些疾病可能包括高血压

糖尿病和心血管疾病,

因为

白人

和非白人之间可能患上

慢性疾病的差异如此之大,

这被归类为 健康

差异 健康差异基本上是

不同人群之间的健康差异

一些差异可能包括有多少

人感染该疾病 疾病

的严重程度 有多少

人死于该疾病

以及有多少人实际上可以获得适当的

医疗保健以进行

筛查 这些疾病

其他人可能会说健康差异

与不同的因素有关,

例如社会因素 经济和

环境因素

某些健康的多样性 c 职业是否

也与健康差异有关

让我们将注意力转向

人口统计数据,看看我们

在某些医疗保健行业中的实际代表情况 下

图是

美国

人口图表 大部分由美国白人组成,

占 76.3% 其次是 18.5 的西班牙裔

拉丁裔

和 13.4

美国黑人

现在让我们来看看物理

治疗专业,

如上图所示,美国白人

仍然占物理治疗人口的很大一部分

,除了那些

认定为亚洲人的少数群体

在物理治疗中的代表性不足,

那么如何做 我们解决了这个问题

我们如何改进

医疗保健中的少数民族 必须有一个

管道系统

或某种类型的策略来

确保弱势和

代表性不足的群体

得到代表

医疗保健缺乏多样性背后的很多原因

是由于缺乏不同的接触

对我来说,少数族裔学生的医疗保健专业

我在高中后期接受了物理治疗,

只是因为我在跑道上脚踝受伤,

但是那些

不是学生运动员

的学生呢?那些家庭可能

没有足够医疗保健保险的学生

支付物理治疗费用

这些学生将如何了解

职业或任何其他

未被充分代表的医疗保健职业 这种管道

模型

有很多层次,从

幼儿时期一直

到医疗专业人员,让孩子们

在大学前接触不同的医疗保健专业 很重要,因为他们

考虑自己想做什么 生活

的下一个层次是本科生的

经历,这对于在申请研究生院之前跟随

志愿服务和接触

该行业至关重要

此后是研究生录取

过程,这是让

这些审查委员会的人倡导

有色人种被接受的关键 最终进入这些课程

执照准备也

很重要 这对于确保这些

学生成功通过

考试

并获得执照的医疗专业人员

很重要 成功管道的一个例子是基于

在俄亥俄州立

大学医学院和

加利福尼亚大学进行的一项研究 学士后课程

这些课程旨在帮助

来自

弱势和代表性不足

背景的有前途的大学毕业生进入医学院并

通过这些努力取得成功 研究人员

发现,

学士后毕业生比非学士学位

毕业生更有可能在 高贫困

社区 高

拉美裔和黑人社区 然而,

研究

一次又一次地表明

,由看起来像他们的医疗保健提供者提供服务的少数群体的患者

有更好的结果 在另一个例子中,

在加利福尼亚州奥克兰进行的一项研究

将黑人随机分配给黑人 和

非黑人医生检查

预防保健的需求,他们发现

分配给黑人医生的黑人男性

增加了他们

对预防保健服务的需求,这些

服务包括接种

流感疫苗、

监测血压、

监测血糖和

监测他们的

来自同一研究的整体健康研究人员还

预测

,黑人和白人男性

心血管死亡率

差距下降 19 黑人男性预期寿命差距下降 8

最终增加少数族裔

在医疗保健中的代表性至关重要,

因为多样性与

积极的健康结果相关

th 这些成果将包括诸如

增加少数族裔获得医疗保健的机会

改善患者提供者的沟通

提高患者满意度

并降低少数群体的发病率和死亡率

医疗保健缺乏多样性是

少数族裔和弱势群体的健康差距

许多医疗保健组织 和

专业学校正在解决

这些问题,

在系统

多样化方面我们还有很长的

路要走

不仅要反映我们服务的人群,

还要

积极改变我们治疗患者的方式并满足

整体人群的持续需求

谢谢