Minorities Fix Health System

February 13, 2007
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African-Americans and Hispanics in Grand Rapids and Kentwood have some less favorable opinions on local health care than the general population.

That is one of the findings of an EPIC–MRA poll conducted for the Grand Rapids African American Health Institute. It's a message the institute plans to carry to local health care institutions, said Dr. Khan Nedd, chairman of the GRAAHI board.

"Regardless of what we know, what clinical evidence tells us, it is also important to understand the perception in terms of the community," Nedd said.

The survey measured those perceptions earlier this year. It questioned 524 adults, as well as an over-sample of 222 African-Americans and 190 Hispanics in the two cities. Among the findings:

  • All three groups — the general population, African-Americans and Hispanics — gave negative ratings to the issue of whether the local health care system meets the needs of all residents, regardless of income.

  • The general population was split evenly over whether the health care system does a good job of providing information on the availability of services to all, but African-American and Hispanic responses were more than 50 percent negative.

  • Twice as many African-Americans, as opposed to the general population, reported they had declined to fill a prescription when they needed it, and almost half said it was due to the cost, even with health insurance.

"It confirmed a lot of things we already knew," Nedd said.

"It begins to open the doors for us to understand how to bridge what people identify as major issues in health care, and what we know about those issues and outcomes."

Lody Zwarensteyn, president of the Alliance for Health, a local health care planning agency, and a GRAAHI board member, said the health care system should take notice of the survey's results.

"A lot of people are worried," Zwarensteyn said. "They really feel the system is not responding to their needs."

Zwarensteyn said he hopes that health care providers will consider the GRAAHI study results and review their own modes of operation in light of them.

Paul Doyle, director of service strategy for Spectrum Health's Healthier Communities, said GRAAHI's role in generating research is crucial.

"Obtaining data and using it to influence our strategies in how we provide services to address the issues is key," said Doyle, also a GRAAHI board member.

As an example, Doyle cited the $2.4 million federal grant that funds Healthy Start, in which multiple providers are zeroing in on infant mortality. Disparity in infant mortality has been an issue in Kent County for many years, he said. For example, the infant death rate for blacks in Michigan in 2003-05 was 17.6 per 100 live births, compared to 6.2 percent for whites during the same time period, according to the Michigan Department of Community Health.

"I think continuous education is very key, internally and externally, to address those issues (of health care disparity)," Doyle said. "Being able to train our providers and how to engage all the diverse population we serve and provide care to in a culturally competent manner is very important. We have to continuously work in that area. I don't think it's something we are just going to meet and then not do any work with."

The GRAAHI survey results mirror similar surveys taken around the nation. Disparity in health care has been the topic of much research.

For example, a study by researchers from Harvard and Brown universities, released in October, reviewed the outcomes for 334,000 Medicare patients in 151 health plans. The study found, for example, that 72 percent of white heart patients had their cholesterol levels under control. But only 57 percent of black heart patients had controlled cholesterol.

Researchers said that rather than overt discrimination, this and other study findings have roots in sociological issues. For example, a doctor might suggest a patient eat more fresh fruits and vegetables, not taking into account whether the patient has access to them, researchers said.

The GRAAHI study was released in October 2006.     HQX

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