Educating health care providers about health disparities is critical to addressing them

“Of all the forms of inequality, injustice in health is the most shocking and the most inhuman, because it often results in physical death.” —Dr. Martin Luther King Jr.

Dr. King’s words from more than 55 years ago could not be more pertinent today as they relate to health outcomes in Rochester and the Finger Lakes region. Sadly, vast disparities in health care outcomes exist among people of color.

As Common Ground Health revealed in our 2021 report, The Color of Health: The Devastating Toll of Racism on Black Lives, racism – whether deliberate or unintentional – undermines physical and mental wellbeing and helps drive poor health outcomes.

Our report revealed that relative to White residents, African Americans in the Rochester-Finger Lakes region are:

• 50% more likely to experience life-threatening complications related to childbirth,
• 3 times as likely to have an infant die in their first year of life,
• 6 times as likely to wind up in the emergency room due to asthma,
• 6 times as likely to be admitted to the hospital for hypertension, and
• 57% more likely to report poor or fair mental health.

In addition, Black residents in our area face a premature mortality rate that is 67% higher than their White neighbors.

Besides race, other social determinants of health — the conditions in which we are born, live, work, worship and age — that drive health outcomes include educational level, employment status, family culture and traditions, community resources, physical environment, individual behaviors and government policy.

Research has shown that 80% of the variation in health outcomes is driven by the social determinants of health — things like access to food, housing, and transportation — the resources that provide the foundation that enables people to stay healthy or get healthy when they are sick.

The COVID-19 pandemic shone an even brighter light on health disparities and on how urgently we need to reinforce our commitment to addressing housing, education, employment, transportation and other social determinants of health.

Educating the next generation of health providers

How can we make progress in addressing these disparities? It is important that future health care providers understand that there is a direct link between a person’s race and their health outcomes.

This year, Common Ground Health issued a report on the state of the health care workforce in the 27-county Finger Lakes region. “Critical Condition: Sustainable Investments Required to Build a Skilled, Supported and Equitable Health Care Workforce” is based on the results of a survey of more than 300 area health care organizations conducted in collaboration with Finger Lakes Performing Provider System (FLPPS), the Central New York Area Health Education Center (AHEC) and the Western New York Rural AHEC.

They key finding in this report is that the single biggest threat to New York state’s health care delivery system is the ability to attract and retain staff.

Our report also provided steps health care institutions can take to continue to make addressing health outcome disparities a priority. This effort will involve a two-pronged approach to:

• Be more consistent in diversity, equity, inclusion and anti-racism (DEIA) training.

Increasing awareness of cultural differences and racial and ethnic health disparities has prompted health care organizations to consider their own implicit biases and roles in dismantling systems of oppression.

While 72% of respondents indicated that their organization offers DEIA training, 21% reported that the training is voluntary. However, there is little consistency in the approach to DEIA training across the health care sector. Some organizations report that DEIA trainings occur at monthly staff meetings, others report that it is a small component of organizational training, or is required only of certain staff, such as managers or new hires.

Survey respondents also identified interest in learning more about such topics as the social determinants of health; working with Deaf and hard of hearing populations, and those with disabilities; rural cultural competency; health literacy; trauma-informed care; and health equity.

2)           Further diversify the health care workforce.

A true commitment to DEIA goes beyond training and requires efforts toward diversifying the workforce at all levels. It is critical that we inspire, encourage and recruit individuals of diverse backgrounds to pursue careers in the medical field. We must begin with children at the grade school level from underrepresented backgrounds, with a continuing commitment to them throughout their educational and professional careers. Supporting underrepresented students through their health care training and medical residencies, and university faculty and health care leadership, are all critically important to working towards the elimination of our region’s health disparities.

Increasing the diversity and cultural competence of the health care workforce is critical to reducing disparities in health outcomes because research shows that patients experience better health outcomes if they have access to doctors and other professionals from their communities of color. A diverse and representative workforce’s lived experiences provide better patient care by providing insights into the social determinants of health, cultural differences in health behaviors and beliefs, and building trust and recognition for patients.

Through this report’s findings and recommendations, we aim to inform health care organizations and educational institutions on their training design and development for staff and students.

Taking these actions can help ensure that future health care providers have the information and tools necessary to recognize that health outcome disparities exist and to understand how they can do their part to help overcome them.

Wade Norwood is the CEO of Common Ground Health, the health research and planning organization for the Rochester-Finger Lakes region. Norwood is a dynamic community health planner with experience in state and local government, community organizing and neighborhood development.