Sick & Tired

What I Learned From Reporting On Racial Health Disparities In Kentucky

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The Heckler Report was first brought to my attention in April, during a conference in Washington, D.C.

I was surprised to find that the federal government had never taken a comprehensive look at the health of African-Americans, Hispanics, Asians and Native Americans until 1985. It seemed that a report of its nature would have been prepared years earlier.

JaNel Johnson

Ja’Nel Johnson

It was also surprising to find out how little data was available at the time for Hispanics, Asians and Native Americans — especially compared with the wealth of information available nowadays.

I walked away from the National Association of Black Journalists’ Health, Health Policy and Health Inequities Conference with many resources and potential story ideas. But I was particularly interested in the Heckler Report.

Many of the 30-year-old report’s findings were not that shocking.

(Find the Sick & Tired series here. You can find more of WFPL’s health reporting here.)

Violence is a public health issue. I know from personal experience.

The report recognized violence as a public health issue, citing the homicide rate for black men as the second-leading cause of death after heart disease.

That’s not eye-opening to someone like me. I grew up in a city dubbed the “murder capital of the nation.” In Gary, Ind., metal detectors and security guards were ever-present at school. Many of my relatives, friends, classmates and acquaintances were murdered or shot. I’ve dodged bullets on several occasions, sometimes while at school. I’ve egged on fist fights. At times, I swung my own fists to protect myself.

Back then, I never made the connection between these incidents and my physical and mental health, or how exposure to violence could affect my adult life.

But it does.

Violence affects everyone.

Health insurance helps, but it’s not a quick fix.

Kentucky’s uninsured rate has seen a sharp and fast decline. Before the federal Affordable Care Act, 20.4 percent of Kentuckians had no health insurance. Now, the uninsured rate is about 9 percent.

But having insurance is not the same as having access to health care.

The federal Agency for Healthcare Research and Quality defines access to care as the timely use of personal health services to achieve the best health outcomes. And in order to have that, a person must gain entry into the health care system, get to a site to receive health care, and find providers who meet their needs and with whom they can develop a relationship based on mutual communication and trust.

Those three steps require different things. Transportation. Time off from work. A patient and empathetic physician.

Several suggested a holistic view of health — on issues including education, workforce, income and environment — as a way to close the gaps. Ja'Nel Johnson

Is it wrong for someone to request a doctor who understands their race and culture?

You can search for a doctor by specialty, gender and location, but why can’t you search for one by race/ethnicity or shared life experiences?

If I want to find a beautician, I’m going to search for a black one who has experience with naturally curly hair — someone who would know how to work with the texture of my hair.

I have had my hair straightened by a white woman, but it was an awkward experience. As soon as water hit my hair and it began to curl, her demeanor changed. She was frazzled and struggled to find the right styling products and flat iron to straighten my hair. Eventually, a black stylist had to assist her with my coif. I politely smiled through it and paid her, but ultimately, I was uncomfortable with her and dissatisfied with the outcome — a straight, yet dry, puffy and bodiless mane. I never went back to her, nor did I buy the products she suggested I use.

The same scenario can be true of medical treatment.

When there is a break in communication between doctor and patient, the patient is the one who suffers the most. Not only has the patient lost time and money, they still haven’t had their health concerns properly addressed. And research shows the patient will probably not follow through with the doctor’s treatment instructions.

“Unfortunately, there can be some significant consequences, like a misdiagnosis, where there is poor communication that results in a delay in diagnosis,” said Dr. Nadine Gracia, director of the Office of Minority Health at the U.S. Department of Health and Human Service. “To ensure that we’re providing high-quality care, it’s important that the care is culturally and linguistically appropriate.”

Just because the hair stylist was a hair stylist, didn’t mean she knew how to best serve me. And just because a doctor is a doctor, that doesn’t mean he or she is the best doctor for a patient.

Kentuckians care about health.

In addition to the series, I also moderated a panel on minority health. I was joined by Stephanie Mayfield, commissioner of the Kentucky Department of Health; colorectal surgeon Wayne Tuckson; Attica Scott, a Robert Wood Johnson community health coach; and Monnica Williams, director of the Center for Mental Health Disparities at the University of Louisville.

With an engaged audience at the Kentucky Center for African-American Heritage, we talked about patient education, environmental health, mental health and much more.

Many in the audience wanted to know how state government planned to make policy more responsive to the health needs of the community. Several suggested a holistic view of health — on issues including education, workforce, income and environment — as a way to close the gaps.

Some audience members demanded leaders take immediate action to end disparities in Kentucky. Others shared personal experiences of changing their diet and exercise habits to create a healthier lifestyle.

I appreciate that so many people came out to voice their concerns and share their experiences.

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