Social Justice: A Public Health Imperative Educating Minorities to become health professionals to help eliminate health disparities Social Justice: A Public Health Imperative APHA 138th Annual Meeting & EXPO November 9, 2010 By Apryl R. Brown, MD, MPH Detroit Medical Reserve Corps

RACIAL AND ETHNIC HEALTH DISPARITIES Refer to gaps in the quality of health and health care across various racial and ethnic groups such as: African Americans Hispanic Americans Native Americans Asian Americans When compared to their white counterparts, these minority groups have a higher incidence of: Preventable chronic diseases A higher mortality Poor health

US Census Bureau One in four Americans is a member of the following racial or ethnic minority groups making up more than a quarter of the nation’s population: African Americans Hispanic Americans Native Americans Although presently they are: Less than nine percent of nurses Six percent of physicians Similar low percentages of other health professions

US CENSUS BUREA It is estimated that by 2050, the majority of Americans will be: African American Hispanic American Native American Asian American Based on the current percentage of racial or ethnic minorities enrolled in programs of health professions, the demographic of health professionals will differ greatly from that of the general population

US CENSUS BUREAU In some cities, minority racial or ethnic groups already represent a majority of the population, for example: In Detroit, Michigan : African Americans comprise 83.00% of the population Hispanic Americans comprise 6.40% of the population

RACIAL AND ETHNIC HEALTH DISPARITIES Lack of access to health care may contribute to health disparities occurring among racial and ethnic minority groups It is due in part to lack of diversity in the health care workforce Cultural differences exist between white health care providers and minority patients. This leads to minority patients not seeking health care.

SULLIVAN ALLIANCE TO TRANSFORM AMERICA’S HEALTH PROFESSIONS Under the direction of Dr. Louis Sullivan, former U.S. Secretary of Health and Human Services and the founding Dean and first President of Morehouse School of Medicine, the Sullivan Alliance to Transform America’s Health Professions was formalized promoting the need to increase diversity in the health professions to help decrease racial and ethnic health disparities

SULLIVAN ALLIANCE TO TRANSFORM AMERICA’S HEALTH PROFESSIONS The Alliance is comprised of the following: Former members of the Institute of Medicine (IOM) Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Health Care Workforce Sullivan Commission on Diversity in the Healthcare Workforce

SULLIVAN ALLIANCE TO TRANSFORM AMERICA’S HEALTH PROFESSIONS During 2004, the Alliance issued the following reports: In the Nation’s Compelling Interest: Ensuring Diversity in the Healthcare Workforce Missing Persons: Minorities in the Health Professions

SULLIVAN ALLIANCE TO TRANSFORM AMERICA’S HEALTH PROFESSIONS Educational barriers preventing minority students from becoming health professionals must be removed. All students should have a quality educational experience from kindergarten to their post secondary education. Primary and secondary schools are currently failing many students

SULLIVAN ALLIANCE TO TRANSFORM AMERICA’S HEALTH PROFESSIONS When compared to their white counterparts, racial and ethnic minority students: Have a K-12 education of lower quality Score lower on standardized exams Are less likely to earn a high school diploma When compared to their white counterparts, racial and ethnic minority students are less likely to graduate from a baccalaureate institution

SULLIVAN ALLIANCE TO TRANSFORM AMERICA’S HEALTH PROFESSIONS Since many minority students enter their post secondary education through community colleges the transition from the two year to the four year institutions of learning is important. Community colleges should have coordinated curricula and guaranteed transfer of credits into the baccalaureate colleges and universities.

SULLIVAN ALLIANCE TO TRANSFORM AMERICA’S HEALTH PROFESSIONS Minority students who successfully earn their baccalaureate degrees are confronted with the following barriers in gaining admission into schools of health professions: An over-reliance on entrance standardized exams Unsupportive institutional cultures Lack of adequate sources of financial aid Leadership without a demonstrated commitment to diversity in health professions

SULLIVAN ALLIANCE TO TRANSFORM AMERICA’S HEALTH PROFESSIONS Assessable financial aid such as scholarships and low-interest loans should be available instead of unsubsidized loans. A heavy loan debt is a barrier to an socioeconomic disadvantage student from pursuing a career in a health profession.

SULLIVAN ALLIANCE TO TRANSFORM AMERICA’S HEALTH PROFESSIONS Post secondary educational institutions should provide socioeconomically disadvantaged students with various supportive services to help them succeed in their studies such as: Mentoring Counseling Test-Taking Skills Interviewing Skills

DETROIT ALLIED HEALTH MIDDLE COLLEGE PROGRAM (DAHMC) MISSION To serve young people who are interested in the Allied Health careers, academically capable, in need of motivation or an alternative learning environment, and to give experience that will bride adjustment to a college campus

DETROIT ALLIED HEALTH MIDDLE COLLEGE PROGRAM (DAHMC) In 2007, DAHMC was opened at the Charles F. Kettering Senior Public High School located in Detroit, Michigan. It is co-sponsored by the: Detroit Public Schools (DPS) Wayne County Community College District (WCCCD) Detroit Medical Center (DMC)

DETROIT ALLIED HEALTH MIDDLE COLLEGE PROGRAM (DAHMC) During December 2007, the Detroit Medical Center (DMC) hosted a gathering for students and their parents about careers available through the Detroit Allied Health Middle College Program

DETROIT ALLIED HEALTH MIDDLE COLLEGE PROGRAM (DAHMC) During February 2008, a White Coat Ceremony (DMC White Lab Coat) was held to honor students who were academically on schedule in their courses of study. During June 2008, students achieving academic excellence and were on the honor roll 3 times during the course of the school year were rewarded with trophies.

DETROIT ALLIED HEALTH MIDDLE COLLEGE PROGRAM (DAHMC) A Resource Coordinating Team (RCT) provided for the students and their parents was composed of: Counselors Social Workers School Psychologists They help address the following type concerns of students: Academic Social Emotional

DETROIT ALLIED HEALTH MIDDLE COLLEGE PROGRAM (DAHMC) At Wayne County Community College District (WCCCD), students enroll in academic as well as allied health courses. In this setting, I taught a biology course to the DAHMC students where they excelled both during lecture as well as in the laboratory. Towards the end of the semester, students toured the laboratories and departments of a DMC hospital and saw biological concepts in which they learned about in class being applied to save the lives of patients.

DETROIT ALLIED HEALTH MIDDLE COLLEGE PROGRAM (DAHMC) Detroit Medical Center Internship Coordinator Arranges for the students to have: Internships in Hospital Settings Practicums Job Shadowing

DETROIT ALLIED HEALTH MIDDLE COLLEGE PROGRAM (DAHMC) Students who successfully complete the program: Earn both a High School Diploma and an Associate Degree Earn a Certificate of Completion in: Pharmacy Technology Phlebotomy Dental Lab Tech Be eligible for admission into a program, such as: Nursing Surgical Technology Dental Hygiene

DETROIT ALLIED HEALTH MIDDLE COLLEGE PROGRAM (DAHMC) Students who do not complete all of the requirements for an associate degree may continue their course of studies at Wayne County Community College District or they may transfer their credits to a baccalaureate institution of learning.

INCREASING DIVERSITY IN THE HEALTH PROFESSIONS Programs such as the Detroit Allied Health Middle College Program help to increase the number of minority health professionals serving the mostly African American population in Detroit, Michigan. This increase diversity of health professionals will improve health care access and quality of care for minority patients. This diversity of the workforce helps to decrease the racial and ethnic health disparities seen within this urban area.

INCREASING DIVERSITY IN THE HEALTH PROFESSIONS Racial or ethnic minority health professionals more often than their white counterparts treat patients who are of racial or ethnic minority groups. They will have the culture sensitivity that is needed in order to gain the patients’ trust. The good rapport between a health care provider and a patient will increase patient compliance. The barrier to communicating effectively with minority patients will decrease.

ACKNOWLEDGEMENTS Funding: Sources: Detroit Medical Reserve Corps Wayne County Community College District Detroit Allied Health Middle College Program Sullivan Alliance to Transform America’s Health Professions Institute of Medicine