1. Healthcare Disparities Module 2018
Kalyan Sreeram

2. What is HEALTH?
Traditional focuses in training physicians include physical and mental well-being. By including social well-being, we could synergistically improve long-term physical and mental well-being for our patients.

3. Health Equity/Disparities
What can influence disparate healthcare delivery?
Social: Race/Ethnicity, Gender, Sexual Orientation
Economic: Employment Status
Cultural: Religion, Literacy/Language
Physical: Geography, Disability
Intellectual: Cognitive/Sensory Impairment

4. What determines HEALTH?
Biology: Age, Gender, Genes
Behaviors: Diet, Exercise, Lifestyle/Daily Habits, Substance Use
Service Access: Insurance, Practitioners, Economy
Environment: Social Norms, Cleanliness, Education

6. Upstream/Downstream Determinants
Upstream: Acute/Immediate decisions or circumstances leading indirectly to an outcome.
“ASSISTS”
Downstream: Chronic decisions or circumstances that end up leading more directly to an outcome.
“POINTS/GOALS”

8. HealthCARE Disparities
EXAMPLES:
Analgesic administration by race/ethnicity
Referrals for transplantation

9. Reasons for Healthcare Disparity

10. Healthcare Literacy RISK FACTORS for Low Health Literacy?
-Limited Education
-Older Age
-Racial Minority
-Low Income
-Compromised Physical Status

11. Whitehall Study of Civil Servants

12. Excess Mortality in Harlem Study

13. Unequal Treatment: Confronting Racial/Ethnic Disparities in Healthcare
Report done by Institute of Medicine

15. Challenges in Healthcare by Minority

16. Challenges in Healthcare by Minority

17. Poverty vs. Health

18. Education vs. Health

19. The Power of Knowledge

21. How can we bridge the gaps?

22. PATIENT PROVIDER SYSTEM ACCESS COMMUNITY
Assess individual social/cultural patterns at each visit
PATIENT
Educate yourself with perspectives from colleagues and about what patients want
PROVIDER
Implement appropriate actions once educated
SYSTEM
Optimize changes based on effects seen in practice
ACCESS
Understand what issues people could face before the need to act arises
COMMUNITY