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Healthcare Disparities Module 2018
Kalyan Sreeram
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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.
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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
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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
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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”
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HealthCARE Disparities
EXAMPLES: Analgesic administration by race/ethnicity Referrals for transplantation
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Reasons for Healthcare Disparity
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Healthcare Literacy RISK FACTORS for Low Health Literacy?
-Limited Education -Older Age -Racial Minority -Low Income -Compromised Physical Status
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Whitehall Study of Civil Servants
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Excess Mortality in Harlem Study
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Unequal Treatment: Confronting Racial/Ethnic Disparities in Healthcare
Report done by Institute of Medicine
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Challenges in Healthcare by Minority
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Challenges in Healthcare by Minority
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Poverty vs. Health
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Education vs. Health
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The Power of Knowledge
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How can we bridge the gaps?
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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
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