Written by Kylin Fulton
After a long day of traveling yesterday, our group of 16 Central Washington University public health students are all here at the 10th annual National Health Disparities Conference in New Orleans, LA. The conference schedule consists of multiple keynote speakers, small break out sessions, and plenty of networking opportunities with public health professionals from all over the United States.
At 8:00am, the conference started with a message from Mrs. Michelle Alletto, the Deputy Secretary of the Louisiana Department of Public Health in Baton Rogue, LA. Her session started the conference on a strong note, and included many tools for students to be the next advocates of social change in the field of Public Health.
Alletto focused on prevention methods primarily, since last year the United States spend 2.6 trillion dollars on healthcare, but only 5% of that cost went to disease prevention. Having no prevention tools raises an issue with health disparities among different areas of Louisiana, since some areas may not have any exposure to any primary, secondary, or even tertiary prevention methods. This could contribute to the varying health disparities around different cities in Louisiana. These health disparities shorten life expectancies, with people living up to 25 years less in certain undeveloped, impoverished areas of Louisiana.
Aside from prevention, Alletto also urged that as a nation the role of racism and bias in relation to health disparities needs to be addressed. In New Orleans alone, some clinics are still side lining people that rely on Medicaid to favor those with private insurance to receive healthcare. Alletto mentioned that some clinics have certain days that Medicaid patients can come in, and some days when they cannot. This restriction on healthcare access adds unnecessary pressure to those who rely on Medicaid that need healthcare, which can increase the occurrence of health disparities among poorer parts of Louisiana. There are even certain 1-800 numbers that patients are supposed to call based on their types of insurance, which determines the quality and urgency of healthcare they receive.
One of the driving points that Alletto mentioned to prevent the occurrence of health disparities in any state is to work on “actualizing your purpose as a healthcare professional”. She used this statement because without healthcare professionals being sensitive to the entire community they are serving, there can be implicit biases (or intentional biases) that rule out people who may not be able to afford healthcare services, or have little to no access to healthcare services. A healthcare professional can state that they are sensitive to the population they work with, however their actual work demonstrations may not always be the case. By making sure health care professionals are educated and proactive about the varying needs of the population they currently serve, there is a higher likelihood of health equity being established.
In comparison to Washington, I found the amount of variance in health disparities based on cities to be astounding. Usually in Washington we have varying wealthy and poor areas, but some parts of Louisiana can be dramatically different, with wealthy parts and impoverished parts. Not to dismiss existing health disparities in Washington state, it was just different and interesting to see the distribution of health disparities among different communities in Louisiana that are dramatically different. Alletto provided in depth insight and statistics for the ongoing disparities in different areas in Louisiana (HIV/AIDS transmission, STIs, etc.) and urged healthcare students and professionals everywhere to be educated about varying areas around our states and the health disparities that different communities face.
After Alletto’s insightful speech, Dr. Camara Phyllis Jones from the Morehouse school of Medicine delivered a simplistic yet incredibly well-done model to address the social determinants of health.
Jones began with a model of a cliff with a person falling off, saying that our goal as people is to avoid falling off the “cliff of good health”. In most cases, when someone falls off the “cliff of good health”, there is nothing to soften the landing. However, when someone does fall off the cliff, there may be an ambulance at the bottom. The ambulance can take you to the hospital, but a net to catch you halfway down would prevent the injury in the first place. Going even further than that, a fence at the edge of the cliff would prevent you from walking off of the cliff at all.
This model demonstrates the necessity for primary, secondary and tertiary prevention methods in the field of health promotion. Having just an ambulance at the bottom of the cliff will save your life, but a net or fence would prevent any injury at all. However, most places in the world don’t have fences or nets, and some do not even have ambulances. Some people may have a fence and a net, and some may have nothing at all, with social determinant pressures that push them closer towards the edge of the cliff (race, income, healthcare access, etc). When there are no barriers to prevent falling off the cliff, that is where health disparities form.
Jones explained the need for all levels of prevention in the field of Public Health with this simple model, and it clearly demonstrated the need for public health professionals to be sensitive to the needs of our communities. As Alletto said earlier, the United States only spends 5% of our healthcare budget on prevention methods, which means we hardly have an ambulance at the bottom of the cliff. In order to build the net, and build the fence as well, public health professionals must be sensitive to their target population, and develop programs that are realistic and effective to prevent the development of health disparities among varying communities.
There are three reasons health disparities arise, according to Jones. Differences of healthcare quality, differences of access to healthcare (including preventative services) and differences of life opportunities. If certain populations have less opportunities to receive healthcare than others, health disparities begin to form and become more prevalent over time. Healthcare professionals can prevent this by eliminating implicit biases, becoming culturally aware of our populations we work in, and being proactive about implementing prevention strategies.
I had always been unsure about the urgency of prevention strategies, since in my experience they have had little to no effect on health outcomes. However, Jones opened my eyes to what I have been lacking in my health promotion knowledge, and gave me tools to apply to health promotion methods I plan to use in the future. I feel better prepared as a student to transition into the field of public health with a knowledge of varying populations, occurrence of health disparities, and effective prevention methods.
Following these two opening sessions, the rest of the speakers were in groups talking in small panels. Our group of CWU students were evenly split throughout the day, some of us going to the Climate Change talk, and some of us attending the Sex Trafficking talk. All the afternoon sessions were extremely informative and provided in depth information about issues that we may not always dig into in Public Health, especially since the courses in our curriculum are only a quarter long and do not allow enough time to analyze health disparities in depth. The sessions gave a new perspective to researching health issues, and provided insights to many of us who specialize in certain areas of public health.
As a pre-nursing student, I was able to benefit from the luncheon speaker, Dr. Reed V. Tuckson, who spoke about being able to devote yourself to your patients while taking care of yourself at the same time. Nursing can be a very intense career, and having tools to manage your time and take care of yourself in order to provide optimal care for patients is critical. Myrinda Wolitarsky and I were able to speak to Dr. Tuckson after his session, and he told us that Public Health Students are essential to secure the future of public health. He was enthusiastic that Central Washington University had so many students attending the conference, and said we were doing a good job by devoting our energy to making a long-lasting change in the field of public health. It motivated me as a student to keep pursuing my major and finding innovative ways to contribute to the field of Public Health.
Overall, the day was organized and ran smoothly. I am proud of our group from CWU for representing our college at every single session, and providing insightful questions and contributions to the keynote speakers. Tomorrow, different students in our CWU public health travel group will report and detail the events of the day. I am impressed with the conference, and it is wonderful to connect and meet so many people who are also passionate about public health. It is an enriching, worthwhile experience that will build a strong foundation for my future public health career.