Kristi Rodriguez, United Healthcare, Generations of Wellness Campaign
United Healthcare has made addressing disparities in health care a greater priority in their business plan. There are three causes of disparities in health care: 1) Patient level variables; 2) Healthcare system variables; 3) Distrust within communities towards health care providers. United Healthcare has been attempting to address the problems of disparities on all three levels by providing education to consumers about wellness and health education. United also attempts to provide its consumers with information about minority physicians in their area, or physicians who have expertise in ethnicity related health problems such as sickle cell anemia. United also attempts to “meet people where they are,” by working with faith-based organizations. This helps to reestablish some of the trust lost from health care organizations.
Hispanic Health Council conducts community based research and develops health interventions based on their research findings. The organization is funded by NIH. Their strategy: all research projects are empirical and all programs are evidence-based and build upon the organization’s’ research. In addition , all of their employees are bilingual and frequently come from multicultural backgrounds. Jeanette recommends to organizations that are specifically dedicated to reducing health disparities, partner with experts in the field of health care and social justice in order to bring necessary resources to your own organizations. The organizations places a high priority on hiring investigators who will be able to integrate into the communities where they conduct research and implement programs. Today Hispanic Health council has 30 programs throughout the state of Connecticut. Most recently the council has helped to develop a policy arm to their organization, the National Latino Policy Institute.
Talking points from the discussion:
There are often conflicting problems that spur health disparities. “How do you include everyone?” “It sometimes feels as if though every group needs to have its own lobby. There is no multidisciplinary or multicultural organizations that address these issues.” This often makes the situation feel very overwhelming to providers and those who are unfamiliar with cultural differences in health. Jeanette DeJesus agreed, saying, “I almost feel as if though it is unethical for me to not include African Americans in my organization’s work…”
Kristi Rodriguez raised a conflicting point however, “One mistake that leads to disparities is that we assume that all African Americans or all Latinos have the same experiences…that is a mistake.’ She makes the point that United has very different outreach on the East and West coast to Latinos. This is because on the east coast the Latino population is consists more of Cuban and South American populations, whereas on the west coast the Latino population is mainly Mexican.
One attendee raised the point that providers are often lacking in basic tools for cross-cultural communication, which frequently makes them shy away from asking culturally sensitive questions about health. Jeanette raised the pint that this is an issue of scale. Health care providers often are not educated on issues of race or culture as it pertains to medicine. Organizations like Hispanic Health Council are limited in their ability to conduct outreach to providers on a larger scale. Greater participation is needed from large health care corporations. Kristi Rodriguez explained that United is beginning to expand their resources in this area, but it is still developing.
Another attendee raised the point that this is the responsibility of the state on some level. In California for example, it is now required by,statute (Title 6) that there are translators available for patients for whom English is not the primary language. there are still hurdles. For example, depending on the language, there often is not an employee on site, but someone who is reachable by phone. More and more medical schools are beginning to incorporate this into their curriculum, and it has been very popular with students.
Aditional challenges: There is not enough focus on wellness care and prevention. These activities are not reimbursed by insurers. However, prevention would reduce many existing health disparities. in general a greater focus is needed on nutrition and helath habits. United Healthcare has it’s Generations of Wellness program, which incorporates a strong educaitonal component, providing funding to schools for health foods.
Jeanette makes the point that in order to improve prevention education on the community level it is imperative to have people who speak the language and who look and act like the people who receive the education. “There must be sincerity and honesty,” Jeanette said.
