In July, a panel of speakers discussed the social determinants of health and how race and sexuality can impact health care disparities during a Texas A&M College of Dentistry’s Virtual Summit on Race, Intersectionality, Sexuality & Equity (RISE). The list of speakers included E. Lisako J. McKyer, Ph.D., M.P.H., Senior Associate Dean for Climate & Diversity at Texas A&M School of Public Health; Neal Newman, J.D., Professor at Texas A&M School of Law; Herminio Perez, D.M.D., M.B.A., Assistant Dean of Student Affairs and Diversity & Inclusion at Rutgers, The State University of New Jersey, School of Dental Medicine; Pamela Zarkowski, B.S.D.H., M.P.H., J.D., Provost and Vice President for Academic Affairs at University of Detroit Mercy; and Sonya Smith, Ed.D., J.D., ADEA Chief Diversity Officer.
“Unfair treatment and discrimination continue to make us sick,” Dr. Smith says during her presentation on The Impact of Intersectionality and Social Justice in Health Care.
Two Models for Addressing Health Equity Barriers
Dr. Smith went on to enumerate the ways that unfair treatment and discrimination can affect the health of ethnic minorities and the LGBTQIA+ community. They include premature death from stroke and higher infant mortality rates among Black people and Black women, specifically; the impact of COVID-19 in mostly Black and Latinx communities, which saw more cases and higher rates of death, as well as LGBTQIA+ health care being impacted by laws that allow them to be denied service based on health care workers’ religious beliefs. Dr. Smith also shared how African Americans, native Hawaiians and Latinx are more impacted by higher levels of hypertension due to racism. LGBTQIA+ also have had higher levels of alcohol, tobacco and substance abuse due to higher levels of discrimination.
Dr. Smith says there are two models for addressing these kinds of health equity barriers: community-driven solutions and upstream and downstream factors. Community-driven solutions include public safety, housing education, transportation and health care systems. She says that in order for this model to work, increasing community capacity and multi-section collaboration must include intersectionality and social justice framework. In the other model, upstream and downstream factors, the emphasis is on strategic partnerships to address institutional inequities through a social justice and intersectional lens. It includes living conditions that can be addressed through policy and civil engagement.
Thinking Outside of the Box
Dr. McKyer also shared ways to address health equity barriers. “We need to redefine what comprehensive health care looks like, expanding beyond health care workers. Maybe even think of community health care or clergy,” she says.
She says the health professional community also must rethink the administration of treatment. “Treating someone the same way is not the same as equitable treatment,” McKyer says. “We have to examine outcomes differently and think outside of the box.” She gave the example of women and the treatment of heart attacks. She says if you used the standard treatment developed for men and applied to women, are the outcomes the same? “If they’re not, it’s not equitable,” she says.
Dr. McKyer says health care professionals should also consider, when doing interprofessional team training, including more disciplines outside the traditional health care teams, such as urban planners, civil engineers, veterinarians and even historians.
She even suggested that in order to help breakdown health equity barriers, health care professionals become more informed in areas outside of their discipline. “Pursue a public health history course, and history courses on populations that are culturally specific like Native American history,” she says.
Published on September 9, 2020