Disparities_in_healthcare_in_CT__Arielle_Levin_Backer_

Introduction

• Discussion on the perception of health and racism.

• Research by the Frameworks Institute on race and equity.

• Shift in focus groups from individualism to systemic issues post-George Floyd's death.

Individual Choices vs. Systemic Issues

• Initial view: health linked to individual choices (exercise, diet, health insurance decisions).

• Post-reaction shift: acknowledgment of systemic racism impacting health.

• Discrepancies persist as most still associate health disparities with individual choices rather than systemic factors.

Health Disparities Overview

• In Connecticut, a healthy state overall ranked 4th by United Health Foundation.

• Connecticut ranks poorly (41st) in health disparities, revealing stratification by race and ethnicity.

• Life expectancy indicators reveal vast disparities:

  • Northeast Hartford: 68.9 years (12 years below state average).

  • West Hartford: 84.6 years (15.5 years above state average).

  • Westport: 89.1 years (21 years above Hartford).

Specific Health Issues with Racial Disparities

• Infant Mortality: Black women face significantly higher rates of infant mortality.

• Asthma: Black and Hispanic populations show elevated complications.

• Diabetes: Higher prevalence and complications among Black and Hispanic residents, including disproportionate rates of amputation.

• Cancer: Black men nearly twice as likely to die from prostate cancer.

• Neurological Conditions: Higher prevalence among African Americans, e.g., Alzheimer's and epilepsy.

Causes of Health Disparities

Access to Health Care

• Coverage discrepancy:

  • 4% White uninsured, 7% Black, 14% Hispanic in Connecticut (2018).

• Regular care availability:

  • 10% White lack a personal doctor vs. 20% Black and 30% Hispanic.

• Emergency care reliance for Black patients vs. outpatient care for White patients.

Socioeconomic Factors

• Broader context of resources affecting health:

  • Housing stability, food affordability, and transportation accessibility.

• 87% White can access a car vs. 65% Black/Hispanic.

• 10% White struggled to buy food vs. 23% Black, 28% Hispanic.

Role of Genetics and Social Constructs

• Genetics do not explain racial health disparities; majority of variability is within racial groups.

• Race considered a social construct rather than a biological determinant.

Effects of Racism on Health

• Discriminatory treatment in healthcare:

  • Black and Hispanic patients receive less aggressive treatments.

• Chronic stress effects:

  • Linked to hypertension, depression, and poor overall health.

• Experience of racism contributes to health issues, including chronic stress responses.

Systemic Racism and Socioeconomic Factors

• Systemic racism interlinked with socioeconomic status; rooted in historical policies like redlining.

• Historical disadvantages shape current health outcomes and resources available.

COVID-19 Disparities

• Higher rates of COVID-19 in Black and Hispanic populations due to:

  • Frontline job placements.

  • Lack of access to savings or safe housing.

  • Pre-existing health conditions exacerbated by systemic issues.

Strategies to Address Disparities

Expanding Health Coverage and Data Collection

• Expanding Medicaid to cover low-income residents effectively.

• Improve collection and analysis of race and ethnicity data in health care.

Community Health Workers

• Utilizing community health workers to bridge gaps in care.

• Challenges due to funding and fee-for-service billing limitations.

Evidence-Based Treatments

• Implementation of standardized treatment protocols to reduce disparities in care.

• Improving care outcomes across racial demographics.

Conclusion

• Addressing health disparities requires systemic changes, targeted outreach, and comprehensive healthcare policies.

• Effective solutions improve overall health quality for all individuals, not just targeted groups.