Despite the somewhat festive atmosphere of a family reunion, I knew that I was all about business last week at the UNITY 2008 journalism convention at McCormick Place in Chicago when I bypassed a booth where one of my favorite R&B singers was sitting so that I could get to an interview with an expert on diabetes prevention initiatives.
The quadrennial conventionheld July 23-27 with more than 5,000 journalists from the Asian American Journalists Association, National Association of Black Journalists, National Association of Hispanic Journalists and Native American Journalists Associationhad major turnout from the healthcare industry this year, including reps from Eli Lilly and Co., GlaxoSmithKline, the March of Dimes, the Mayo Clinic, the National Institutes of Health, the National Diabetes Education Program and Novo Nordisk. The industry insiders were there to inform journalists about how better to present healthcare issues from the perspectives of people of color.
Novo Nordisk sponsored one of the first healthcare-oriented workshops, titled The Exploding Diabetes Epidemic: A Call to Action for Journalists of Color, with physicians and researchers from Harvard Medical School and Johns Hopkins University discussing the ways diabetes disproportionately affects minorities and what can be done to stem the rising numbers of Type 2 diabetes among that population. Citing the fact that both her husband and son have a hereditary link to diabetes, panel member Sherita Hill Golden, associate professor of medicine and epidemiology at Johns Hopkins University School of Medicine, said, I plan to spend the rest of my career trying to figure out what causes it and (how) to fight it.
Hill Golden, along with Anne Sumner, clinical investigator at the National Institute of Health; Enrique Caballero, assistant professor of medicine at Harvard Medical School; Mona Khanna, a physician and former journalist and Food and Drug Administration advisory panel member; and Telemundo broadcast anchor Zoraida Sambolin all stressed the importance of cultural sensitivity and education in understanding why people of color are affected with diabetes in higher numbers than whites, and in order to better treat and prevent it. Traditional diet, socio-economic factors, language barriers, stereotyping bias, and underlying mistrust all play a role, Caballero said. He relayed a story of a Latino patient who misread a bottle of pills that directed once a day to take 11 pills at one time, because once in Spanish means 11. She almost died. Either the patient did not understand and couldnt make her lack of comprehension clear or the doctor did not take the time to explain, he said. We need to go beyond the usual in order to have effective treatment with our patients.
Caballero suggested that states increase for their teaching hospitals credits or reimbursement for doctors who take classes related to what he called cultural competency.
Hill Golden said that primary-care physicians should be stressing prevention more with this population. People think that being at Johns Hopkins that we can sprinkle something magic on them and their diabetes will go away. But we tell them about lifestyle changes. To lose weight and eat better, she said.
At the end of the panel, during which lunch had been provided, there were whole tables full of apples that were completely untouched. Most of the chips and cookies were gone.
Another major healthcare-related session was Confronting the Nations Most Pressing Health Issues, sponsored by Eli Lilly and moderated by CNN anchor Soledad OBrien, who seemed unable to resist plugging her recent CNN special on the black experience in America before asking every question. Panel members included Alfonso Alanis, chairman and chief executive officer of Anaclim, an Indianapolis-based contract research organization working to get more people of color to participate in clinical trials; Liany Elba Arroyo, director of the Institute for Hispanic Health; Garth Graham, deputy assistant secretary for minority health at HHS Office of Minority Health; D.J. Ida, executive director of the National Asian American Pacific Islander Mental Health Association; and Robert Moore, district 3 council representative of the Rosebud Sioux tribe in South Dakota.
Access, access and access, again, is the key to addressing disparities of care between people of color and whites, according to Arroyo. In addition to some of the issues cited by the diabetes panel, the health issues panelists said that socio-economic factors and a lack of primary-care physiciansparticularly minority doctorscan often lead to the disparities in treatment that in turn contribute to the prevalence of expensive and debilitating illnesses and chronic diseases in minority communities.
The panel also pointed to cultural reasons for mental health treatment disparities between whites and people of color. For us mental healthcare has happened to us, not with us, Moore said. On the tribal side, were trying to restore a sense of tribal identity and explore cultural and spiritual methods to strengthen their identity to better address mental health issues such as depression, he said.
Ida agreed that the same was true in the Asian American and Latino communities. There is often a lack of language to discuss whats going on, she said. Depression and alcoholism are showing up disproportionately in communities where young children with immigrant or non-English speaking parents have to take on translation and other grown-up responsibilities at a young age, causing extreme stress, she added. Garth cited studies done on depression in the African-American community and the role stress plays, particularly for black women, who may suffer more physical side-effects of their depression such as higher infant mortality rates, high blood pressure and high cholesterol.
However, one of the more interesting facts was presented by Alanis. The problem with data for new treatmentwith data on diseases that affect minority populationsis that the data is mostly generated in nonminority communities, he said. An estimated 85% of people who participate in clinical trials are white, he said. When looking at treating diseases that disproportionately affect people of color, how effective can drugs be when not tested on the people who are affected by them the most and who have physical variables that affect drugs efficacy? Who wouldnt want minorities in their trials if these are the people who are going to be buying your drugs? Alanis asked.
By addressing issues of access such as providing transportation, payment or reimbursement of lost wages, and even providing childcare for participants, Alanis says his organization has a 97% compliance rate.
The panel wrapped up with a discussion on how well healthcare issues of minorities are being covered in the media, and ended exactly on time, as OBrien sternly told those with questions to wrap it up. You know how I am about time! Other panels included one on HIV prevention, during which the same concerns were expressed about the lack of minority participation in clinical trials for treatment drugs and for a possible vaccine.
Stacie Williams is a Chicago-based copy editor for Modern Healthcare. She can be reached at [email protected]