Nov. 5--An overhaul of the U.S. health-care system has gained the floor of national debate, speakers at a conference on health disparities said yesterday.
What is done to spur and inspire changes in culture, lifestyle and infrastructure will determine whether changes happen in meaningful and measurable ways within local communities.
The town-hall meeting, featuring national health-care experts, served as the opener of a three-day conference, "Faces of a Healthy Future," in downtown Winston-Salem.
The conference is being conducted by the Center of Excellence for the Elimination of Health Disparities at Winston-Salem State University. The goal is discussing health-care issues for specific populations, including people of African, Asian, Hispanic and American Indian descent, and of veterans, the disabled and those with mental illness.
Although the panelists offered national data as evidence of health disparities, they acknowledged that opinions are often better swayed by identifying local gaps, issues and concerns.
For example, several panelists cited the fact there were 6.4 deaths of white infants and 25.3 deaths of nonwhite infants for every 1,000 live births in Forsyth County during 2009. The Forsyth County Health Department said that blacks represent more than 80 percent of the nonwhite population in the county.
"When it's a national report, that's other people, that's them," said Dr. Carolyn Clancy, the director of the federal Agency for Healthcare Research and Quality. "If it is your hospital's data, suddenly this is personal and everyone is extremely uncomfortable."
Disparities touch most aspects of health care, according to the panelists and other speakers.
One certainty about the H1N1 virus is that it does not respect socioeconomic boundaries, said Dr. Jeff Engel, the state's health director. He spoke before the panel discussion.
However, Engel said, minorities are affected by disparities in most chronic illnesses, such as heart disease and diabetes, as well as infant mortality and sexually transmitted diseases.
"We need evidence-based research and strategies for narrowing the gap of health disparity and the outcome," Engel said.
The panel's moderator, Dr. Sanjay Gupta, a neurologist and the senior medical correspondent for CNN, said that effective health-care reform cannot take place without conferences such as this one.
"The things that people want in regards to their health are the same in eastern Africa as they are in the eastern United States," Gupta said. "It can be a great common denominator.
"But health disparities can also be some of the most awful and tragic stories. How to resolve those disparities is one of the great challenges of our time."
Dr. Carolyn Britton, the past president of the National Medical Association, said that her agency encourages a crib-to-grave approach to educating consumers about taking responsibility for their health, through such tools as diet and exercise, and dealing with disparities.
Panelists said that institutional bias, sometimes manifesting itself as racism, is contributing to health disparity. They said that it can be the culture within a hospital or the attitude of an individual physician.
Identifying and uprooting the bias is necessary to keep it from affecting the medical outcome of patients, said Dr. Garth Graham, the deputy assistant secretary for minority health for the U.S. Department of Health and Human Services.
The panelists said that changing the infrastructure encompasses a wide spectrum, such as having more interpreters in emergency rooms to eliminate language barriers, more money for loan-repayment incentives for medical students, and more exercise outlets for low-income residents.
"I'm rather optimistic that eliminating health disparities can and will get done," said John Ruffin, the director of the National Center on Minority Health and Health Disparities for the National Institutes of Health. "We have shown we can recruit the best and the brightest to research how to resolve these disparities."
For some minority groups, health disparities can be an issue of trust regarding health-care providers and medical breakthroughs, Ruffin said. Some of the conversation about the H1N1 vaccine wasn't about its availability, but "whether I should take this, should I let my grandchildren take this?" he said.
Ruffin said that efforts must go beyond the "discussion of the month" to sustainability.
"We can't give up the research until the disease has been eliminated," he said. "Our strategy cannot be isolated or stagnant. It will take all of us working together to eliminate health disparities."
rcraver@wsjournal.com
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More activities
"Faces of a Healthy Future: National Conference to End Health Disparities II" will run until noon Friday at the Benton Convention Center, Embassy Suites and Marriott in downtown Winston-Salem, and at Winston-Salem State University.
There are ticketed activities open to the public today at Embassy Suites:
A 12:30 p.m. luncheon on disparity issues in the area of breast cancer will feature Elizabeth Edwards as a guest speaker. The cost is $50.
An awards gala will be held from 6:30-11 p.m. Cornel West, a professor at Princeton University, will be the featured speaker. The cost is $85.
A book-signing will be held from 3:30-4 p.m. today involving authors Sergio Auguilar-Glaxiola, Dr. James Gordon and David Moller.
For more information, call Patty Drummond at 704-326-6338.
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