Novello: An Inside View of Minority Healthcare

Uneven delivery of health care across the socioeconomic and ethnic spectrum is one of the major aspects of the crisis in health care that we face here in the United States. With that in mind, we are going to examine Dennis Taylor’s article in today’s issue of the The Monterey Herald, where he shares details from a lecture by Dr. Antonia Novello at the Monterey Conference Center:

The Puerto Rican-born physician offered the health care system of New York state — where she has been commissioner of health since 1999 — as an example of how to improve the system.

"People believe that socio-economic issues are the only things that trigger disparities in health care in our country, but it has been found that it is much more than that," said Novello, who became the first woman and first Latina to serve as U.S. Surgeon General during the administration of President George H.W. Bush. "The factors include poverty, lack of good health insurance, lack of good health care, distrust of the system."

Cultural and communication problems are a big part of the problem, she said. […]

Another perception, she said, is that private patients get seen by attending physicians, while the poor get seen by medical students or residents.

"Sometimes those students are tremendously sharp," she said. "The problem is that a patient rarely is seen by the same student at the next appointment."

Poverty is another concern, the doctor said, when exorbitant percentages of a person's income go to necessities such as rent, food, child care and transportation.
"Every time you have to make a decision, you have to ask yourself, 'Where do I invest my money?' Sometimes it's not that we don't want to (seek medical help); it's that we can't because our money is positioned to serve certain necessities."

Novello stressed that health care professionals must take time to inform people of the avenues that are available to them, because "information is power," she said.

Information is, indeed, key. People need to have access to accurate data in order to make informed decisions about their health care. You cannot choose if you don’t know the options available. You cannot choose if communication with your provider is obscure or unclear. You cannot choose if there is no adequate way of comparing the performance of potential providers.
Information, data portability, transparency, and common provider numbers are all extremely important steps on the road to universal health care.

SOURCE: " Improving minority health care " 01/25/08
photo courtesy of akeg, used under this Creative Commons license