As a part of the Luncheon Lectures Program, sponsored by the Texas Department of Health and Human Services, Dr. Alfred McAlister, PhD, a professor in the UT Austin Public Health Department, gave a presentation on the disparities that communities of color often face in accessing healthcare. Dr. McAlister gave his presentation on July 23, 2013 from 12:00-1:00PM. Friday, September 7, 2012.
Latinos and African Americans combined make up close to half of the Travis County population and will exceed that soon. To combat health disparities and chronic disease burdens disproportionately affecting lower-income Latinos and African-Americans here, the Austin City Council has authorized the award of a contract with the University Of Texas School Of Public Health to work with community based nonprofit health organizations. A total of $198,000 is anticipated through September 2013 when full approval is granted.
This contract is supported by the Austin/Travis County Health and Human Services Department with approximately 10% of the funds that were competitively awarded at the national level for Community Transformation Grants (CTG) from the U.S. Centers for Disease Control. This is the first step taken in Austin toward implementation of a key element of the Patient Protection and Affordable Care act: Reducing costs by implementing best practices for disease prevention with an emphasis on the long-term elimination of health disparities.
Dr. McAlister noted that three reports were used to gather data concerning healthcare resources and their accessibility to persons of color: The Critical Health Indicators Report, May, 2012; the Behavioral Risk Factor Surveillance System (BRFSS); and the Children’s Optimal Health data. Used in combination, results for disparities were observed, giving the evidence-based content for various action strategies to be implemented.
Of personal importance to me was seeing if answers and solutions could be provided for the question: what are some of the causes of lack of accessibility to communities of color in the area of mental health? I’m in recovery for mental illness (Bipolar II) and chemical dependency; but I am a white male and have the “privilege” of having healthcare services provided by the VA (I’m a Vietnam Era Vet). So this is a major difference of which I’m very aware.
We have to remember that we still aren’t close to universal healthcare in our nation. It’s become a political “football” and the concern for lower income folks and generally many who live in communities of color simply isn’t there yet. Our country’s elected officials won’t put their money where their mouth is (sorry to be so blunt, but that’s the advantage of being a free-lance blogger—what can I say). This shows an abysmal disregard and negligence for each person who lives in this nation, but especially persons of color who have historically had less resources and accessibility. The disparities still exist, but it’s the hope of the partners, who are a part of this initiative that the Community Transformation Grant, may begin to change this picture.
So, what about Mental Health? There is a correlation between poverty, and the access to healthcare services. The BRFSS demonstrates that 58.4% of the overall population of Travis County is persons of color (African Americans Latino Hispanics, Asian Americans) living at or below the poverty level: this is twice the percentage of Non-Hispanic whites who live in Travis County. In the City of Austin, of all children under five years old living in poverty, 82.8% are Latino American, 13.21% are African American, and 2.3% are non-Hispanic white.
Poverty in communities of color presents stresses that add to mental health issues. Having to choose between paying rent and buying groceries is a major stressor to moms or dads who have children; living in overcrowded situations that many persons and families of color deal with on a day-by-day basis is another stressor. These along with many other stressors can keep folks in a state of high anxiety, or if they have a mental illness can create crisis emergencies, need for crisis intervention, and the need for outpatient or inpatient care.
In data gathering for this initiative, in interviews with residents, in focus groups or structured interviews, residents said that Mental Health Services were foremost among health concerns. Central Health Connection, as a result of their interviews found that 20% of Travis County residents experienced 5 or more days of poor mental health in the past month. Of this category ‘African Americans totaled 24.3%, Latino-Hispanics totaled 26.6%, and the white-non-Hispanic cohort totaled 17.9. This clearly shows us the major difference in mental health concerns and need for services when you combine all groups of color with the percentage of Anglo non-Hispanics.
The focus groups’ members indicated that there are many challenges in the realm of necessary mental health services—the need for affordable, bilingual and culturally competent staff and systems. Focus groups said the emphasis should on the ability to understand and identify mental health needs and accessing services.
These same groups mentioned the overwhelming lack of resources for folks in their communities with mental illness. Insufficient resources translate to longer waiting lists for inpatient services, not to mention the option of choosing your own therapist. Residents also said that the greatest need in the mental health area was removing cultural barriers around mental health. Mental health services for the recently incarcerated were identified as critical; a few residents had concerns that the school system’s capacity to address mental health issues among children who were displaying inappropriate or disrupting behaviors was questionable. Many of these factors may cause or contribute to stigmatization of mental health issues of persons of color.
At the heart of disparities of ethnic groups of color, the need for accessing health care services, whether they be mental health or medical services, is that it’s another line of division and conflict between we as Anglos and various cultures of color or poverty ; this fact continues to perpetuate a superior/inferior dynamic in Travis County; the corollary to any deficiency of access is that real strategies to increase access of each human being who lives within Travis County are implemented–most pointedly to persons and communities of color; in doing so this is tangible evidence of treating all residents with full respect, personhood and dignity; another truism is that accessibility to health care resources and services for all human beings is one of the Universal Human Rights with which we are all born and share together.
If you would like to be a participant, volunteer or engage in some way in any of these initiatives, please contact: http://utsph-arc-transformationgrant.blogspot.com/ to find out more information of how you can do that.
© Christopher Bear-Beam July 25, 2013