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Reducing health care disparities in Rhode Island
By / April 8, 2015 /   Loading Disqus...

“Everyone has their story.”

That was how Dr. Marshall Chin began his presentation on reducing health care disparities at the Foundation last Thursday. His point was that health care providers must be experts in the technical aspects of health care as well as attentive to the social and emotional factors that affect a patient’s well-being.

We were pleased to host Dr. Chin as part of our Civic Leadership Fund Community Conversations series along with partners Brown University Executive Master of Healthcare Leadership, Rhode Island Department of Health and Blue Cross Blue Shield of Rhode Island.

Dr. Chin is a professor of medicine at the University of Chicago and a general internist with extensive experience improving the care of vulnerable patients with chronic disease. He also leads initiatives to improve health care strategies at a national level. 

Dr. Chin pointed out some startling Rhode Island statistics: 
16.6% of African-Americans and 11.3% of Hispanics in Rhode Island have diabetes, compared to 9.3% of the total population. 
23.5% of African-Americans and 37.9% of Hispanics lack health insurance coverage, compared to a statewide rate of 14.6%.
The teen pregnancy rate is 62.9 per 1,000 for African-Americans and 63.5 for Hispanics, compared to 34.0 statewide. Geography matters, too; the teen pregnancy rate is 92.1 in Central Falls, 86.8 in Woonsocket, and 56.1 in all core cities. 

Dr. Chin walked us through his Roadmap to Reduce Disparities, a six-step outline that begins with a recognition that disparities exist and commitment to reducing them. Dr. Chin also made the business case for reducing disparities, pointing out that between 2003 and 2006, disparities in health care cost the United States $229 billion in direct medical costs. ($229 billion!) 

A panel of local experts weighed in on the topic. 

Moderator Visael “Bobby” Rodriguez, vice president and chief diversity officer of Blue Cross Blue Shield of Rhode Island, kicked off the conversation with the question, what would a healthy Rhode Island look like? Angela Ankoma, chief of the Office of Minority Health at the Rhode Island Department of Health, said that the DOH has asked Rhode Islanders this very question, and they clearly know what they need to be healthy, including access to fresh food, safe communities, and quality childcare. She also reminded us that economics and education are two ‘huge” determinants of health. 

Dr. Joseph Diaz, physician-in-chief at Memorial Hospital, emphasized the importance of linking quality and equity. He spoke about shifting the emphasis at Memorial from “the doctor is in” to “the doctor is out (in the community)”. And Marie Ghazal, CEO of the Rhode Island Free Clinic, reminded us that despite gains over the past several years, many Rhode Islanders are still uninsured.

Dr. Chin concluded his presentation with four bullet points for those in the health field to achieve health equity: 
1. Look at your data
2. Talk to your patients and tailor care
3. Align the incentives
4. Assist the safety net

As our panelists pointed out, Rhode Island is moving in the right direction. These steps are aligned with the state’s focus on care coordination, innovative models that meet patient needs, and the payment and delivery systems. The Foundation is pleased to have invested in many of these efforts, and we are committed to working with you to reduce health disparities in Rhode Island. 

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