Exploring Factors Affecting Diverse Communities During COVID-19

ACIA 2021

Presenters

Eva Lopez, Au.D. Brittney Sprouse, Au.D.

Bilingual CI Consumer Specialist, Advanced Bionics Director of Audiology, University of Chicago

Medicine

Financial Disclosure: Eva Lopez is a paid employee of Advanced Bionics. Advanced Bionics is the manufacturer of the HiResolution

Bionics System.

Learning Edges and Comfort Zone

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Threats Fear

ActionAwareness

Information

Comfort

Zone

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The death of George Floyd sparked an outpour of emotions

Why are we here today?

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History

Women’s Health

• James Marion Sims• 19th century physician, credited as the “father of modern gynecology”

• Developed pioneering tools and surgical techniques related to women’s reproductive health

• Research was conducted on enslaved black women without anesthesia, even after it became available

• Operated under misguided belief that black people do not experience pain like white people do

• Henrietta Lacks• Prior to her death in 1951, her surgeon took samples of her cervical cancer tumor without consent

• Lacks’ cells, nicknamed “HeLa” cells, doubled every 20 to 24 hours

• The cells are used to study the effects of toxins, drugs, hormones and viruses on the growth of cancer cells without

experimenting on humans.

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History

Tuskegee Study

• Began in 1932 to record the natural history of syphilis to justify treatment programs for blacks

• Study was called,

“The Tuskagee Study of Untreated Syphilis in the Negro Male”

• Initially involved 600 black males

399 with syphilis, 201 without syphilis

• Study was meant to last 6 months, yet lasted 40 years

• In July 1972, an Associated Press story about the study caused a public outcry

Led the Assistant Secretary for Health and Scientific Affairs to appoint an Ad Hoc Panel to review

the study

• The advisory panel concluded that the Tuskegee Study was “ethically unjustified”

The study was ended in October 1972

Current Health Disparities

Affecting the African-American Community

BIPOC (Black, Indigenous, People of Color) Experience Increased Health Risks with COVID-19

Due to racial/ethnic disparities that exist in American society

• African-Americans, Latinos, and American Indians/Alaskan Natives are 4 times more likely to be hospitalized than white Americans

• African-Americans and Latinos are 4 times more likely to be die from COVID-19 than white Americans

CDC.GOV (Updated

01.14.21)

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Health Disparities

“A particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.” (Healthy People 2020)

Racial Health Disparities:

• Implicit Bias refers to learned stereotypes and prejudices that operate automatically

and unconsciously

• Systemic racism takes into account the many ways societies foster racial

discrimination through housing, education, employment, media, health care, criminal

justice, and other systems.

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Different Types of Racisms

• Colorism• Privileging of lighter skin over darker skin

• Colorblind• “I don’t see color.”

• “All lives matter.”

• Laissez-faire• Blaming minorities for their problems

• Anti-native, perceives racial group a threat

• Implicit bias• Hiring someone because they share the same experiences as you

• Making assumptions about someone’s experience

Different Types of Racisms

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Systemic Racism

defined

First defined by Stokely and Hamilton (1967), institutional racism refers to particular and general instances of racial discrimination, inequality, exploitation, and domination in organizational or institutional contexts, such as the labor market or the nation-state.

The rules, processes, and opportunity structures that enable such disparate impacts are what constitute institutional racism

Systemic racism operates at the societal level and is the power used by the dominant group to provide members of the group with advantages, while disadvantaging the nondominant group. The dominant group uses systemic racism not only to obtain resources, such as employment and wages, but also to limit the nondominant group’s access to these resources.

Examples:

• Racial profiling by police

• Misrepresentation of certain racial groups in media outlets

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Healthcare System and Medical Resources

Systemic Examples

• Healthcare facilities more likely to close in poor and minority communities• Unequal access to healthcare

• Minorities are more likely to be misdiagnosed and receive improper care• Leading to poorer health

• Clinics in poor and minority communities are overwhelmed, long wait times for appointments

• Leads to delayed services and care

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Healthcare System and Medical Resources

During COVID-19

• Access to COVID-19 testing sites• Difficult to get to for some

• Cost of testing

• Delayed results at free sites

• Loss of healthcare• Inadequate care with COVID

• Lack of protective gear (PPE)• Cost of PPE

• Distribution of COVID-19 vaccine• Barriers to distributing in underserved neighborhoods

Tips and Considerations

Check-in

Be ready to listen to experiences unlike your own

Make sure basic needs are being met

Consider that your experiences may be different

Do not invalidate fears and concerns surrounding COVID-19

When working with diverse populations

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Ways to Overcome Cultural Barriers

Enables patients to play a meaningful role

in developing solutions

Build partnerships with patients

These are more likely to be

effective

Use interventions that target multiple determinants of health

Use clinical guidelines, standardized

checklists

Remove as much individual discretion as possible

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The importance of culture in healthcare

• Cultural differences are powerful determinants of health-

related behavior

• Understanding someone’s culture includes understanding

the effects systemic racism has had in their life.