Overcome health disparities with communication, respect -- November 2002 -- FP Report

November 2002 • Volume 8 • Number 11

"Much of the important stuff that goes on to eliminate disparity is what goes on between doctor and patient," says Denise Rodgers, M.D.

Overcome health disparities with communication, respect

BY CINDY McCANSE

If providing preventive services for minority patients is a significant part of your practice, chances are you already know overcoming health disparities is the name of the game. That observation came courtesy of Denise Rodgers, M.D., during her Oct. 17 lecture, "Primary and Secondary Prevention in Minority Populations."

Rodgers is associate dean for community health at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick. The session was offered as part of the 2003 Annual Clinical Focus on prevention, which kicked off at the Assembly.

Reports of health disparities based on gender, race, ethnicity and other factors are abundant in the medical literature, Rodgers noted. For example, in 1999, the most recent year for which data were available:

the life expectancy at birth for blacks was six years less than that for whites;
the infant mortality rate among blacks was 2.4 times that for whites, while Native Americans were 1.6 times more likely to die in the first year of life than were whites; and
black adults were 28 percent more likely than whites to die from heart disease and were 38 percent more likely than whites to die from cerebrovascular disease.

The numbers clearly show the problem. What they don't show is the solution. "Much of the important stuff that goes on to eliminate disparity is what goes on between doctor and patient," Rodgers said.

"As family physicians, we are extremely aware of the importance of effective communication in doing our jobs," she said. Poor communication leads to poor quality of care and, ultimately, poor outcomes.

Respect -- both for your patients and for their health beliefs -- is key in getting those patients to communicate with you, Rodgers added. Surveys have shown that a sizeable proportion of patients feel they are disrespected within the health care system. That percentage is greatest among minority populations, she said.

Pose the following question to yourself, Rodgers suggested: "'How do I begin as a physician to understand the health beliefs that you as a patient bring to the office?' Until we break down some of these health belief barriers and begin to learn from our patients, we're going to continue to see these disparities."

Putting that insight to practical use is the next step, according to Rodgers. "If we do not figure out how to streamline our practices so that we can once again develop meaningful, longitudinal relationships with our patients -- so that we can understand their health beliefs and their health practices -- we will not be able to educate patients in ways that will make a difference in the elimination of disparity," she said.

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