Meeting African American patients where they are

Diabetes, cancer and heart disease can affect African American patients in Kentucky and Indiana at higher rates than the general population.

Recognizing the unique needs of these patients and the critical role a primary care provider plays in addressing them is critical to improving health outcomes in the African American community.

Giavonne D. Rondo-Hillman, M.D., internal medicine physician with Norton Community Medical Associates – Jeffersonville, answers some questions about treating African American patients and new approaches to reaching these patients who may have a historical distrust of medical providers.

What are some barriers African Americans may face to seeing a primary care provider or getting screenings?

There are several things that may play a role in African Americans not seeing a primary care provider. Traditionally our country’s history of African American enslavement laid an unfortunate foundation in the mistreatment of African Americans. This was followed by Jim Crow laws, enforced segregation and lack of education. These placed institutional barriers to adequate health care for African Americans.

Economic and cultural factors play a role. When you have a disenfranchised, poor population overall, your focus is to go to work and put food on the table, rather than take time off to see a health care provider.

I also think there may be a certain amount of distrust in and fear of the medical establishment. When you look at health care in general, you’re more likely to trust someone and take the person’s advice if you believe the person has your best interest at heart. The health care field lacks diversity, and there is a particular gap with African American physicians who are able to show African American patients that we are there and we do care.

The schools of medicine, dentistry and nursing are working hard to improve diversity.

What can be done to improve health outcomes for African Americans?

There are so many different ways to approach these issues, but the first thing is identifying that problems and disparities do exist, because you can’t fix a problem you won’t face.

We as African Americans can do a lot for ourselves by taking inventory of our lives, our families and our communities, and being open, honest and direct about our health. A primary care provider can help us take inventory of our health and identify issues.

It’s important for each individual to account for what and how much we eat, how much we exercise daily, how we handle stress, how much we sleep, and unhealthy behaviors like smoking, excessive alcohol use, any illicit drug use, exposure to firearms and the environment or community where we live. Today, we have to consider how things like texting while driving affect our health.

What are some ways to overcome any distrust of the medical community?

African American churches play a major role in African American communities, so I see a lot more health-related topics in churches and churches hosting health fairs, screenings, discussions and other health-related activities.

Schools play a role in healthier lifestyles by providing healthier meals that place importance on fruit, vegetables, whole grains, lean meat and water intake, and encouraging physical activity with more movement in the classroom, recess and sports.

In some larger cities, practitioners are coming into barber shops or hair salons to see people, or the barber is checking blood pressures. There are screenings occurring in grocery stores and other places in the community to meet people where they are.

Telemedicine and services like Norton eCare may help us provide services to people who can’t have those needs met in the traditional fashion.

We’re still looking at different options and trying to get out into the African American community. We have to meet people where they are, and we have to reach outside the box.

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