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Racism called factor in health-care disparities

Stepping outside of traditional model is the key, expert says

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A dialogue on the role racism plays in health care must be addressed as part of any real solution to health disparities racial and ethnic minorities face, according to Brian Gibbs, director of Harvard School of Public Health's Program to Eliminate Health Disparities.

"It's not just the health-care system. It's a confluence of what we consider to be our society," Gibbs told those attending the statewide health summit "Eliminating Inequalities in Utah's Health" Thursday.

He noted that black Americans spent 246 years in slavery, then another 100 years with virtually no civil rights, facing segregation even in hospitals. It wasn't until the Voting Rights Act of 1965, or for the most recent 10 percent of their American history, that blacks have had "a voice," he said.

"We have to be able to step outside of the traditional health model," Gibbs said. "Are we ready to walk this walk? Historically, we've been in this box for over 340 years."

The conference at the Salt Lake City Library was sponsored by Utah Issues, the Utah Department of Health, and the State Office of Ethnic Affairs. It sought to strengthen partnerships among communities and the public and private sectors.

It also sought to define one- and five-year goals for eliminating health disparities in coverage and access, culture and language, data and research, policy and statewide infrastructure, and healthy lifestyles, health promotion and education. Working groups were formed to move forward with those goals.

Agnes Chiao, multicultural health analyst and coordinator for Utah Issues, said solutions will involve public-private partnerships and focus on policy.

"This really is a holistic approach to eliminating health disparities," she said. "It's involving all the different aspects."

According to a Utah Department of Health report on "Health Status by Race and Ethnicity" from 1997 to 2004, some of Utah's health disparities include:

Health insurance: One in four Hispanics doesn't have coverage — more than double the overall uninsured rate.

Infant mortality: Utah's rate is 5.2 deaths per 1,000 live births. The black infant mortality rate is 13.8, the Hispanic rate is 6.4.

Life expectancy: Blacks and American Indians have the shortest at 74.2 years and 74.5 years, compared to 77.9 years overall.

Dr. George Delavan, the health department's division director of Community and Family Health Services, said the state's Multicultural Health Center is working closely with community health centers to improve services.

Delavan said two key issues are coverage and access. He said the health department and the Utah Insurance Department are working closely with Gov. Jon Huntsman Jr.'s office on finding ways to cover the uninsured.

"As far as actually affecting people's access and improving their health access, it's a long road," he said. "Getting to the end point of equal access and then equal outcome is going to take some time and a commitment from all of us."

The conference was the second such held in Utah. The Multicultural Health Center was established by legislative action following the first meeting in November 2003.

The center's ongoing funding doubled to $100,000 this past legislative session, Delavan said, which has allowed for a second position at the center, currently staffed only by the director.

Delavan said the center also recently applied for a federal grant that could potentially add another $150,000 to $175,000 to its budget over the next three years. That funding would allow the center to hire a third staff member and to do more work with communities, he said.

"The main thing we're really working on at this point is to really build the infrastructure at the state level," Delavan said.

E-mail: dbulkeley@desnews.com