OGDEN — Michelle Chino believes that community involvement is key to addressing health disparities.
So, as director of the Center for Health Disparities Research at the University of Nevada, Las Vegas School of Public Health, Chino said, "We put put the public back into public health."
Chino discussed her efforts in "community based participatory research" Friday at Weber State University's eighth annual Diversity Conference.
The conference, themed "Diversity, Equity and Access to Health Care" brought together students, faculty, staff and community leaders to discuss the challenges of making health care accessible to all and closing health disparities.
"We have to be partners with our community if we are going to address public health issues," Chino said. "When we work as partners with the communities on health issues, we empower communities ... leaders emerge."
Chino pointed to some indicators that there are disparities in health care.
American Indians and Alaska Natives were 2.6 times as likely as non-Hispanic whites to have diagnosed diabetes in 2000. Blacks and Hispanics were both about twice as likely, according to the Centers for Disease Control and Prevention.
And, the CDC reported blacks and Hispanics comprised 26 percent of the nation's population in 2001, and 66 percent of adult AIDS cases and 82 percent of pediatric AIDS cases reported in the first half of that year.
Chino said the issue of health disparities extends beyond racial and ethnic groups.
Disparities, she said, can come from socioeconomicfactors, including poverty, the communities where people live or their environment. There are gender disparities and disparities among people living in different parts of the country, and between those living in urban and rural areas, she said.
"My priorities for research have been understanding the differences between populations," she said. "There are problems we can fix, but we don't always know how to begin to address them.
"We're not talking about genetics, we're not talking about personal choice. We're talking about outcomes," she said.
By working with communities, it's possible to engage in dialogues to address issues, such as social and political issues, along with health disparities, she said.
"One of the most important things we need to do is to build trust," she said. "And build a common framework for understanding a health problem."
During one of the sessions, those who work closely with community health discussed some of the ways they're addressing barriers people face to accessing health care — from language to distance.
"It's hard to access health care if you don't have insurance and you don't have a lot of money," said Lisa Nichols, executive director of Midtown Community Health Clinic, which serves low-income patients. "The majority of people we serve are working."
Don Beckwith, Health Program manager for the Utah Department of Health, said those who live in rural areas often face a "huge barrier" to access, as do those who live in urban areas but lack transportation.
He said telemedicine is, to a point, helping to allow doctors in rural areas communicate with specialists at the University of Utah.
Nichols added that even in urban areas, transportation can be an issue. For advanced AIDS patients, the nearest clinic is in Salt Lake, which can mean a two-hour bus ride.
Betty Sawyer, director of the Harambee African-American Tobacco and Health Network, said a community's attitude and belief about physicians is important, as is culturally competent care.
"In Utah, almost 100 percent of African Americans have never been to an African American physician in their life," she said. "Having someone you feel comfortable with goes a long way."
Sawyer said doctors need to ask more questions of patients who may not know what questions to ask. She said her organization is an effort aimed at "getting our community to understand more about their health, taking charge, so they can ask more questions."
E-mail: dbulkeley@desnews.com