HV Triad 1: Do things differently

Inequity in Care- and how unconscious bias can influence patient outcomes

Years ago I did a home visit for a middle school student who cared for her grandmother. When I arrived, she was also caring for her cousin who was 2 years old. Her cousin was missing his hands and feet. At some point, the mother arrived and shared the story of how her son lost his limbs. She shared he was sick, and she went to several er’s and was turned away and accused of abusing her son as his limbs were black and blue. Eventually her son was received at a hospital, and was eventually diagnosed treated for an infection, eventually resulting in the loss of limbs. I always wondered if this mother was taken seriously at the 1st hospital, and her son received the appropriate treatment in a timely manor, would he still have his hands and feet. This experience demonstrated to me people may have a difference experience when seeking medical care based on unconscious biases people have.

Racial Inequity in the workforce.

When the pandemic hit, many more black employees in our workforce had to continue working at our group homes whereas most white employees were able to work from home. This resulted in a much higher rate of black employees contracting the virus versus white employees. Due to their circumstances and lack of access to educational opportunities, black employees hold most of the lowest paid positions at our company, while mostly white employees hold management or senior management positions.

Inequality of Opportunity in a Prison

Last spring, prior to the pandemic, I volunteered as a teaching assistant at a prison that offered some inmates the opportunity to receive an associate degree. In order to be eligible, there were requirements such as not having had an incident in the past 6 months. Despite the majority of prisoners being Black, my class only had 3 Black students of 13 students total. This represents inequity because in a prison where less than 25% of prisoners are white, white prisoners represented over 75% of this class, a class which was designed to create more opportunities for them upon release.

Stolen Dreams and Opportunities

When I was in college I wanted to study abroad. I completed my application and submitted all of the necessary papers. However, my advisor did not support my interest and he actually did not provide any information for me to review. My advisor told me that was not a good fit for me and that it was too much for me to handle with my course work. I had to do my own research for opportunities such as exchange student and scholarships. I did not know the process or where to begin, it was really discouraging at 18 years old. My roommate had the same advisor and not only did he encourage her, she was provided informational packets and then shared her excitement with me. Well, guess who announced that she was selected to study abroad the following semester with all expenses paid. My college roommate! The information that she received was not available for everyone and it was totally unfair. Inequity on so many levels. I had a higher GPA than she did, I expressed my interest and she did not but, was chosen! Information was not shared with everyone and the selection was bias! Application process was never shared!

Childhood dreams

While at a conference, that was primarily attended by while colleagues, I was often in spaces where I was the only black person. on one occasion the conversation drifted to childhood and upbringing and even how the majority of my white colleagues raised their children. It amazes me how much they had access to. how much more of the world they were exposed to and how race wasn’t a constant conversation in their home. It makes me jealous and joyful at the same time. but that access/equity will never sit well with me

Access During Pandemic

During the pandemic, there continues to be a gap in access between “the Coast” and “the Glades”. When the began to offer COVID-19 testing at the Ballpark and Delray, it was almost 4-6 weeks later until testing was available in the Glades. Now with the vaccines, the same thing is happening again with Glades not being given “access” because we don’t have a Publix in our community.

Challenges of SSI Disability Benefits

For those individuals seeking SSI-Disability Benefits, individuals who can afford to hire an attorney to advocate and complete forms, and work within the system are two times more likely to be approved for benefits on the first “go around” that those who don’t and definitely increase the approval rating when reapplying after initial denial. However, those who are really in need of guidance, often have lower incomes (if any) and cannot afford or have the ability or access to easily obtain legal counsel. Once approved for benefits, the waiting period for health care access and services through Medicare does not begin until 2 years after approval — a time when many need it most. “People who will become eligible for SSDI benefits are significantly more likely to be uninsured than other workers—an average of 22 percent over the three years prior to SSDI entry, compared with 16 percent in the general population” with the likelihood “living in a family whose income is below the federal poverty level being twice as high among people receiving SSDI benefits as among those who have not yet become disabled” The cost of coverage through COBRA is “cost-prohibitive” for many of these individuals.

Many individuals and families absolutely give up even trying to obtain these benefits even though they are entitled to receive the funds and critical health care services.

Changed Systems

I came from very humble beginnings growing up in the hard of Boynton Beach. I experienced all the risk factors many young black men in similar communities face each day (Single parent household, juvenile delinquency, teen parent). The odds were stacked against me and I was able to maneuver through the systems and barriers and graduate high school and college. In spite of my success, graduating college and becoming a success story for the Department of Juvenile Justice, I was unable to gain employment with the agency because of my juvenile record. There were inequities in their systems which prevented individuals like myself from being a part of the agency. They have made changes and modifications to their process to allow individuals with backgrounds the opportunity to work for the agency considering they are of good moral character.

Adoption Bias in OBGYN Setting

As a black women with fertility concerns, my Asian OB-GYN, suggested I freeze my eggs or start planning for adoption. However, the doctor warned me not to get a black baby because they usually crack babies, and to think about adopting a Chinese baby.