When it comes to health, there are disparities that often fall along racial lines.
This is evident here in Lexington, where the coronavirus pandemic has disproportionately been affecting Black and Hispanic communities, according to data from the Lexington-Fayette Urban County Health Department. As of July 31, the health department has reported 3,164 COVID-19 cases in Lexington. Of these patients, 27% have been reported to identify as Hispanic and 20% have been reported to identify as Black. However, these communities make up around 14.4% and 7% of Lexington’s population, respectively.
A committee met for a town hall meeting over Zoom on Thursday evening to discuss issues of health disparity within the Lexington community. The group, a subcommittee of Mayor Linda Gorton’s Commission for Racial Justice & Equality, streamed the meeting over YouTube and took questions from the general public through email. Issues such as food deserts, the utilization of community health workers and major social determinants of health were presented and discussed by the committee.
“We need to start thinking about those social determinants,” said Vivian Lasley-Bibbs, the Vice Chair and a Director of the Foundation for a Health Kentucky. “Where you live where, you learn, where you work, where you play and even where you pray.”
Social determinants of health are social needs such as transportation, quality of education, availability of resources and other major social and economic conditions. According to the Office of Disease Prevention and Health Promotion, a lack of meeting these social needs are a cause of health disparities. During the talk, Bibbs highlighted the use of programs and tools that can overlay census data with health data to find areas of the highest risk conditions, right down to the individual streets.
“Often it’s been said when patients come to see us, the advice we give they have heard it before,” said Dr. Lovoria B. Williams, a professor in UK’s College of Nursing. “They have heard they should change their diet, they should exercise…but we don’t pause enough to ask what are the barriers, the challenges that they are facing so they are unable to do those things.”
“Yes we want to reduce the number of diabetes, that’s great, but there’s also other things we need to change,” said Kacy Allen-Bryant, who serves on the Lexington-Fayette County Health Department Board of Health. Allen-Bryant is also a lecturer and clinical instructor for UK’s College of Nursing. “Other societal, policy-level items we need to change to really help our black and brown communities, and that’s what I would like to see.”
Allen-Bryant listed examples of such policy items including safer parks and recreational areas, mandating grocery stores to have fresh produce, and mandating hospitals to have off-hour outreaches to make healthcare more accessible.
The COVID-19 pandemic has highlighted health disparities across Lexington. One disparity is access to food and the issue of food deserts. The Food Empowerment Project describes food deserts as, “geographic areas where residents’ access to affordable, healthy food options (especially fresh fruits and vegetables) is restricted or nonexistent due to the absence of grocery stores within convenient traveling distance.”
“One of the things that we have seen during COVID-19 is the importance of getting food into the community where people live, rather than expecting people to go to the food,” said Michael Halligan. Halligan serves on the Health Disparities Committee and is currently the CEO of God’s Pantry.
One solution to the health disparities within Lexington communities discussed at the meeting was the community health workers, volunteers who are trusted members within communities. The use of community health workers which has been utilized in Appalachia for more than 20 years.
Dr. Williams also went into detail about the importance of what community health workers would do. “This individual would not just navigate to resources…but that individual would also have an advocacy role where they are at the table.”
Dr. Williams emphasized the importance of communication within communities facing health disparities when members of the community don’t fully trust those within healthcare.
“One thing that I learned early on in my career is that people don’t care how much you know, until they know how much you care,” said Dr. Williams.
Dr. Gerald Smith, a historian of African American studies at UK, brought up the issue of racism within the medical field itself.
“As a historian, I think it is vitaly and critically important that we address the reality that medical racism exists, one, and that there is a long history to that medical racism dating back to slavery,” said Dr. Smit. “That historically, the Black body has been this involuntary site of medical experimentation, dissection and exploitation, and it’s carried over well into the 21st century. And because of that, we have this continuing distrust factor between patient and physician.”
Dr. Smith says that many physicians are unaware of this history which is why he believes implicit bias training is, “vitally important.”
Another issue brought up several times was the lack of minority doctors.
Halligan said, “The ability for someone who looks like Dr. Gerald Smith to find a healthcare professional that has similar color of skin, similar background and experiences is far more difficult than it is for Michael Halligan to find someone, who I can build a relationship with and someone I trust.”
“How do we advocate to change systemic bias in the availability of professional development in one type of community member versus another?” asked Halligan.
“I say this respectively, we don’t need anymore coaches, we don’t need anymore basketball or football players,” said Dr. Smith, whose youngest daughter is going into medical school. “We need nurses, we need engineers, we need attorneys, we need teachers and so forth. So I don’t get excited for coaching programs or athletic programs, that’s not going to change where we are right now.”
There will be another virtual town hall on YouTube from Mayor Gorton’s Commission for Racial Justice & Equality on Tuesday, August 4 at 6:30pm. The meeting will focus on the topics of housing and gentrification and law enforcement, justice and accountability.