Story by: Rebecca Hall on February 26, 2019
Kentucky and Indiana face many challenges when it comes to the health of their residents. They rank among the worst states for obesity and physical inactivity, health outcomes such as diabetes, and cancer and heart disease deaths.
Many of these diseases affect African Americans at higher rates.
Giavonne D. Rondo-Hillman, M.D., internal medicine physician with Norton Community Medical Associates – Jeffersonville, explains why primary care providers are critical to improving health outcomes in the African-American community.
Our primary care providers work with you to prevent disease and keep you well.
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What is the role of a primary care provider?
Primary care is the initial gateway for health and wellness, and a primary care provider sees you first for acute and chronic conditions. Primary care providers are important because we have broad knowledge of general medical conditions, take care of people of all ages and genders, and should have an established relationship with you. A primary care provider can initiate referrals to specialists and then follow up so there is true continuity of care.
The rates of some diseases like heart disease, heart failure, high blood pressure, high cholesterol and diabetes are higher among African Americans and show up at an earlier age. What role does primary care play in preventing, diagnosing, treating and managing these?
There are so many factors within the African-American community that affect health. These include genetics, cultural predispositions, economics, diet and even ZIP code. Primary care providers play a major role because they are the front line in a person’s health and wellness. Patients need to feel like they can talk to their doctor about their family history, diet, health conditions, physical activity and economic situation.
The primary care provider plays a holistic role in helping patients with all of these factors. He or she assesses a person’s health conditions and contributing factors, makes a diagnosis, prescribes treatment, and also educates patients on factors they can do something about, like managing stress or exercising. The primary care provider is also the gateway to the specialist, and can refer a patient with diabetes to a dietician or endocrinologist to help the person learn more about managing the disease.
African Americans are less likely to see a primary care provider or get screenings. What are some barriers they may face?
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 and what role do primary care providers play?
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 affects our health.
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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