Partnerships can help reduce health disparities
Imagine a jumbo jet taking off from an airport every day and crashing, killing all 265 people on board, said David Williams, the Harold R. Cruse Collegiate Professor of Sociology, March 28 to an auditorium full of people.
The same number of deaths occurred daily in 1998 in the African American community due to racial health disparities, according to a 2001 study.
"That is 96,800 Black people a year who wouldn't have to die if there were no racial disparities in health," said Williams, who also is a senior research scientist at the Institute for Social Research and professor of epidemiology in the School of Public Health (SPH). "We have failed; we have made little progress in reducing the elevated death rates of Blacks relative to whites," Williams said as he opened a recent colloquium hosted by U-M on health disparities.
Differences in death rates among people from the African American, Latino, American Indian and white communities is one health disparity Williams examined. Others included infant mortality, life expectancy and vulnerability to conditions such as heart disease, cancer and diabetes.
Williams said that in 2001, African Americans had a higher mortality rate than whites in 12 of 15 leading causes of death and that the death rate for Blacks today is equivalent to that of whites 30 years ago. He said socioeconomic factors, segregation and racism all contribute to poor health and create gaps. "In the last 50 years, although overall health has increased, racial differences in health disparities are unchanged," he said.
Forming campus-community partnerships to close these gaps was the subject of "Beyond Description: Addressing Health Disparities through Campus-Community Partnerships," presented March 28-29 by the U-M National Center for Institutional Diversity (NCID). Organizers said the event extended beyond simple descriptions of the gaps that divide society and instead focused on how colleges, universities and their partners can work together to address the underlying causes that affect health.
NCID Acting Director Patricia Gurin said she was pleased the colloquium advisory committee did not plan the conference around uninsurance, or other factors commonly associated with poor health, but instead focused on the root causes of health disparities in the United States.
"This conference was a reminder that racism, poverty and segregation are the fundamental reasons for health disparities," Gurin said. "Whatever (the conference attendees) are doing, we are chipping away at these root causes."
Much of the first day of the colloquium focused on efforts to reduce malaria and asthma, and address nutrition, obesity and oral health problems. Day 2 participants studied what works when campuses and communities come together, and how to sustain healthy change.
"We are faced with challenges, but they also create opportunities," said Michigan Surgeon General Dr. Kimberlydawn Wisdom. "We not only have to look at behavioral changes, but also policy and environment changes."
These include making healthier foods available in all communities. Sister Mary Ellen Howard of the Cabrini Clinicthe oldest free medical clinic in the United Stateslives in Detroit and says she cannot find fresh produce or skim milk, and that the closest Meijer is 20 miles away. "When people are hungry and poor, they will eat whatever they can get their hands on," she said.
Dr. Kim Eagle, the Albion Walter Hewett Professor of Internal Medicine and clinical director of the Cardiovascular Center, talked of the Ann Arbor Healthy Schools Project, which has increased physical activity and healthy food choices in middle schools.
"We are killing our kids with food," Eagle said, noting that in the 1950s the average soft drink size was 6.5 ounces; today it's 20 ounces. "Your child and my child deserve better."
The Ann Arbor schools project was one of several campus-community partnerships highlighted during the colloquium. Barbara Israel, SPH professor of health behavior and health education, said when universities reach out to partner with communities to do research on health, efforts must involve community members and researchers equally. Creating a university-community partnership is a long process, she said, "and it must benefit the community."
Cleopatra Howard Caldwell, SPH associate professor of health behavior and health education, agreed that partnerships take time to develop: "This process does not include only one project," she said. "This is a long-term commitment."
Mildred Thompson, associate director of PolicyLinka national nonprofit organization working to advance policies to achieve economic and social equitysays sustaining partnerships and making a difference involves gaining trust. "You are not going to be able to go in and make wholesale changes," she said. "There needs to be a trust; a win-win for both sides."
Dr. David Gordon, associate dean for diversity and career development in the Medical School, professor of pathology and colloquium steering committee member, opened the first day with an example of a successful change in one historic health trend.
"These things may seem like insurmountable goals," he said, citing a lack of organ donation in the African American community. "That has been addressed in many local and national forums, and now the organ donation rate among African Americans is comparable to the rest of the population."
"It is an example of what we can do when we put our minds to it."