Build Your Pre Med Resume.

Consider Developing a Health Disparities Project

 _____

Your Health Disparities Project:

Developing Your Pre Med Resume Through Service & Research

Jo Peterson, Ph.D.

Director, Minnesota’s Future Doctors

Thinking about becoming a doctor?

You’ll need to get into medical school first.

It’s true. Medical schools are looking for applicants who have high college grade point averages and excellent MCAT scores (scores from the Medical College Admissions Test).

It’s also true that the smartest students in college biology and chemistry classes aren’t always accepted into medical school.

What’s the disconnect?

What’s the key to becoming an excellent medical school applicant?

Well Rounded Medical School Applicants Have Unique Experineces in Medicine

The truth is, many medical school applicants haven’t taken the time to become well-rounded in medicine during their undergraduate college years. They haven’t volunteered within underserved communities who have limited access to healthcare, led projects related to health care, or set foot in a medical facility to see what doctors do on a day to day basis.

Why would a medical school admissions committee select an applicant who hasn’t been active in healthcare settings or demonstrated his or her interest in helping challenged communities become healthier? Wouldn’t a medical school admissions committee look for someone who has been in healthcare, volunteered in at risk communities, and developed leadership skills while serving in a healthcare environment?

Today’s medical schools are looking for young leaders with compassion. They’re also looking for future leaders who have demonstrated their commitment to do research, helped underserved communities become more healthy, and thought about what it means to have health concerns in a country that is known for world class medicine.

You can be a leader. You can demonstrate your commitment to serving others.

One way to demonstrate your leadership qualities, interest in research, and commitment to serving underserved communities is to create and implement a health disparities project.

Health Disparities that Impact You

Health Disparities Defined

Health disparities refer to gaps in the quality of health and health care across racial, ethnic, and socioeconomic groups.

This information was found in:

U.S. Department of Health and Human Services (HHS), Healthy People 2010: National Health Promotion and Disease Prevention Objectives, conference ed. in two vols (Washington, D.C., January 2000).

In the United States, health disparities are well documented in minority populations such as African Americans, Native Americans, Asian Americans, and Latinos. When compared to whites, minority groups have higher incidence of chronic diseases, higher mortality, and poorer health outcomes. Among the disease-specific examples of racial and ethnic disparities in the United States is the cancer incidence rate among African Americans, which is 10% higher than among whites. In addition, adult African Americans and Latinos have approximately twice the risk as whites of developing diabetes. Minorities also have higher rates of cardiovascular disease, HIV/AIDS, and infant mortality than whites.

This information was found in:

Goldberg, J., Hayes, W., and Huntley, J. "Understanding Health Disparities." Health Policy Institute of Ohio (November 2004), pages 4-5.

American Public Health Association (APHA), Eliminating Health Disparities: Toolkit (2004).

Causes of Health Disparities

There is debate about what causes health disparities between ethnic and racial groups. However, many recognize that disparities can result from three main areas:

1.                    From the personal, socioeconomic, and environmental characteristics of different ethnic and racial groups.

2.                    From the barriers certain racial and ethnic groups encounter when trying to enter into the health care delivery system.

3.                    From the quality of health care different ethnic and racial groups receive.

Is Access to Healthcare the Cause of Most Disparities?

Each of these three dimensions have been suggested as possible causes for disparities between racial and ethnic groups. However, most attention on the issue has been given to the health outcomes that result from differences in access to medical care among groups, and the quality of care different groups receive.

Reasons for disparities in access to health care are many, but can include the following:

Lack of insurance coverage.

Without health insurance, patients are more likely to postpone medical care, more likely to go without needed medical care, and more likely to go without prescription medicines. Minority groups in the United States lack insurance coverage at higher rates than whites.

Lack of a regular source of care.

Without access to a regular source of care, patients have greater difficulty obtaining care, fewer doctor visits, and more difficulty obtaining prescription drugs. Compared to whites, minority groups in the United States are less likely to have a doctor they go to on a regular basis and are more likely to use emergency rooms and clinics as their regular source of care.

Lack of financial resources.

Although the lack of financial resources is a barrier to health care access for many Americans, the impact on access appears to be greater for minority populations.

Legal barriers.

Access to medical care by low-income immigrant minorities can be hindered by legal barriers to public insurance programs. For example, in the United States federal law bars states from providing Medicaid coverage to immigrants who have been in the country fewer than five years.

Structural barriers.

These barriers include poor transportation, an inability to schedule appointments quickly or during convenient hours, and excessive time spent in the waiting room, all of which affect a person's ability and willingness to obtain needed care.

The health care financing system.

The Institute of Medicine in the United States says fragmentation of the U.S. health care delivery and financing system is a barrier to accessing care. Racial and ethnic minorities are more likely to be enrolled in health insurance plans which place limits on covered services and offer a limited number of health care providers.

Scarcity of providers.

In inner cities, rural areas, and communities with high concentrations of minority populations, access to medical care can be limited due to the scarcity of primary care practitioners, specialists, and diagnostic facilities.

Language barriers.

Language differences restrict access to medical care for minorities in the United States who are not English-proficient.

Health literacy.

This is where patients have problems obtaining, processing, and understanding basic health information. For example, patients with a poor understanding of good health may not know when it is necessary to seek care for certain symptoms. While problems with health literacy are not limited to minority groups, the problem can be more pronounced in these groups than in whites due to socioeconomic and educational factors.

Lack of diversity in the health care workforce.

A major reason for disparities in access to care are the cultural differences between predominantly white health care providers and minority patients. Only 4% of physicians in the United States are African American, and Hispanics represent just 5%, even though these percentages are much less than their groups' proportion of the United States population.

Health Disparities: Your Paln

You’re going to follow some steps to create a small, yet effective health disparities project. You may wish to develop a project that works directly with individuals who need to change their lifestyles or research an issue and share their findings with healthcare leaders, doctors, and policy makers (ie:  elected officials). Health Disparities projects must be meaningful to you.

Steps for creating your own health disparities project:

1.                   Identify

2.                   Research

3.                   Listen

4.                   Summarize

5.                   Plan

6.                   Implement

7.                   Evaluate

8.                   Share

9.                   Return

Step 1:

Identify a Health Disparities Issue that Concerns You

Figure out what you care about.

Ask yourself, “What’s happening to a group of people that I care about?”

What happened to a friend or family member that appears to be a concern among all people in my community?

How are the health concerns of people in my community changing? What is causing these changes?

Step 2:

Research Your Health Disparities Concern

Look for five sources of printed information and five leaders in the local medical community that share your concerns.

What general research has been done on the topic outside of Minnesota?

What general research has been done by the University of Minnesota or the Mayo Clinic?

Remember you can look at “popular” research that has been put into common magazines and online with Google. However, you must dig deeper into literature that is used by doctors and other health professionals to make decisions.

You may need some help from your campus biology faculty, your college librarian, or a medical professional to get access to medical journals, common databases, and specific information that the medical community has access to.

Step 3:

Listen to Others Discuss this Health Disparities Issue

Imagine youself as a physician in the year 2020. You’ve noticed that a specific group of people have a health disparities issue (list your concern here) in the community you serve.

Find five doctors, non profit leaders, community liaisons, or individuals who share your health disparities concerns or concerns about a specific community that you’ve identified. Those will be the people “in the trenches” who work with your targeted group every single day.

Often some of the best people that will help you find doctors or other health care providers, who work with specific health disparities issues are already working with a targeted community in a different way. These may be individuals who focus on public transportation, affordable housing, banking services, childcare, culturally-related communications professionals (radio, newspaper). Networks run deep.

To understand a local health disparity issue, it is important to learn more about the doctors, community leaders, and supporters who promote and support healthy behavior and provide quality health information. You’ll need to travel to and visit a few sites to learn what’s already going on. If you’re not interested in making those “house calls”, chances are – your health disparities project will lack vibrancy and won’t give you much insight into the community.

Does your target audience meet together? If so, where? Go there. Ask questions and listen, listen, listen.

Step 4:

Summarize Your Findings & Thoughts

After you’ve read common popular articles, sifted through medical research on your topic, and talked to community stakeholders, ask yourself… “What did I learn?”

Step 5:

Plan Your Health Disparities Project

Actually doing something about a health disparities concern is what will separate you from all of the other medical school candidates. You can do a project or ignore the issue. The choice is yours.

Ø       Leaders take action.

Ø       Followers watch TV, surf the net, and find excuses.

Determine if you want to research the issue and add to the body of knowledge, influence change in a specific group, help provide access to better health care, raise money for a specific health concern, or simply learn more about the issue from a grass roots point of view.

Step 6

Implement Your Plan

Use an activity sheet, like the one below, to set small, monthly goals. Chart your progress each month.