EDITOR’S NOTE: This is the sixth in a series of stories about this week’s Richland County Community Equity Challenge. Today’s topic deals with healthcare.)
MANSFIELD — A simple drive through the north end of Mansfield reveals clear physical evidence of health care disparities in Richland County.
There are few permanent medical facilities in and around neighborhoods that are predominately Black and represent some of the lowest-income census tracts in the county.
But the systemic problems involving health care issues in Richland County run far deeper than the simple nearby availability of a primary care physician’s office, an urgent care center or a hospital, according to leaders of the Richland County Task Force on Racism.
That’s why the task force has chosen health care as one of its key areas of focus, including Day 6 of the Richland County Community Equity Challenge. a week-long effort aimed at creating dedicated time and space to build more effective social justice habits, particularly those dealing with issues of race, power, privilege and leadership.
The eight-day effort, which runs through Nov. 21, allows participants to receive daily emails or text messages with links to videos, podcasts and/or reading assignments.
The data surrounding a Black person’s health in America is stark:
— Black women are up to four times more likely to die of pregnancy related complications than White women.
— The Centers for Disease Control and Prevention report that Blacks aged 18-49 are twice as likely to die from heart disease than Whites.
— Black residents between the ages of 35 to 64 are 50 percent more likely to have high blood pressure than Whites.
— Black people in the United States in general are more likely to die at early ages from all causes.
Statistics show that being Black is bad for your health. Multiple public health studies over more than three decades argue that systemic racism is a cause.
The average life expectancy of Black people is four years lower than the rest of the U.S. population.
This report was compiled in January, 2020.
The data clearly argues that racism is a public health crisis because racism permeates every aspect of public health, despite a 5-4 vote by Mansfield City Council in 2020 to defeat a resolution that would have declared racism as a public health crisis.
That defeat spurred on the local task force which has seen the formation of steering groups working on various aspects of systemic racism in the community.
“We do know that health inequities at their very core are due to (systemic) racism,” said Dr. Georges Benjamin, executive director of the American Public Health Association, a quote used in Day 6 of the Equity Challenge. “There’s no doubt about it.”
As part of the Day 6 challenge materials, organizers said Richland County has deep disparities across communities.
“Your zip code and census tract is a strong predictor of your opportunities in life. When these two factors are combined with race, people of color are disproportionately impacted by this reality.
“The (North End Community Improvement Collaborative) Richland County State of the African American 2020 noted several key findings in the area of healthcare.
“You recently learned on the business and employment days of the Equity Challenge, many African Americans in Richland County live in poverty due to systemic barriers. As a county, 30.6 percent of children under the age of 5 and 22.5 percent of children under the age of 18 in Richland County live below the poverty line.
“Poverty comes with an array of lifelong health issues: food insecurity, housing insecurity, lack of access to healthcare, negative influences on academic achievement, an increased risk for disease and premature death, and much more,” organizers said.
The issues seem clear to three members of the OhioHealth system that operates hospitals in Mansfield and Shelby.
Rev. Angela Brooks-Wright
Rev. Angela Brooks-Wright, M.Div., the manager of pastoral care for OhioHealth Mansfield Hospital and OhioHealth Shelby Hospital, said Day 6 of the Equity Challenge helped bring health care disparities into focus.
“For me, the biggest take away was that all things are not created equal. As such systemic racism, inequities and implicit biases are deeply ingrained,” Brooks-Wright said. “This is true from both perspectives: those inflicting the injustice as well as those that receive the injustice.”
She cited an allegory found in the Gardener’s Tale in which two pots seemingly designed with the same purpose yielded different results due to the gardener’s actions.
“Did the gardener not care enough to give both sets of flowers the same chance? The flowers themselves, did they understand that they were at a disadvantage almost destined to fail or always fall short. Then there are the flowers that remain that feel either entitled or less than never knowing that they were given an advantage of disadvantage from the moment they were sprouted in the dirt,” she said.
Brooks-Wright said individuals “planted” in Richland County experience health inequity due to their zip code or geographical location when their access is limited to suitable healthcare, clinicians, pharmacies or emergency services.
“Add to this the compounded accounts of generational neglect, and one can become disillusioned that a broken system is the norm. What I have learned is that our community and/or county can only be as strong as its weakest population. Equity (potted soil) must be evenly distributed across each section and accessible by all,” she said.
Brooks-Wright said there has been improvements, but the system remains broken.
“The broken system is impacting everyone across the racial divide. Specifically, when we consider the aging black/brown community the disparities are staggering. Accessibility, early detection, screenings, continuum of care … these factors are critical if we are to thrive and survive.
“Admittedly, I am new to the community and county (moving to Ohio from New Jersey earlier this year). However, I am seeing in a short period of time gaps in areas that are underserved.”
Patricia Kastelic MS, RN, NEA-BC, CRA
Kastelic, director of cancer services and imaging for OhioHealth Mansfield Hospital and OhioHealth Shelby Hospital, said Day 6 of the Equity Challenge was a reminder everyone has a responsibility to be self-aware and realize racism contributes to health care challenges.
“It is difficult to see our privilege if we have not experienced disparity in some way,” Kastelic said. “We need to open our lens to evaluate what the pressing health issues are in our community and address them.
“We need to provide a community forum for input and representation in order to develop a plan to combat issues, concerns, and high priority health issues,” she said, adding that improvements can lead to better identification of multiple diseases that can be mitigated through education, screening, treatment, and surveillance to avoid catastrophic impact to quality of life.
Kastelic, who has worked as a health professional for more than 40 years, said preventative screening and education for many health-related issues are essential.
“The (COVID-19) pandemic has limited access to screening over the last two years. There may be various reasons that screenings do not occur due to disparity in health care access,” she said, citing specific examples.
“When we have gone out into the industry and community with the mobile breast screening van, some individuals do not have insurance or have high out-of-pocket costs. Several local cancer funds provide the means to help those who cannot afford mammogram costs. Transportation or availability of access may be a challenge for individuals to attend breast screening. Therefore, an opportunity to take the service to an accessible site would be fruitful,” Kastelic said.
“Awareness and educational support to screenings and significance of monitoring and surveillance. Breast, lung, and colon cancers have better outcomes if identified early. These and many other cancers can be identified prior to symptoms appearing and demonstrating more advanced disease.
“Lack of identification and surveillance to diabetes and high blood pressure can have devastating impacts on quality of life. These can lead to loss of extremities or vision, as well as organ failure, such as kidneys ultimately requiring lifelong dialysis,” she said.
Like Brooks-Wright, Kastelic called for a “change in the lens that we see disparity and need for health care services tied to racism and inequities. We must recognize that this is a concern that requires action and realize how we can influence others to decide priority of services and resources.”
Kastelic called for a community forum aimed at generating action that involves “key stakeholders” who have the power to make decisions, act and impact the resources needed.
Shaunte Brown, RN, clinical lead in behavioral health at OhioHealth Mansfield Hospital
Brown said Day 6 of the Equity Challenge has helped to “shine a light” on the importance of increasing diversity as a critical step in achieving health equity.
“Research and reality is providing proof of the disparities. However, it can be easy for a situation to go unrecognized when the concerns being addressed are not reality for those unaffected by it. We cannot continue to push the issue to the side and hope it will resolve itself. I’ve learned it will take more than one group, we need a community effort,” Brown said.
In her own daily work, Brown said she has tried to make a difference.
“My experience with equity in healthcare has involved trying to ensure all patients are feeling comfortable and experiencing the best care. As a nurse, it’s important for me to be aware of disparities and be the best advocate I can for my patients,” she said.
She said the biggest challenge locally is to move people out of the mindset and feeling of “that’s just the way it is here.”
“OhioHealth has taken steps to have our workforce match the community. I’m in involved in a pipeline mentoring program that provides opportunity to increase diversity into leadership positions.
“It’s important for our community to have healthcare facilities that are conscious of all backgrounds, beliefs, and ethnicities, to provide the best quality care for all patients. It’s important for all members of the community to feel they are being represented, having employees that mirror and understand the community they serve.
“It is imperative for us to be able to create a diverse employee base at all levels within the healthcare system which helps contribute to optimum patient care,” Brown said.
The eight-day Equity Challenge, which runs through Nov. 21, allows will allow participants to receive daily emails or text messages with links to videos, podcasts and/or reading assignments, each aimed at exploring the impact of systemic racism in the following areas:
Day 1 — Implicit bias and wealth gap
Day 2 — Business
Day 3 — Criminal Justice
Day 4 — Education
Day 5 — Employment
Day 6 — Healthcare
Day 7 — Housing
Day 8 — Mental health
Sign up for the challenge here.
If anyone has signed up for the challenge and not received an email, organizers ask they check their “spam” folder on their email service.
