‘Changing the conversation’ on Buffalo’s health disparities

More than 200 participants — including members of the UB community and other institutions, health care providers, members of the clergy, community activists and neighborhood organizers — attended a daylong conference last Saturday to learn about and address Buffalo’s African-American health disparities.

The goal of organizers of “Igniting Hope: Building a Just Community with a Culture of Health and Equity,” held at the Jacobs School of Medicine and Biomedical Sciences, is to gain support to address and reverse these disparities by establishing an Office of African-American Health Disparities in Buffalo to provide resources for research and advocacy.

Speakers reported on the magnitude of disparities between African-Americans and whites: that 38 percent of African-Americans live in poverty in Buffalo versus 15 percent for all races in Erie County, and that African-Americans are paid 75 cents, at best, on the dollar that white people are paid. They discussed the legacy of national horrors like the Tuskegee experiments, which ended in 1972 but weren’t acknowledged or apologized for until 1997.

Race has no basis in science, explained keynote speaker Consuelo Wilkins, executive director of the Meharry-Vanderbilt Alliance in Tennessee and an expert in improving community health through community-engaged research. The attributes that people assume are the basis of race are simply physical characteristics of hair, skin, lips, she said, noting the differences people assume are race-based are actually based on ancestral descent and geography.

Yet, disparities loom large and that needs to be acknowledged, Wilkins said. “One thing I hear from colleagues about race is, ‘it doesn’t have anything to do with me.’ If you’re a black man, or you’re married to a black man, or are raising one, or if you love a black man, it’s different for you.”

She talked about the consistent impact of enduring a lifetime of “micro aggressions” and “macro aggressions,” which, she said, have become more frequent in the past 18 months.

“You don’t have to apologize for everything,” she said to whites in the audience, “but you need to acknowledge that people have warranted reasons to be concerned. If they’re not trusting, there’s a reason.”

Wilkins’ message to her colleagues in the research community was clear: Participants in research must be compensated. “People won’t stay at the table if there isn’t something in it for them,” she said. “If I ask you to do a survey that’s longer than 20 minutes, I pay you. It all gets written into the grant. At every level, there’s compensation.”

She started a program in which community organizations propose problems they want Wilkins and her team of researchers and students to solve. “We pay the community organizations for working with us,” Wilkins said, and she and her team also started a faith-based equity award program that rewards churches with $1,000 for their efforts to promote health equity in their communities.

Stephen Thomas of the University of Maryland Center for Health Equity and a leading scholar on eliminating racial and ethnic health disparities, also addressed the group. He described programs he helped start in Baltimore that bring health care into neighborhood barber shops, where members of the community gather. Students and practicing physicians visit the barbershops and administer blood pressure and blood sugar screenings. He showed a video in which the president of the University of Maryland sat in a barber’s chair, laughing with a group gathered in the shop. The commitment of institutional leaders is essential, Thomas noted.

Another UMD program involved students and dental practitioners taking over the university’s vast basketball arena to provide free dental care to 1,185 people in the community. Thomas pointed out that dental care is often even less available than medical care. “They started lining up for this the night before,” he said. “And we are 11 miles from the White House.”

Willie Underwood III, associate professor at Roswell Park Comprehensive Cancer Center, cited a common criticism that it’s the behavior of African-Americans that causes these disparities; If African-Americans had gone to school or behaved differently, somehow these differences wouldn’t exist.

Underwood then referenced a peer-reviewed study about jobseekers of different races that he said revealed a surprising conclusion that underscored the odds facing African-Americans. The study, he said, found that white felons were more likely to get a callback for a job than a black or Latino person who wasn’t a felon.

“You cannot address health disparities without addressing these other disparities,” noted conference organizer Rev. George F. Nicholas, pastor of Lincoln Memorial United Methodist Church-Buffalo and a member of the African American Health Disparities Task Force and the Greater Buffalo Racial Equity Roundtable.

Women’s health was the focus of the talk by Kenyani Davis, a physician with UBMD Internal Medicine. She told the audience that the No. 1 killer for all women, regardless of race, is coronary heart disease and that 64 percent of women who die suddenly from this condition have exhibited no previous symptoms. She said black women are 30 percent more likely to die from heart disease, and mortality for black women with high blood pressure is a staggering 352 percent higher than it is for Caucasian women.

“And this is a condition that’s easily treated,” Davis said.

Moreover, African-American women are three to four times more likely to die in childbirth than white women, and that remains true regardless of their socio-economic status, Davis said, attributing that to “weathering,” or the “wear and tear on the body.”

She discussed the case of Shalon Irving, a highly educated Centers for Disease Control and Prevention researcher who was herself studying the epidemiology of race-based disparities. Irving had excellent health insurance, Davis pointed out, but died three weeks after giving birth due to a blood clot and a stroke. She also noted that Serena Williams, the world tennis champion, also nearly died after childbirth.

“This information is a heavy burden,” Thomas said, adding that for young African-American women who haven’t had children yet, it’s particularly striking. But, he said, it also offers an opportunity. “Sometimes, the ignition is a tear.”

Looking out over the rows of participants, Nicholson said the presence of so many people had already made the conference a success. “We are building a movement,” he said. “You and your talents will enable us and empower us to eliminate race-based disparities.”

In his remarks opening the conference, Charles F. Zukoski, UB provost and executive vice president for academic affairs, said that “UB alone cannot eliminate health care disparities, but what we can do is understand its origins and work with the community.”

“We are committed to building solutions and moving continuously toward a just society,” he said.

The idea for the conference emerged from a collaboration between UB, the African American Health Disparities Task Force, Millennium Collaborative Care, Erie County Medical Center, Population Health Collaborative and Greater Buffalo United Churches. It also was sponsored by UB’s Clinical and Translational Science Institute, which is committed to involving more diverse patient populations in its research.

Organizations represented at the conference included the Erie County Department of Health, Buffalo Public Schools, Community Foundation for Greater Buffalo, Community Health Center of Buffalo, Food Bank of WNY, Independent Health, Jericho Road Community Health Center, local branches of the NAACP, Planned Parenthood, the Center for Hospice and Palliative Care.