Page 3 - Health Inequity Care Summary Report

training and research are often white focused. A current example is the lack of information identifying the
COVID-19 rash for people of color. There is economic bias in health care. Doctors and hospitals often
locate offices in areas of affluence. This behavior then limits access for lower income patients. Other
illustrations are that doctors limit or do not accept certain types of medical assistance/insurance, and
coverage for mental health issues is very limited. Generational trauma needs to be understood and
addressed. Some noted that there has been little progress in addressing bias in health care for people of
color.

Addressing Local Issues

Access and Time

Lack of access spawns inequity of care. Many limitations on access are systemic issues, such as the
need for better insurance, insurance not based on income, not enough practitioners, and lack of resources
that then create barriers such as transportation. Limited access to technology and the internet, hospitals,
doctors, and pharmacies create inequities. Doctors and health care workers who do not understand the
culture of people of color inadvertently serve to limit access. Economic issues are a huge driver of
limited access.

What this looks like in Southern Maryland:

1) Lack of time with the provider: This was the highest rated issue. Participants cited that the 15-
minute allocated time with the doctor does not allow enough time to develop patient/doctor
rapport or for the patient to address all their symptoms or concerns. This often complicates proper
diagnosis by the provider and the follow-through by patients.

2) Cultural awareness: Another frequently cited issue was the lack of doctors of color in the area,
and the lack of doctors and health care workers who have cultural awareness (ones who
understand the local history and background of the patient). Thus, patients feel they are
stereotyped, not listened to, and that myths get in the way of understanding the obstacles patients
encounter trying to follow prescribed treatments. For example, it is a myth that people of color are
more tolerant of pain, yet it is reported that even children of color receive less pain medication to
relieve pain than their white peers.

3) Communication problems: Because of the first two listed issues, health care providers often
prescribe without understanding the cultural context or the inability or difficulty for the patient to
access the treatment due to transportation, insurance, economic, or trust issues. This then results in
misdiagnosis or the patient not following-up on prescribed treatments. Patients are reluctant to
share personal information due to lack of trust.

4) Location: Hospitals, doctors and pharmacies tend to locate in areas of more affluence over ease of
access. For people with lower incomes this becomes a transportation and economic hardship -
given that it may take all day for a patient to keep an appointment. Western Charles County is an
example – it is a health care desert and very difficult to get doctors to practice in the area because
it is low income.

5) Medicaid and health insurance: Some local doctors put a limit on the number of patients they
have with Medicaid. This limits access to and quality of care. In Southern Maryland those with
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