Page 4 - Health Inequity Care Summary Report

lower incomes are often people of color and Medicaid is based on income; it affects them the
most.

6) Mental health deficiencies: Lack of mental health providers and comprehensive insurance
coverage for mental health are greater problems for people of color.

7) Lack of health care in early life: As a result of living in rural areas, many people of color do not
receive health care until they are adults or in the military. People in this situation lack an adequate
expectation of proper health care.

8) Connections: People of color lack the contacts, within the health care system, that white people
have to access quality care.

Trust / Mistrust

Lack of Trust: Generational trauma and historical medical experimentation on people of color have led
to distrust in the health care system for many African Americans. Not taking the time to understand the
patient’s needs or circumstances has led to misdiagnoses or limited treatment. Lack of trust extends to
people of color not trusting the qualifications of doctors and nurses that are also people of color. This
mistrust results in an unwillingness for people of color to participate in vaccinations for flu or
preventative care screenings such as mammograms, colonoscopies and routine wellness checks.

Advocates and Advocacy

Need for Advocacy: Individuals need guidance and support in accessing and navigating their health care.
All people can benefit from advocacy. As it is now, if people of color do not know someone with “power”
to advocate for them, they have trouble navigating the system and accessing needed care. Lack of
advocacy often results in people of color not getting the health care they need. It was expressed that
patients need advocates other than physicians. Other health care providers were perceived as tending to
understand patients’ needs and concerns better than doctors. Two types of advocates are needed: (1) self-
advocates - teach people how to advocate for their own health care and that of family members and (2)
trained advocate positions within health care. COVID-19 has made this need clear since others cannot
accompany family members to medical visits or hospitals.

Addressing General and Systemic Issues

Changes in the Health Care System

Changes in the health care system: Southern Maryland’s health care system should reflect all the
people. As it exists, it is perceived as being for people with economic means and education both in who
the providers are and who is served. The following suggestions were made:

1) The three counties health care systems should assess, name, acknowledge and address its history,
bias and discriminatory practices and policies.

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