American Medical Student Association

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American Medical Student Association

• Take the Challenge!
• Student Action for Zero Health Disparities

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Disparities Infant Mortality Rates (Mothers gt 20
Years of Age)
Source DHHS. Health, United States, 1998
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DisparitiesCardiovascular Disease and Cancer

• African Americans continue to have the highest
  mortality rates from heart disease-50 greater
  than whites
• The death rate for cancer for African American
  men is approx. 50 higher than for white men
• Source Kaiser Family Foundation Key Facts on
  Race, Ethnicity and Medical Care,1999
• Source Health Care Rx Access For All- The
  Presidents Initiative on Race

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Disparities Asthma

• Asthma is 26 percent more prevalent in African
  American children than in white children
• AA children 3X more likely than whites to be
  hospitalized for asthma
• Among 5 to 24 year olds, African Americans are 4
  to 6 times more likely to die from asthma than
  whites
• Preventable?
• Source CDC, American Lung Association
• Source Kaiser Family Foundation Key Facts on
  Race, Ethnicity and Medical Care, 1999

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Biases in Medicine Differences in Heart Surgery
Rates by Race, Disease Severity, and Survival
Benefit
Source Kaiser Family Foundation Key Facts on
Race, Ethnicity and Medical Care, 1999
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Biases in Medicine

• Recent study in NEJM (February,1999) reports
  landmark finding that race and sex of patients
  affect physician decisions about whether to refer
  patients with chest pain for cardiac
  catheterization (when controlling for clinical
  presentation)
• 1994 GLMA survey showed 67medical students and
  physicians report substandard or denial of care
  to gay/lesbian patients

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Patient Perceptions For the Average African
American and Latino, How Big a Problem is?
Difficulty Getting Care Because of
Race/Ethnicity
Having Enough Doctors and Providers Near Home
Source Kaiser Family Foundation Survey of Race,
Ethnicity and Medical Care Public Perceptions
and Experiences, 10/99
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Patient PerceptionsExperience With Being
Treated Unfairly When Seeking Medical Care
Because of Race/Ethnicity
Source Kaiser Family Foundation Survey of Race,
Ethnicity and Medical Care Public Perceptions
and Experiences, 10/99
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Physician Maldistribution Limits Access

• Poor urban racial and ethnic communities are more
  likely to have a physician shortage
• Poor urban communities with high proportions of
  Hispanic(H) and African Americans(AA) have only
  24 physicians /100,000 people compared to 69
  physicians /100,000 in similar communities with a
  low proportion of H and AA

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Physician Race/Ethnicity as a Predictor
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US Population Forecast
Source US Bureau of the Census
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Medical School Enrollment Trends
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Under-represented Minority Applicants and
Enrollees
Source AAMC Data Warehouse, 1999
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MCAT Is this the best way to select our nations
physicians?
Source AAMC Annual Meeting, 1998
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Summarizing the Problem

• Persistent racial disparities in leading health
  areas
• Evidence of physician bias
• Limited access to health services

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The American Medical Student Association

• What can we do?
• Educate
• Diversify the physician workforce
• Promote a supportive environment

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Student Education

• Peer Education
• Brown bag lunch discussions
• Diversity shuffle
• Orientation activities

• Cultural Competency
• Curricula
• Teaching physicians to deliver effective medical
  care to people of all different backgrounds
• Enforce LCME standard
• Assess your school
• Partner with the Dean to improve or create
  curricula

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Legislative Approach

• Lobby in support of cultural competency
  curricula
• H.R. 3250 provides grants to medical schools
  for cultural competency curriculum development
• MAC/WIM lobby day on September 22, 2000
• Letter writing campaigns
• Call!

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2001 AMSA National Convention

• Take the Challenge! Student Action For Zero
  Health Disparities
• March 28- April 1, 2001
• Anaheim, California

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Diversify Workforce

• Recruitment Program- encouraging
  under-represented minority youth to pursue
  careers in medicine
• Talk to the Dean of Admissions
• Students on committee
• Admissions policies

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Supportive Environment

• There must be a supportive and healthy
• environment for all students
• AMSA Medical Student Bill of Rights
• Peer counseling/tutoring
• Adequate student affairs resources
• Minority faculty as guest speakers

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Coalition Building

• Work With Other Interested Groups
• Co-Sponsor Events with Local SNMA, Chicano
  Medical Student Chapter, etc.
• Talk to the Minority Affairs Office at your
  school and help with initiatives already in place
• Work with Deans/Admissions Office

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Summary

• As our nation continues to become more diverse,
  it is imperative that we, as future doctors, take
  the challenge to eliminate disparities in health
  and medical education.

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American Medical Student Association

• Take the Challenge!
• Student Action for Zero Health Disparities