NEW ALBANY — In Southern Indiana, minority health gaps are widest in addressing cancer, obesity and diabetes, according to Pam Clark, minority health initiative director for Community Action Southern Indiana.
But in parts of Indianapolis, access to healthy food reigns as a barrier to healthy lives.
While minority health disparities in Indiana can be diminished through public policy, legislative answers can sometimes fall short. It’s up to community partners to fill in the gaps with tailor-made solutions.
“ ... It’s community that really has to take ownership over community,” said Dr. Will Cooke, a panelist in Wednesday evening’s discussion on minority health disparities. “We have to listen to those who are trying to serve because often they already have the answers.”
The discussion, hosted by the Indiana Minority Health Coalition at St. Mark’s United Church of Christ, touched on the ways the state legislature is addressing health outcomes.
Panelists also urged the 25 audience members not just to engage with elected officials in issues they experience but to take charge in forming community partnerships.
“I’m all for pie in the sky, but I believe collective community faces can make change happen,” said Tony Gillespie, a panelist and vice president of public policy and engagement for IMHC.
Cindy Hunt, a nurse for Goodwill Industries’ Nurse Family Partnership, attended the panel on Wednesday. Hunt helps impoverished first-time moms navigate pregnancy and the two years following birth of the child.
“For me, I’m just trying to figure out the community, trying to get connected with people who can help me help my moms,” she said.
As the System of Care coordinator for Clark/Floyd System of Care, Ann Carruthers’ goal is to assist families with mental health and addiction needs.
“This is a good cultural platform in which we can empower our community,” she said of Wednesday’s panel.
One legislative measure signed into law this year was a cervical cancer prevention bill. The state department of health is now tasked with creating a comprehensive state report on cervical cancer, which will provide data to better target minorities or underserved communities.
“The thing that hasn’t changed across the board in all the cancers is minorities are underrepresented in early screening and diagnosis but overrepresented in morbidity,” Gillespie said.
The law comes with no funding attached because the strategic plan will be developed as an administrative function of the Indiana State Department of Health and Family Social Services Administration.
Some discussion involved legislation that would certify hospitals to handle new specialties, such as stroke treatment. Gillespie warned that certification without funding attached may not allow hospitals to truly address these cases, though it may lead to higher provider reimbursement rates.
“If it doesn’t come with a dollar attached with it, it’s an idea,” he said. “If it does come with a dollar attached to it, it’s a plan that we can implement and measure.”
Indiana ranks in the bottom five against other states in public health funding per capita, state Rep. Ed Clere, R-New Albany, a panelist, said.
“Until we address that, it’s going to be very difficult to make progress in most areas,” Clere said.
But it’s not impossible. Cooke, Austin’s physician who treats Scott County’s HIV-positive patients, has been able to offer more specialties in the underserved, resource-lacking community despite not receiving public funding or grants.
“Things are possible,” Cooke said. “We just have to be willing to work together and think outside the box sometimes.”
Many health disparities can be traced back to the health care system.
“I would go back to reimbursement rates and recognizing that there is a concentration of Medicaid participants in low-income areas, and often those are minority communities,” Clere said. “ ... When Medicaid pays rates that are unattractive to doctors and other providers, they’re going to be fewer doctors and other providers in communities that have a high concentration of Medicaid.”
Cooke believes it may take a mindset shift — that the solution is finding doctors who are committed to their communities.
“You can’t change a community by paying somebody enough to do it,” he said.
Clark, of CASI, told the group that Wednesday night shouldn’t be the last time they discuss these issues.
“That’s one thing about community — you can’t work in a silo,” she said. “You have got to work together, and when they say it takes a village, it takes a village to keep us healthy.”