As a health care system serving much of the upper Midwest, Sanford Health has identified closing minority health care disparities as a priority.
According to the U.S. Department of Health and Human Services Office of Minority Health, Black Americans have the highest mortality rate for all cancers combined compared with any other racial and ethnic group.
In addition, the Centers for Disease Control and Prevention reports 11 infant deaths per 1,000 live births among Black Americans. This is almost twice the national average of 5.8 infant deaths per 1,000 live births.
“We can’t address what we don’t acknowledge,” said Natasha Smith, Sanford Health’s head of diversity, equity and inclusion. “Illuminating disparities is one way that we’re equipping our health system to be responsive to community needs in the Black African American community and beyond.”
Responding to marginalized patients
There are important questions at the root of that disparity. For instance, are health care numbers behind because of a lack of access? And how much of it is because of a lack of trust in health care in general?
“We’re uniquely equipped to be training our employees to be responsive to that so that our community feels like we are an inclusive and affirming health environment that can impact clinical outcomes,” Smith said. “If we are providing an inclusive and affirming environment as a health care provider, that will break down those barriers of bias and communication and trust.”
Sanford is also making a concerted effort in its hiring practices. It is another way to add impact to Black health and wellness.
“We want to be known as a premier employer for all populations in our community,” Smith said. “We want people to know that when you come to work at Sanford Health, you can bring your whole self to work. You’ll be valued and celebrated for exactly who you are.”
Addressing implicit bias in medicine
Michael Burson is a senior social worker at the Sanford Roger Maris Cancer Center in Fargo, North Dakota, who has witnessed racism and experienced it personally.
As a Black person operating in a professional environment in the Midwest, Burson can identify with the challenges brought about by being a person of color. He can also identify with ways he’s privileged.
Being sensitive to both perspectives has been helpful in the approach to addressing race in the context of health care.
“I’m heterosexual, I’m Christian, I’m able-bodied and I have a higher socioeconomic status as compared to many,” he said. “I’ve had the opportunity to educate many people that I’ve come across.”
It’s called implicit bias and, in Burson’s words, “it’s the way our country was built.”
“It’s not our fault, it’s not my fault – I don’t take responsibility for any of it,” he said. “But I do accept responsibility for the way I approach that (now). I would encourage people to learn about their bias.”
Burson suffers from migraines occasionally. In one instance in Denver, while out with his wife, he began to suffer what is called a hemiplegic migraine. His optic nerve was inflamed and as a result he could no longer move his right eye. He was terrified. He thought he was having a stroke or was suffering from a brain tumor.
Thinking the worst, he went directly to the emergency room.
“I was questioned heavily for more than a half hour in the midst of a medical crisis about all the drugs I was using,” Burson recalled. “At the time I was in graduate school, and I actually worked at that same hospital while getting my master’s.
“They couldn’t see that I was a graduate student having a medical crisis. They thought I was using drugs. … It made me feel like maybe I wasn’t going to be taken care of, and maybe they weren’t going to believe me, and maybe they were going to do something that wasn’t necessary.”
‘It’s important that we get this right’
Understandably, it’s an episode that stays with him.
“I was very scared about it, and it still impacts me today,” he said. “It forms the way I look at health care now.
“I am very proud to work at Sanford Health and to be part of the efforts in adjusting this level of thinking. I would never dream of holding anyone responsible for the experiences of Black people in the past. However, I think people 300 years from now will hold us accountable for the way we dealt with the information that we have now. It’s important that we get this right.”
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