Health disparities between white and black communities persist despite years of efforts to address heart disease, diabetes, mental illness and scores of problems plaguing American minorities.
Blacks are 20 percent more likely to report having serious psychological distress than whites, according to the Office of Minority Health, a division of the Department of Health and Human Services. Mental illness affects people of all ethnicities, but Pittsburgh health providers say for many reasons, communities of color are less likely to seek out mental health care.
The American Psychological Association estimated in 2007 that around 90 percent of mental health professionals are white, while 36 percent of the American population identifies as a racial or ethnic minority.
Pittsburgh psychiatrist Ken Thompson sees refugees from Bhutan, Iraq and the Congo at the Squirrel Hill Health Center. The disconnect between racial backgrounds is a frequent an obstacle to care, Thompson said.
Jeannette South-Paul, the chair of medicine for the University of Pittsburgh School of Medicine, said all ethnic groups may have issues with mental health, but in Pittsburgh and Allegheny County, minority populations also overlap with lower socio-economic groups.
“What you find is that many of them are struggling to get primary care health services and that has a lot to do with not having enough primary care physicians and clinicians equitably distributed around the county,” she said.
Resources aren't distributed based on need or "the burdens that people carry," Thompson said.
“They tend to be based more on who can pay," he said. "And if you don’t have money to pay then there’s going to be significant problems.”
The Squirrel Hill Health Center offers sliding-scale payment options, which helps, Thompson said. But for new Pittsburghers, especially those who may not speak English, finding those options can be difficult.
Even with interpreters, cultural competency doesn't always translate, Thompson said. (link: http://wesa.fm/post/navigating-health-care-can-often-leave-refugees-lost-translation)
“The most important thing is ... cultural humility, the capacity to be able to listen and try and learn from other people what their experience is and how they understand it and to incorporate that into your own feeling and thinking,” he said.
As a primary care provider, Jeannette South-Paul is on the front lines connecting people to mental health care. Stigmas persist, she said.
“More minorities and more of the population in general actually seek their care from primary care clinicians than initially access behavioral health providers directly,” she said.
So she and other providers now link mental health screens into general health exams.
“If I have (a patient) who says, 'I’m not depressed. I don’t have problems with mental illness,' I mention that we’ve learned that those who struggle with issues of mental illness are less likely to be able to manage their medical complaints,” she said.
Richard Garland, Violence Prevention Project coordinator at the University of Pittsburgh’s Center for Health Equity, visits gunshot victims at local trauma centers and speaks to them about social and health issues. About 87 percent of gunshot victims in Pittsburgh are black, according to data collected by the center.
“They just can’t deal with all the stuff going on in their community and the trauma of being shot as well,” he said.
