Reducing Health Care Disparities through
Innovative Community Wellness Interventions for
African Americans
CDR Dwayne L. Buckingham, Ph.D., LCSW, BCD
UNITED STATES PUBLIC HEALTH SERVICE
SERVICE CHIEF, RESILIENCY AND PSYCHOLOGICAL HEALTH SERVICE
WALTER REED NATIONAL MILITARY MEDICAL CENTER
BETHESDA, MARYLAND
Disclaimer
 The views expressed in this presentation are those of the authors and do not
reflect the official policy of the Department of Defense, United States Public
Health Service or the U.S. Government.
Objectives
 Identify common health care disparities that impact African Americans
 Discuss cultural and economic barriers that inhibit African Americans from
utilizing needed health and wellness interventions.
 Summarize how disparities in healthcare for African Americans threaten the
advancement of health equity in the U.S.
 Describe practical and evidence-based community interventions that empowers
African Americans to live healthy lifestyles
Health Care Disparities
 A “health care disparity” typically refers to differences between groups in
health coverage, access to care, and quality of care.
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Racial and ethnic minorities have health that is worse overall than the health of White
Americans (Bahls, 2011)
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1 out of 3 African Americans who need help receives it (NIMH)
African Americans are more likely to stop treatment early and are less likely to receive follow-up
care
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Access to Care
Cultural and Economic Barriers
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Experience on-going inequities in accessing education, employment, and health care
Lack of Culturally Competent Care
Receipts of less or poor quality care
View mental health issues such as depression as the “blues”
Lack health care insurance, money and other resources needed to access services
Distrust in the health care system and struggles with the mental health stigma
Lack education about the need and benefits of health care
Seek support from non-medical resources: church, family, friends, and
community groups
Source: American Psychiatric Association
Disparities in Healthcare for African Americans
threatens the Advancement of Health Equity in the U.S.
 Equity in health can be defined as the absence of systematic disparities in
health between social groups who have different levels of underlying social
advantage/disadvantage—that is, wealth, power or prestige.
 Inequities in health care systematically put groups of people who are already
socially disadvantaged at further disadvantage with respect to their health;
health is essential to well-being and to overcoming other effects of social
disadvantage.
Source: P Braveman, S Gruskin J Epidemiol Community Health, 2003
Disparities in Healthcare for African Americans
threatens the Advancement of Health Equity in the U.S.
 Disparities in health and health care limit continued improvement
in overall quality of care and population health and result in
unnecessary costs.
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Recent analysis estimates that 30% of direct medical costs for Blacks, Hispanics, and Asian Americans are
excess costs due to health inequities and that the economy loses an estimated $309 billion per year due to
the direct and indirect costs of disparities. As the population becomes more diverse, with people of color
projected to account for over half of the population by 2050, it is increasingly important to address health
disparities.
Health Equality for all Americans can not be achieved until African Americans receive adequate
mental health intervention.
Source: Kaiser Family Foundation, Nov 2012
How can African Americans be empowered to
live healthier lifestyles?
Innovative Community Wellness Interventions
 Innovative Intervention #1 – Serve and Connect
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Strong social connections in the community setting have help many African
Americans overcome adversity and maintain optimal mental health
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In light of the loss of Michael Brown, an unarmed 18 year-old black male
who was shot and killed by a police officer in a St. Louis suburb, I returned
home to St. Louis, MO on August 21, 20015 and facilitated a 3 hour psychoeducational session at a local community center. The purpose of the
community forum was to educate individuals about healthy grieving, conflict
resolution and anger management.
Innovative Community Wellness Interventions
 Innovative Intervention # 2 - Provide services in locations
and places where they Feel Comfortable
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Barbershops, beauty-shops, churches, community centers
Innovative Community Wellness Interventions
 Practical Intervention #3 - Provide Psychological Aid Early
and Regularly
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No Psychological Intervention- No Peace!
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Psychological peace is the key to creating a healthy nation
Empower African Americans by highlighting their strengths, not their
struggles.
Innovative Community Wellness Interventions
 Innovative Intervention #4 – Create opportunities for more
Africans American to work in the Health Care arena
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Cultural identity impacts willingness to seek treatment
Conclusion
 Equity in health is an ethical value, inherently normative, grounded in the
ethical principle of distributive justice and consonant with human rights
principles.
 Equity in health means equal opportunity to be healthy, for all population
groups. Equity in health thus implies that resources are distributed and
processes are designed in ways most likely to move toward equalizing the
health outcomes of disadvantaged social groups with the outcomes of their
more advantaged counterparts.
 The challenge of delivering health and wellness interventions to African
Americans is not an easy task, but public health providers can levy the playing
field and reduce health care disparities through the delivery of innovative
services at the community level.