As highly-publicized debates over national healthcare legislation unfold in Congress, it can be easy to forget that there is no single solution to the local delivery of healthcare. Different communities, after all, face different medical concerns. For example, many minority groups face a systemic barrier to healthcare access, ranging from lack of insurance, mistrust of physicians to simply a language barrier. Mindful physicians and medical students have tried to break down this barrier with free clinics and screenings. On behalf of Team HBV, a student organization on campus that raises awareness for Hepatitis B in the local community, I participated in a screening with medical students from the Alpert Medical School held at the Chinese Christian Church of Rhode Island on Oct. 29. Our main goal at Team HBV is to raise awareness for Hepatitis B, an infection of the liver that can cause liver cirrhosis and liver cancer and that disproportionately affects Asian immigrant communities, according to epidemiological studies. Team HBV’s work at CCCRI, in conjunction with the efforts of the Med School, illustrates the importance of preventative and culturally attuned healthcare — interventions that must not be forgotten in broader discussions about healthcare policy.
A survey of Asian/Pacific Islander residents in New York showed that 21.4 percent of those born in China had HBV, according to a 2009 study. And according to the Department of Homeland Security, immigrants from Asia make up about 40 percent of the total number of immigrants in the United States. This lack of immunity against the Hepatitis B virus is a serious problem, because it is not treatable and imposes serious costs on the healthcare system: As of 2003, Hepatitis B-related hospitalizations cost $1.5 billion.
Screenings like these are critical to community health, for they offer key medical services to patients who may not have the time or resources to obtain them otherwise. At the screening, medical students tested blood glucose levels and blood pressure. Measuring blood pressure and blood glucose is essential for identifying patients at risk for Type two diabetes and hypertension, common chronic diseases that can lead to complications as patients get older. To help educate the local Asian community in Pawtucket — where CCCRI is located — about hypertension and diabetes, every patient who was screened got a form with their blood pressure and blood glucose results and educational information that offers dietary suggestions, exercise regimens and general health advice that could help them control or maintain their blood pressure and blood sugar. Many of the medical students who participated in the screening were able to speak Chinese or used a translator. I contributed to the screening as a translator, and distributed information about Hepatitis B, hypertension and Type two diabetes to patients in Chinese. The services provided at the screening were preventative — they helped patients identify their risk factors for chronic illnesses and gave them tools to address these risks. In the long run, preventative healthcare may help patients avoid more serious complications and reduce the burden on the broader healthcare system.
As a volunteer at the screening, I realized how important culturally attuned healthcare is. Although some of the people we helped during the screening spoke English, many of them preferred to communicate in Mandarin or Cantonese. Having volunteers like me who speak Mandarin made members of the community more comfortable because we could interact with them in a culturally sensitive manner and help break down the language barrier. Many of the community members said they preferred to interact with people who spoke their language and were familiar with their cultural customs. Thus, culturally sensitive screenings are important because they eliminate the stress that patients might feel if they went to a hospital, where they might encounter unfamiliar doctors, terminologies and practices. Moreover, these patients are more likely to interact with healthcare providers with whom they can connect and open up a dialogue about their health. On the whole, these screenings become imperative because they are able to distribute information and care to communities that are unable or hesitant to seek medical advice.
In a broader healthcare system, culturally attuned screenings that meet patients in their communities and address their specific needs are crucial. But today, preventive care and other necessary programs for the disadvantaged, like Medicaid, are in danger of Congressional cuts. One legislative proposal, the American Health Care Act, introduced this summer would have allowed insurance companies to offer plans that do not offer preventive care and other essential benefits. Likewise, the AHCA — which died in the Senate late July — aimed to cut Medicaid, which provides healthcare to the country’s poorest and neediest patients.
Screenings like the one held at CCCRI demonstrate both the importance of preventive care as well as the enormous demand for healthcare among immigrant communities. As a regular volunteer at screenings and health clinics, it is obvious to me that we should be channeling more funds into preventive care, free clinics and Medicaid to provide healthcare for all who need it. But spending large sums of money isn’t going to solve everything; minority and immigrant communities must be made to feel comfortable with seeking out and obtaining healthcare. We need to approach them in a culturally sensitive and knowledgeable way, so that they come to trust the healthcare system whenever they need medical attention or a checkup. We need to have physicians, nurses and volunteers with specific training so that they will be able to help overcome language and cultural barriers. We can only achieve our goal of better community health if healthcare providers tailor their services to members of marginalized communities and respect their cultures.
Eric Zhong ’19 can be reached at eric_zhong@brown.edu. Please send responses to this opinion to letters@browndailyherald.com and other op-eds to opinions@browndailyherald.com.
