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Hello, this is Dr. Charmaine Herman. And I’m back again for another episode of cultural competence. Thank you, ChiroSecure for having the opportunity to talk to other chiropractors about these issues. Thank you for this programming and allowing us to go ahead and share all this information. I want to go ahead and get started.
Cause I have a few things to talk about today. Not today. We’re going to discuss cult. We’ll be talking about cultural competence and how it affects us as doctors of chiropractic. Right now in this segment, I’m looking more at things such as health disparities. So again, I’m Dr. Charmaine Herman. I’m a practicing chiropractor at Alpharetta Georgia.
I’m also a associate professor at the University. I’m sorry. at Life University in the College of Chiropractic. I’ve been there now almost 13 years and I teach and educate doctors of current and future doctors of chiropractic about how to be better. Doctors, how to understand the communities as a big part of my educational goal, helping these new doctors, I’m originally from New York and I’ve graduated from the university of South Carolina.
And I’ve been a chiropractor now for gosh, almost 15 years. So our goals today, we have two topics. We’re actually going to talk about the African-American community. And we’re also going to talk about the health disparities that affect black and African-American communities. When I say black slash African American people tend to want to be.
Called based upon their nation of origin. So many people of color, like to be called black because they might not be from the United States, but they are associated with Africa. And it is where I’d rather just be called black, where other people who are associated with this country born in this country, families that have been slaves in this country.
You want to be called African-American to show both their kinship with Africa, as well as. They’re kinship with this country. So you can use either terms. They use interchangeably. When we look at data from the CDC or from the office of minority health. And when you come to meeting patients that are of color, you may want to ask them if they will move forward to be called black, or would they prefer to be called African American?
If your intake forms have that information. They let them check it and let them decide how they would like to be addressed. So definitely always ask people how they like to readdress what they like to be called, what they’re comfortable with. That’s just one of the things we’ve been talking about as being culturally competent doctors of chiropractic.
So we’re going to move on with the slides. Now, hope disparities are defined as. As far as the fine is differences and health between various population groups. And that’s the key we’re looking at populations not just your community, but an overall us population to always see talking about health disparities.
And this month we’re talking about the entire United States and different populations within the United States and how this, these differences may affect the health of individuals.
So talk about how this bird is. We’re normally talking about people who are adversely affected by various things and how they obtain healthcare in the United States, whether it’s because of their age, their race, their religion, their gender, their sexual orientation, their ability, or inability, any mental.
Mental health issues or geographical location. We’re talking about how people actually obtain health and how this systematically affects various groups in our country. Usually the ones that are, have been excluded or find themselves being discriminated against in our society. So we’re looking mostly at our minority groups in the United States when we’re talking about health disparities and these other groups.
But these are the groups that we want to have. We want to care for as doctors of chiropractic, we want to actually make an impact in their lives because we want to take chiropractic to the world. We don’t want to just keep Kat chiropractic and exclusive club. We want to take it to the world. So it’s good to understand how health disparities may affect those people that we as doctors with chiropractic care for and want to care for.
So things that can also lead to various health disparities are things such as poverty. Again, access to health care behavioral or mental issues, education in our inequities. I heard someone tell me recently what chiropractic is an exclusive group of people who go to chiropractors usually have a certain financial level.
They live in certain communities. It’s not something for the entire us. It’s not for all the communities in the us. But it is for everyone. So we need to be aware of the factors that would keep people from seeking chiropractic care or understanding what chiropractic care is because of a possibility of education inequities.
They don’t know what that means. What does chiropractic was different from medical doctors? How do I know the difference? So I’m understanding that chiropractic is for everyone. It is up to us to deal with health disparities so we can meet the needs of our entire population.
There are also some non-biological health disparities, not because of race or gender, but there’s some things that will cause individuals to find themselves more subject to experiencing health disparities. Things such as violence with women are more likely to experience violence, mental health disorders, and men alcoholism and abuse.
These are what we call socioeconomic conditions that can shape. Individuals gender, which can also shape their access to healthcare and chiropractic care and put them in that level of finding themselves in this parities when it comes down to health care. So we put them in those groups because again, women are most likely in this country is like 90% of violence is against women.
So they find themselves also based upon their socioeconomic status, unable to cry out and get the help that they need. So this puts them also in a category of health disparities.
So we, as doctors of chiropractic, wanting to serve more and more diverse communities to look into certain things, we need to first be aware of the health disparities that affect our communities. Every community is different. We all practice in various areas. Some of us are in hospitals, some of us are in clinics and things that.
You teach at a school like I do, but I still have a private practice, but I need to be familiar with the health disparities that affect the minorities in my community. So I know how to better help them reach better levels of health in my office. I should also be very careful about monitoring my patients, who I know have preexisting conditions, such as hypertension or heart disease.
I want to pay attention to them when they’re in my office, because they’re more likely to be in my office than they are in a medical doctor’s office. Close attention. I want to monitor and document things such as blood pressure. I do that for all my patients that have hypertension, I check their blood pressure pre and post adjustments to make sure that the blood pressure it was, if it’s changed.
That’s great. If it’s lower, that’s amazing, but I want to make sure that. Blood pressure is at a level that is comfortable because it is a silent killer. So I monitor those things for my patients who do have hypertension in my office. I also, as a doctor of chiropractic, we also be able and willing to make referrals if a patient is in our practice and we don’t see them progressing on the chiropractic care.
And we also see some other issues presenting themselves. Then we ought to be willing and able to refer to the right healthcare provider. So our patients get the best care. So again, a patient in my office who they have hypertension and it’s not being controlled and is getting worse and worse.
I’ll definitely want to refer them to a cardiologist or a clinic in my community where they can get their. The care that they need, based upon that condition chiropractic is amazing. We know when we clear the nervous system, the body responds well, but there is still a limitation of matter. And some people’s bodies don’t respond as well, and they do have these pre-existing conditions.
So we should be willing and able to refer to our patients have better outcomes when they’re under our care.
So I’m going to do like a review. A lot of this information is a lot of statistical stuff and no one likes statistics, it tells us a lot about our communities. So I’m going to talk a lot about the statistics with our African black and African-American communities. So again, this is a lot of numbers, a lot of dates and things like that.
So I apologize ahead of time, but I think it’s important to understand where our black and African-American populations are in. In 2000, 1940 0.6 million people in United States are considered non-Hispanic black and that’s about 12.8% of our population. African-Americans are the second largest minority group in the United States, which Hispanic Latinos being the first in 2019, the majority of blacks lived actually in the south.
If you weathered 58.7% of African-Americans or blacks lived in the south and this population. Compared to 35.8% of non-Hispanic whites. The largest cities that have black and African-Americans are places like Texas, Georgia, Florida, New York, North Carolina. California, Maryland, Illinois, and Virginia, as well as Louisiana.
That was in 2019. So the populations African-Americans are not a large population is actually considered what’s called an emerging majority as more and more. Our populations are changing by 2050, but again, it’s 12.8% of our population will find most of them in the south, but we still find that mostly also in urban areas.
Not so much in the south Louisiana, a lot rural areas, but they’re also in a lot of the urban areas in the south as well. We talk about economics. According to the census bureau in 2019, the average non Hispanic black median household income was 43,000. So imagine a 71 compared to 71,664. We’re looking at our non-Hispanic white populations in 2019, it was imported at 21.2% of non-Hispanic blacks compared to 9% of non-Hispanic whites were living at the poverty level.
So that’s something to pay attention to. When we talk about people living at the poverty level, these are folks that really meet our. In 2019, it was also seen that unemployment rates for non Hispanic blacks were twice as much as that for non-Hispanic whites. That was at 7.1% compared to 3.7%. So many of our people, that many people that need our care of those that are unemployed and are living in the pot above, below the poverty level in our country.
Unfortunately in 2019, we’re looking at health insurance and that’s a big issue because many docs say people can get mat health insurance to afford our care. And that’s true, but not everyone is. Taking advantage of health insurance. And none of them that’d be, will qualify still for health insurance in 2019 55.9% of non-Hispanic blacks compared to 74% of non-Hispanic whites use private health insurance 43.5% of non Hispanics, blacks compared to 34.3% Hispanic whites actually relied on that.
As well as public health insurance and 10% of non-Hispanic blacks compared to 6.3% of non-Hispanic whites are just not insured at all. I had the experience of having someone come to my office who wasn’t shored. He was African-American gentleman and he wasn’t shored, but chiropractor was not covered under his insurance.
And then he had. Issue of also being unemployed. So he had not employed, but he was also on disability with his job because he could not work due to the issue he was dealing with the condition. So I ended up seeing him. I think we saw him for almost a year. Without charging him for the care. Cause I couldn’t see myself charging him and he wasn’t employed and he was able to get back to work and it was so great that just really blessed us as that, after he started back to work he would send this money to thank us.
He would send us, he sent us over $500 at one point, just to thank us for taking care of him when he wasn’t able to do better. So the reward was there. A lot of people don’t want to see patients for free and I understand that we have to keep our practices going. We have to actually. Live and survive.
But part of our chiropractic oath is that we’ve delivered care despite of a person’s ability to pay. So we delivered care and we saw some great results and got some really great feedback from him. So that was a great thing to do for us, that we felt really good about it. When we talk about life expectancy African-Americans or what we say, black African-Americans as far as 20 in the year of 2020 the birth rates were at 70, 70 becomes I.
Expressly from birth to death was 77 years. As an average, women lived 77, 79 0.8 years compared to men 74 compared to non-Hispanic whites where the projection is 80.6 years of age to live between life and death. And the men live to 78.4, where women live to 82.7. In both cases. Again, the women do live longer.
And we do see that in most committees, but African-Americans are projected to die at a younger age compared to white Americans. Generally we see higher mortality rates for African-Americans due to heart disease, stroke, cancer, asthma influenza, pneumonia, diabetes, HIV aids, and homicide. Looking at infant mortality rates.
It’s also documented that non-Hispanic blacks have a two time, 2.3%, two times higher percentage of mortality rates when we’re talking about infant mortality. We’re all we also see that babies will either die from complications or from low birth weight, as well as they’re two times more likely to die from SIDS, sudden infant deaths.
In addition to that in 2018, it was documented that non Hispanic, black African-American mothers were twice as likely to receive late prenatal care as compared to non-Hispanic white mothers. It’s also documented some research now about treatment, even in hospitals, how a women of color black African-American women or Hispanic women tend to be ignored in hospitals after having babies, when they, when there was an emergency and most likely that.
After childbirth and I in our country today, and that, to me, that’s an atrocity with all the healthcare that we have out there, all the wonderful technology we have for mothers to actually have to die because they’re being ignored in the hospitals when they tell the nurses or the doctors that they’re not feeling well after having given birth and things like that.
And they find that later they have a complication that. After giving birth. So that’s another issue. I believe that our country needs to work on as far as better treatment for all people in our facilities. We go on to things such as African-American heart disease in 2018, African-Americans were 30% more likely to die from heart disease compared to non Hispanic whites.
Although African-American adults are 40% more likely to have hypertension or high blood pressure, they are less likely than non Hispanic whites to have their blood pressure under. That’s where the due to medication or due to things like chiropractic care that has been documented to be able to help with controlling the hypertension and things like that.
They’re still most likely not to have their hypertension under control and African-American women are 60% more likely to have high blood pressure compared to African-American or non oh, it’s compared to non white non-Hispanic white women.
This is a chart done by the CDC showing the differences in non-white Hispanics blacks, non whites, blacks, and Hispanics. I’m looking at hypertension and in all three of them, the total black women, men are still the highest levels of hypertension in our communities. That’s why, again, Area. I definitely monitor on my patients, especially if they are African-American or black, I do check their blood pressure pretty regularly because of those statistics.
Looking at things such as cancer, African-Americans actually more likely to die from all cancers compared to any other population group in our country. In 2014 and 2018 African American men were most likely to die from prostate cancer or colon cancer. Same thing with. Stomach cancers as well as black and African-American men have a lower five-year cancer survival rate from most cancer sites compared to other.
Populate, especially non-whites on Hispanic, white men, black African-American men are twice as likely to die from prostate cancer. In 2014, 2018, the data shows that black African-American women were just as likely to have been diagnosed with breast cancer. However, they are 40% more likely to die from breast cancer than non-Hispanic white women.
Black and African American women also twice as likely to be diagnosed with stomach cancer. And they are two times more likely to die from stomach cancer compared to their white counterparts.
Asthma is a big thing that I need so many patients with asthma, but I’ve noticed that most of them are people of black or African-American heritage. And the data shows that 2.7 million non Hispanic blacks are reported to currently have hypertension in 2018 non Hispanic African-Americans were 40% more likely to have asthma.
Then non-Hispanic whites. And in 2019 non-Hispanic blacks were most likely to wear three times most likely to die from asthma than non-Hispanic whites in the population. Also the death rate of children with asthma who are black or African-American are, is eight times higher than those of non-Hispanic white sharks.
And lastly, not as many non Hispanic, black children or five times more likely to be admitted to the hospital for asthma compared to non Hispanic, white children and 2017. So again chiropractic is wonderful when we have seen miracles with young people with asthma, and there’s so many young people that don’t have not had the advantage of being under chiropractic care and can see their body.
Just healed from that. I know. And I know quite a few that I’ve seen some really great healings. I call them healings because they haven’t had a asthma attack in months. So years after coming under chiropractic care. And I’d love to see that for all our other populations. Obesity is always an issue in our country.
We still have a very low have an obese population in many areas, blacks and African-Americans tend to be four out of five times. For about four out of five African-American women tend to be overweight or obese in 2018. Blacks were considered 1.3 times more likely to be obese compared to non-Hispanic whites.
African-American women are 50% more likely to be obese than non Hispanic whites and see 2018 African-Americans were 20%. Less likely to engage in physical activity as compared to non-Hispanic whites. One thing about data, I think data can be skewed if you’re not careful and understand data, our numbers of what we’ve currently the rates or the numbers that we use for obesity, as far as what weight means, it makes a personal beats.
I think that also needs to be changed. Most black African-American women have. Larger bone structures. And I think we see that a lot with our patients and the documentation is there. The term obese may not be the best term for women who are larger and may have more weight, but they also have heavier bone density.
That’s a big part of that as well. So I think those also need to be altered just a little bit, too, not to make African Americans look that they’re. Eating everything. And they just fat and large. And I think that’s an understatement for how the numbers actually look. So I looked at this data and I thought about it, especially the one about people getting physical activity.
When we look at 10% of our population of African-American and black being living under the poverty level, I don’t think getting exercise or finding a park. Around is top of their list when it comes down to actually making sure you’re able to feed your family. So I do believe the data can be a bit skewed based upon people’s ability to even go to a safe area, to walk or get exercise and things that does that.
So again, I’m giving a lot of data, but I take in consideration actual people in the conditions that they may find themselves in.
Mental health is also an issue right now. Suicide is a big thing among young people. And in the 2019 data shows that it was the second leading cause suicide is the second leading cause of death for black African Americans between the ages of 15 and 20. The data is, was, is very shaky to me when I read it.
Death rate from suicide for a black or African-American man was four times greater in 2018 than African-American women. Overall suicide rate for black or African Americans was 60% lower than that of white Americans black female. Grades nine through 12 are 60% more likely to attempt suicide in 2019 as compared to non-Hispanic white females in the same age group, poverty is a big area that affects mental health.
And those who live under the poverty level are twice as likely to suffer from psychological disorders because of the stress. Being being under the poverty level and even the surgeon general found in 2000, between 1980 to 1995, the suicide rate among African-Americans between the ages of 10 to 14 increased 233% compared to a hundred.
20% we’re looking at non-Hispanic whites. So we do have children and young people that are really in danger of suicide and not being heard and going through all of these, so many horrible things in our country. And these are the things we need to pay attention to when, what, when our patients are in front of us and we’re seeing them and talking to them, these statistics may not be just for your area.
And not just before the United States, but what was important is going to places like the office of minority health. And if you go to their website, minority health, H S s.gov. They can actually find, you can actually find what the numbers are for the people of African-American or black descent in your community.
So you see specifically what those numbers look like. I just gave an overall for the United States for going through that website is where I actually went to get the information and they have every minority group and every community’s. I look at your committee and see what those numbers are, as well as contacting the county health department for your state or your community to find out what those numbers are, what issues are prevalent, what health disparities do exist in your community.
Another place to go is the CDC. Because the CDC also has an office of minority health and health equity, and they also have training in cultural competence. So in the CDC is also find data for what’s going on in your community. So you can be more informed and know where the needs are for the people that you hopefully want to serve as a doctor of chiropractic and not to let any stone go on tired or anyone fall through the cracks.
That could actually be a benefit from chiropractic care because what we do is so amazing for everyone and everyone should be included.
So next episode, I’m going to talk about the Hispanic, Latino, Latin community and our country. I’m also going to talk about the host disparities that exist within the Hispanic, Latin America, Latin communities as well. So I hope you can come by and check those out. Thank you again, ChiroSecure for giving me a space to talk about things like health disparities.
They’re not always beautiful than how pretty the picture actually is. Very sad. In many instances for me as a woman of African-American black descent. So I definitely want to pay attention to what’s going on. Cause I wanna be able to serve my community cause serving my family. Thank you for tuning in.
I hope this gave you some great insight and information. I look forward to seeing you again. Thanks.