4021.0: Tuesday, November 14, 2000 - 9:00 AM

Abstract #6491

Challenging the healthcare apartheid: Equality and equity for people of color

Raquel Z. Ordoņez, MPA, Dept. of Medicine, Division of Infectious Disease, Center for AIDS Research & Treatment, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030, 516 562 4289, ordonez@nshs.edu

The U.S. health care apartheid is more than a metaphor; it is a flesh-and-blood reality manifesting in excess deaths and disabilities, and widening disparities in health experiences and outcomes between majority and minority peoples. This paper demonstrates how the ideological, structural, financial and ethno-cultural elements reinforce and perpetuate the already entrenched health care apartheid. It also recognizes societal aspiration for equity and social justice and describes the efforts to realize this hope.

Analyzed in this context, the results of a three-year Community Health Survey conducted in New York City, 1994-96, gain social dimension and meaning. Respondents (n=564)identified themselves as Latino and Asian American immigrants living in NYC. The survey instrument was developed by the New York State Office of Minority Health. Supported by the NYS Office of Minority Health and the US DHHS Office of Minority Health, the survey sought to understand the issues of access, cultural competency and quality of care as seen through the eyes of people of color. While the survey reinforces the findings of earlier studies and research literature, it has stunning revelations. For instance, high educational attainment does not guarantee access; employment does not mean higher income and health coverage; availability of services does not necessarily mean these services will be utilized even by those who have insurance. These questions point to the complexity of the needs of minority populations, especially those who are at the same time, immigrants and people of color.

Learning Objectives: At the conclusion of the session, the participant will be able to: 1. Recognize the uniqueness and complexity of the issues of immigrants vis-a-vis access to healthcare services. 2. Analyze the healthcare issues of immigrants in the context of the political and ideological environment. 3. Analyze the interrelationship of access, cultural competency and quality of care. 4. Identify the socio-economic and ethno-cultural factors that present as barriers to access to healthcare. 5. Identify specific ethno-cultural factors that we can build on to expand healthcare services to immigrants. 6. Develop a framework around issues of access, cultural competence and quality of care as a tool in advocating policy recommendations for increased and culturally appropriate healthcare services to immigrants

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Coalition for the Advancement of Filipino Women (CAFW), New York State Office of Minority Health, US DHHS Office of Minority Health
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA