Oral

The Institute of Medicine (IOM) has reported that racial-ethnic minority patients are less likely than whites to receive needed healthcare services including clinically necessary treatment and procedures for cancer, cardiovascular disease, HIV/AIDS, diabetes, and other illnesses and chronic conditions. Health status and clinical outcomes suffer as a consequence. Contributing factors identified by IOM include provider prejudice or bias and patient mistrust of the healthcare system in addition to issues around access to care and provider decision making. This session will begin with a needs assessment done in inner city Houston which addressed issues of access, transportation, insurance, cost, and environmental concerns. Our next presentation will discuss the issue of trust of the healthcare system among African-American and Latino patients, focusing on quality of care, physician competence, staff treatment, and experience at health clinics. This will be followed by a discussion of perceptions of a medical home among inner city patients in New York City, focusing on its characteristics as defined by the American Academy of Pediatrics (continuous, accessible, comprehensive, coordinated, family centered, compassionate, and culturally effective). Next, a strategy to improve diabetes outcomes for high-risk patients will be presented. Finally, the role of limited English proficiency in healthcare access for families in the child welfare system will be discussed.

Session Objectives: At the end of this session, participants will be better able to: • List ways that institutions build trust and/or foster distrust for patients of different ethnic/racial groups • Discuss ways in which health care institutions can build trust by changing structural barriers to care (such as insurance problems, interpreter services and improved racial relations) • Identify methods or strategies used to address culture, health knowledge, and literacy in a community health program • Describe the perceptions of the medical home domains among inner city families • Discuss the types of health access barriers related to limited English proficiency of caregivers in the child welfare system