Oct. 18, 2012 | Jocelyn Elders, M.D., and former U.S. Surgeon General, exhorted physicians Oct. 10 at the University of Arkansas for Medical Sciences (UAMS) to “educate, educate, educate” and take a stronger leadership role to reduce health disparities nationwide.

A graduate of and professor emeritus at UAMS, she spoke to students, faculty and staff at the UAMS Donald W. Reynolds Institute on Aging as a guest of the College of Medicine’s Department of Family and Preventive Medicine.

Elders defined a health disparity as a gap in care in one population group when it is compared to another group, chiefly groups that differ in race, ethnicity, gender, age or sexual orientation.

Physicians need to educate themselves to better understand the cultural and ethnic differences that sometimes impede communication with patients. Health education in public schools needs to be more robust and thorough, and medical professionals need to more vigorously educate the general public about the importance of preventive care, she said.

“Doctors need to take leadership in reducing health disparities and not shrug it off,” Elders said.

They need to better organize, lobby state legislative committees and get involved in other ways to get policies enacted that will help close gaps in care.

In response to a question about political strategy from Knight, chairman of the UAMS Department of Family and Preventive Medicine, she said, “We have not twisted enough arms and made ourselves heard.”

Her policy recommendations to reduce disparities include universal health insurance, a more diverse work force in the health care sector, care that is patient centered and better data collection.

Elders speaks Oct. 10 at UAMS about how to reduce health disparities.

Much of her lecture was devoted to describing health disparities and the problems underlying them.

Although the United States is first in the world in spending on health care, 66 countries have lower mortality rates.

Poverty affects access to health care as well as access to things that affect health like safe housing and good nutrition, Elders said. The United States also has the worst poverty rate among developed nations, and 52 million Americans are without any kind of health insurance.

Access also is often limited by the lack of affordable transportation, the heavy financial cost of health care and cultural differences.

“Different cultures perceive care differently,” she said.

Elders, right, talks to a former colleague, retired physician Betty Lowe, after her Oct. 10 lecture at UAMS.

Physicians and other medical professionals need to be aware to understand and overcome those differences of perception as well as have the resources to overcome any language barriers. Having an ethnically diverse, health care workforce that reflects and represents the patient population can provide an important bridge, Elders said.

“The largest health care workforce is the patient,” she said.

Once educated and informed, that patient needs to be at the center of decision making about his or her own care.

“We’ve been out there working for this for a long time,” Elders said. “But I always remember that health care, especially public health, is like dancing with a bear. When you’re dancing with a bear, you can’t get tired and sit down. You have to wait until the bear gets tired. That bear will get tired. I can see that on all these bright faces that will take over when I can’t anymore.”