UAMS.EDU

Diversity Week sets vision for greater diversity and inclusion at UAMS

Dan Rahn, M.D., UAMS Chancellor

By Nancy Dockter, MPH
Diversity Process Coordinator
Center for Diversity Affairs

MONDAY

Kick-off event with Chancellor Dan Rahn, MD, and Vice Chancellor for Diversity and Inclusion Billy Thomas, MD

The 20th annual celebration of diversity at UAMS opened with a rollout of a long-range plan to build diversity and inclusion into every aspect of the institution’s mission. Chancellor Dan Rahn, and Billy Thomas, MD, the newly appointed vice chancellor for diversity and inclusion, unveiled the vision as well as one- and five-year goals across eight domains of activity for the state’s sole academic health center.

Rahn said that it is critical that diversity and inclusion are embraced as core values by everyone working at UAMS in order for the institution to be competitive nationally and globally.

The secret of the United States success, Rahn said, is that it has been an “incubator for innovation – an environment for new ideas that move the human condition forward.”

“We need to continue to be a magnet for global talent; if this is to continue we must have the capacity to assimilate talent from all over the nation and world,” Rahn said. “UAMS needs to be a part of that, in order to be able to recruit, support, and retain global talent.”

The diversity and inclusion plan spells out broad goals in the areas of campus climate and communication, recruitment and retention, patient care, education and training, research, human resources, institutional data, and community engagement.

“We want to create an environment that capitalizes on the richness of human diversity – not just tolerate it, but embrace it,” Rahn said.

“Diversity is not just about race and ethnic background, but also personality, learning styles and life experience,” Thomas said.

Rahn emphasized that the plan can only succeed with the full involvement of all campus units, not just the Center for Diversity Affairs.

“It cannot be Dr. Thomas’s responsibility to assure that we achieve goals in diversity; it has to be everyone’s responsibility,” Rahn said.

Rahn noted that patient care and health professions education call for a broader view of health.

“We have got to have a holistic view of healing and all the determinants that affect health,” he said.

Thomas said that a “steep learning curve” lies ahead, but emphasized there will also be the opportunity for the institution to become a “pathfinder, a national leader” in the areas of diversity, inclusion and cultural competency.

Strategies proposed for achieving greater cultural competency at UAMS, Thomas said, include community-based learning, a lecture series for which CME credit can be earned for attendance, improved language services, training for employees, a more diverse faculty and student body, and the analytic tools for assessing performance and progress.

All of this will take time and everyone working together, Thomas said. “This is not an academic endeavor but an entire campus initiative.”

TUESDAY

Cumulative UAMS Multiple Myeloma Program Patients as of April 11, 2011. View larger map.

“Real Life: Diversity Mission Possible,” presented by Bart Barlogie, MD, PhD, Director of the Myeloma Institute for Research and Therapy (MIRT); Trevor Arnett, LCSW, Social Worker with the MIRT

Barlogie and Arnett provided a snapshot of the richly diverse world of the MIRT where the lives of patients as well as the staff are transformed by the shared experience of illness, care-giving, and dying.

Since 1989, more than 9,700 people have come to the MIRT for treatment. They are from every state, with the bulk from Arkansas and the southeast. International patients, totaling more than 230, have been from 55 nations.

“All kinds of issues come up around diversity – cultural background, personal beliefs, and faith,” even the use of the refrigerator by some patients whose culture influences their food preferences and need to have special foods on hand, Arnett said.

No one is turned away from the MIRT due to inability to pay, but finances still impact a patient’s access to care. Those who are poor, without strong social support, or from an outlying area often are without the means to travel to Little Rock.

A part of the MIRT culture is the strong involvement of staff in the lives of their patients, who open their homes and hearts to them. In one case, a physician’s assistant turned over his home to a gay patient and his partner who had no place to stay. Another staff person routinely takes patients on shopping trips, a meal out or a day trip around the state during evenings and weekends.

“Multiple myeloma is the great equalizer,” Barlogie said of how the disease can change, for the better, some patients who arrive at the MIRT with an attitude of superiority. In one instance, a very wealthy man over time became sensitive to the plight of the patients who are poverty-stricken.

“What if someone runs out of gas in this economy?” he asked. In response, he donated more than a million dollars to establish a fund for patient assistance.

Race and ethnicity, gender, sexual orientation, age, socio-economic status, geography, psychosocial condition, and education, as well as financial ability and family support all are factors in how the patient copes with the disease, accesses care and accepts treatment and his or her provider. In turn, those factors affect a physician’s acceptance of a patient. 

Establishing rapport begins with the capacity “to put yourself on the level of the patient,” said Barlogie, who interspersed his presentation with a sometimes irreverent commentary on the U.S. health care system.

“Callous selfishness in light of financial distress” is a troubling aspect of the system, he said. “When patients leave [treatment], no safety net is there. It is almost like throwing somebody out in the cold.”

“There is so much emphasis on HIPAA and paperwork, the essentials get lost,” he continued. “In medical training there is a need for effective role models who exhibit humanity. All people are so well-intended, but if you don’t have role models it just doesn’t happen.” 

“It is important for us all to work to be agents of change,” Arnett said in conclusion. “Sometimes that takes stirring things up, to agitate for change. There is potential at UAMS to have a large impact for change.”

WEDNESDAY

“Pathway to Health Professions Diversity,” presented by Pat Edgerson, MPH, CHES, Director of Outreach Programs, Center for Diversity Affairs Scientific poster session – UAMS staff, faculty and students

Pat Edgerson gave an overview of the many academic enrichment programs offered by the Center for Diversity Affairs for underrepresented minority and disadvantaged students beginning in kindergarten through under-graduate studies. The objective is to develop a more diverse healthcare workforce. This past summer more than 500 students benefitted from the six- to eight-week-long, structured programs that provided instruction in the basic sciences, math and literature.

Elementary (K-6) programs are essentially geared to expose youngsters to the sciences and mathematics, while middle and high school programs such as “Hey Everybody! I’m Going to be a Doctor!” and Bridging the Gap/ACT preparation focus on basic skills for success as they approach college and exposes students to the different health professions. On the college level, the Undergraduate Summer Science Enrichment Program (USSEP) courses I and II offer an introduction to the sciences that are foundational to medicine and an intensive MCAT preparation course. The outreach programs also offer opportunities for research, shadowing and mentoring.

Following Edgerson’s presentation, six past participants of the enrichment programs presented on how they had benefitted and their career goals:

  • Darius Ford, 10th grade, Parkview High School, pharmacist
  • Alisa Roy, 10th grade, Parkview High School, obstetrician/gynecologist
  • Maya Merriweather, 11th grade, Central High School, pediatric surgeon
  • LaDijah Wood, freshman and presidential scholar, Philander Smith College, dentist
  • LaKaiya Wood, junior, Philander Smith College, physician
  • Randall Walker, 2nd UAMS College of Public Health, 1st UAMS College of Medicine

All had high praise for many facets of the summer programs, including prep for the ACT, MCAT, and daunting medical school application process as well as opportunities to step into the work world of various health care professions while at UAMS. They also expressed deep gratitude for those at UAMS who have lent support along the way.

“They are concerned not only with our success but also our wellbeing,” Walker said of the CDA staff. “The journey has not always been easy, but when you have the support of the Center for Diversity Affairs staff and the medical school students, it makes it a lot easier.”

For the remainder of the noon hour, the audience was invited to visit a scientific poster and exhibit session in the concourse of Education II.

POSTER SESSION

Decision-Making Factors Regarding HIV Testing among Rural African-American Cocaine Users, Patricia B. Wright, MPH, RN, MPH, Katharine E. Stewart, PhD, Geoffrey M. Curran, PhD, Sandra K. Walker, Brenda M. Booth, PhD

Linguistic Variations in ASL: Do Black Students Sign Different?  Andrea Toliver-Smith, MS, and Betholyn Gentry, PhD

Innovative Methods to Train Residents in Cultural Competence and in Serving the Underserved, Diane Jarrett, EdD

Poorly Controlled Asthma among High Risk Children Living in a Rural Environment, Tamara Perry, MD

African American Depression, Keneshia J. Bryant, PhD, RN, FNP-BC

Religiosity & Sexual Behavior among Individuals Living with HIV in America’s “Bible Belt,”  Brooke E. E. Montgomery, MPH, PhD,  Jean C. McSweeney, PhD, RN, FAHA, FAAN, Desi A. Sims, and Katharine E. Stewart, PhD, MPH

The Role of Religion in HIV-Risk Behaviors among Rural African-American Cocaine Users: Pilot Interviews, Brooke E. E. Montgomery, MPH, PhD,  Jean C. McSweeney, PhD, RN, FAHA, FAAN, Desi A. Sims, and Katharine E. Stewart, PhD, MPH

Disproportionality of African Americans (AA) in Special Education, Gregory C. Robinson, PhD, Pamela C. Norton, PhD, and Andi Toliver-Smith, MS

Perceptions of Hypertension Treatment among African Americans, Christina “Tina” Pettey, MNSc, FNP-BC, APN

Community Education in Geriatric Palliative Care/ Community Education, Kimberly Angelina Curseen, MD 

The Community Connector Program: Effectiveness and Current Social Network Research, M. Kathryn Stewart, MD MPH, Holly Felix, PhD, MPA, Glen Mays, PhD MPH, Naomi Cottoms, MA, Mary Olson, DMin

THURSDAY

“Improving Health in Arkansas: What More Can We Do?” presented by Creshelle Nash, MD, MPH, Assistant Professor, Dept. of Health Policy and Management, COPH

In an interactive presentation that made connections between diversity, health disparities and inequities, cultural competency and the social determinants of health, Nash posed the idea that UAMS needs to expand its view of health and health care if Arkansas is to pull out of the bottom rungs of national health rankings.

Nash distinguished two terms that are often used interchangeably: health disparity, which is a difference in health status among segments of the population, and health inequity, which is a difference in health or health care that are systemic and avoidable, and therefore are considered unfair or unjust. 

“It is not possible for everyone to have the same health, but everyone should achieve the highest level that they can by addressing injustices in the system.”

Providing culturally competent care and having structures in place to evaluate competency is an important part of the change that needs to happen, Nash said.

She asked the audience to weigh in on the question, “Is UAMS cultural competent?” then countered, “How do you know?” 

“I don’t know how culturally competent we are,” Nash said, but seeking an answer to that question could “be a huge lever for improving care for all. Have we ever looked, have we ever asked? I don’t think so, but there are lots of tools out there.”

Models developed by University of Wisconsin researchers and others, Nash noted, peg the impact of clinical care on health at a mere 20%, whereas social and economic factors and environmental factors are believed to contribute 40%, and physical environment, 10%. Health behaviors have a 30% impact.

The annual financial burden to the nation stemming from health inequities has been estimated at $1.24 trillion, when the cost of health care as well as costs associated with lost productivity, lost wages, absenteeism, family leave, and premature death are considered, according to researchers at Johns Hopkins and University of Maryland.

Nash challenged her audience to join those at UAMS who are already engaged in various efforts to address health disparities. Faculty, administrators, staff, clinicians, researchers, students, the community, and policymakers can all be a part of the multi-sector approach that is needed.

“Racial and ethnic health disparities are a prominent feature in our health care system, and academic health centers have a significant role in the solution by addressing the root causes of these disparities,” Nash concluded. “UAMS is on the path, but we have more work to do. I hope you will join me.”

FRIDAY

International Fest

In the Education II concourse, UAMS faculty, staff and students displayed cultural items and offered samples of ethnic dishes from countries from around the world, including India, China, South Korea, Kenya, Ghana, Egypt, Nigeria, Haiti, Sierra Leone, Suinam, Bahamas, Belarus, Thailand, Mexico, the Philippines, and the Czech Republic.