Lancaster needs more doctors, dentists and mental health counselors of color, and patients need reforms that reduce their financial hurdles and other barriers to care, panelists said Tuesday in United Way of Lancaster County’s August “Conversation About OUR Community.”
Moderated by United Way of Lancaster County President & CEO Kevin Ressler, the Zoom forum looked at “Expanding the Scope of Wellness.” Equity needs to be front and center, the panelists said.
“It is racism, not race, that creates racial disparities,” said Dr. Cherise Hamblin, an obstetrician-gynecologist at Penn Medicine Lancaster General Health and founder of the nonprofit Patients R Waiting.
Studies show that Black patients have better health outcomes when they visit Black doctors, she said. Black women who receive maternity care from Black providers have much lower infant mortality rates. However, Black students who pursue medical careers face an uphill climb: They typically have fewer social connections in the field than their White peers and are more likely to be dissuaded by teachers and guidance counselors and by the sheer cost of medical education.
Shoring up that “leaky pipeline” is crucial to expanding opportunity and increasing minority representation in medicine, she said.
Latinia Shell, a licensed professional counselor and owner of Diversity Works, likewise said there are far too few providers of color in mental health.
Clients, she said, “want a therapist that they can relate to, who has the same shared lived experience, who understands their culture, who understands their identity, who can assist them.”
Black and Hispanic men continue to struggle with the stigma around mental health, said Jobany Bedoya, owner of Red Tie Affairs and Diversity Mixers: “We were brought up and raised thinking that you go to a therapist because you’re crazy.”
He has learned to be more willing to express emotions and more comfortable with seeing a therapist to maintain mental health and talk through concerns, but it has taken time.
Like Shell, Bedoya said it’s crucial that Black and Latino have access to providers who understand first-hand the trauma of racism and the challenges of coming from a cultural minority.
Lancaster County has fewer doctors, dentists and mental health counselors than Pennsylvania as a whole, said Jackie Concepcion, vice president of operations, Union Community Care.
Concepcion kicked off the forum with an overview of Lancaster County health statistics, drawn from the Community Health Needs Assessment released this spring by Penn Medicine Lancaster General Health and WellSpan Health.
Around one in six patients surveyed for the assessment reported delaying medical, dental or mental health care. Their reasons included cost, the difficulty of securing a timely appointment and ongoing Covid-19 fears, Concepcion said.
A significant fraction of the county population continues to lack health insurance, including 29% of the population in Lancaster city’s south-side neighborhoods. A full 20.8% of the county’s children under age 6 are uninsured, which Concepcion called “incredibly high.”
Many of those patients would likely qualify for Medicaid, the Children’s Health Insurance Program, or other programs, but families may not realize it, and signing up can be complicated. Union Community Care has 10 social workers devoted to helping patients sign up for health insurance, Concepcion said.
Even patients with insurance often struggle with affordability, due to high deductibles and other plan limitations, she and other panelists said.
The Lancaster Moravian Church thinks a lot about equity at its Adult Day Center, said the Rev. Mandy Mastros, the church’s pastor.
The Adult Day Center is the county’s sole stand-alone center for seniors who need memory support or other assistance with everyday activities. Different clients are supported by different funding sources, but the organization works hard to make sure everyone receives the same benefits and programming, Mastros said.
Asked how they would like to “challenge” the community to improve wellness, the panelists called for greater understanding and support of people who may be dealing with crises or issues that aren’t immediately obvious; to get to know other people’s stories; to take time for self-care; and to insist on high standards of care for everyone, no matter their social status or circumstances.
We should “raise the floor of what’s acceptable,” Hamblin said.
Concepcion said Union Community Care aims to give every patient the best care possible.
“Let’s work toward getting people that red carpet treatment,” she said.