1. Rahn Kennedy Bailey, M.D., D.F.A.P.A 113 th President National Medical Association Chairman & Professor DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES ELAM MENTAL HEALTH CENTER MEHARRY MEDICAL COLLEGE NASHVILLE, TENNESSEE 1/21

2. Overcoming Stigma Together: Changing lives, families and communities NOVEMBER 7, 2014 2/21

3. Definition of Sigma A mark of disgrace associated with a particular circumstance, quality, or person. Stigma. 2014. In Merriam-Webster.com. Retrieved October 1, 2014, from http://www.merriam-Webster.com/dictionary/sigma 3/21

4. Effects of Stigma…  Recent definitions of stigma focus on the RESULTS of stigma – the prejudice, avoidance, rejection and discrimination directed at people believed to have an illness, disorder or other trait perceived to be undesirable  Stigma causes unnecessary suffering, possibly causing a person to deny symptoms, delay treatment and refrain from daily activities  Stigma can omit people from access to housing, employment, insurance and appropriate medical care  Stigma can interfere with prevention efforts http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5920a3.htm 4/21

5. How stigmas influence the health of the African American Community http://www.count-me-in.ca/forums/slides/inclusion2.html 5/21

6. The “Un” Populations Underserved Undeserved Underprivileged Unemployed Underclass Uninsured Underinsured Undocumented Undereducated Uninformed http://www.slideshare.net/antz505/hepe-introduction-to-health-disparities-1 6/21

7. Health Is A Function Of Many Factors…  Education  Economic Stability  Social and Community Atmosphere  Neighborhood and Surrounding Environment  Health and Health Care Services Social Determinants of Health http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39 7/21

8. Social Determinants Of Health Lead To… Health Disparities www.citymatch.org:8080/05conf/MMaskay.ppt 8/21

9. Health Disparities  Gaps in quality of health and health care that reflect differences in:  Socioeconomic status  Racial and ethnic backgrounds  Education level  Disparities stem from factors including:  Accessibility of health care  Increased risk of disease  Occupational exposure  Increased risk of disease from underlying genetic, ethnic or familial factors http://www.niaid.nih.gov/topics/minorityHealth/Pages/disparities.aspx 9/21

10. Significant Statistics 10/21

11. Chronic Disease Death Rates by Race and Ethnicity http://www.patientnavigatortraining.com11/21

12. Prostate Cancer http://www.cdc.gov/Features/dsProstateCancer/12/21

13. New HIV Infections by Race/Ethnicity http://www.thebody.com/content/48447/basic-hiv-statistics.html13/21

14. Infant Mortality http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a6.htm14/21

15. Homicides Rates http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6227a1.htm15/21

16. Incarceration Rates 16/21

17. Addressing Health Disparities in the African American Community  Ongoing process  Not a discrete event  Requires collaboration from many partners  Must be evaluated frequently to:  Assess progress  Judge impact  Identify gaps, strengths and opportunities  Celebrate successes www.citymatch.org:8080/05conf/MMaskay.ppt 17/21

18. Addressing Mental Health Disparities in the African American Community  Recognize the facts:  Cultural biases against mental health professionals and health care professionals in general prevent many African Americans from accessing care, due to prior experiences with historical misdiagnoses, inadequate treatment and a lack of cultural understanding  African Americans are less likely to receive an accurate diagnoses than their Caucasian counterparts  Only 2% of Psychiatrist, 2% of Psychologists and 4% of Social Workers in the U.S. are African American  African Americans are much more likely to seek help through their primary care doctors as opposed to accessing specialty care http://www.nami.org/Content/ContentGroups/Multicultural_Support1/Fact_Sheets1/AfricanAmerican_ MentalHealth_FactSheet_2009.pdf 18/21

19. Addressing Mental Health Disparities in the African American Community  Recognize the facts:  African Americans are often at a socioeconomic disadvantage in terms of accessing both medical and mental health care  Experiences of mental illness vary across cultures and there needs to be improved cultural awareness and competence in the health care and mental health workforce  Children in foster care and the child welfare system are more likely to develop mental illness. African American children comprise 45% of the public foster care population  African Americans comprise 40% of the homeless population and only 12% of the U.S. population. People experiencing homelessness are at a greater risk for developing a mental illness http://www.nami.org/Content/ContentGroups/Multicultural_Support1/Fact_Sheets1/AfricanAmerican_ MentalHealth_FactSheet_2009.pdf 19/21

20. Where do we go from here: Overcoming Stigma in Health Care  To achieve large and sustained improvements in health outcomes we need to:  Address the Underlying Cause:  Culture  Thoughts  Treat Symptoms  Change Legislation  Evoke New Policies  Provide Funding Opportunities http://ctb.ku.edu/en/table-of-contents/analyze/analyze-community-problems-and-solutions/social-determinants-of-health/main20/21

21. Thank you! QUESTIONS AND ANSWERS 21/21