New center to address the health of minority women, children

The National Center for Minority Health and Health Disparities, a division of the National Institutes of Health, has named UW Medical School’s Center for the Study of Cultural Diversity in Healthcare a comprehensive center of excellence in minority health and health disparities. The distinction carries an award of approximately $4 million.

The new center will concentrate on health inequalities experienced by poor women and children of racial and ethnic minorities who live in Milwaukee. The high health risks and low health status of this group are serious and often unrecognized problems.

“Wisconsin is consistently ranked among the healthiest states in the nation, but the statistics often do not reflect the health status of disenfranchised women and their children residing in the state’s largest city,” says Gloria Johnson-Powell, Medical School associate dean for faculty development and CDH director. “According to the Wisconsin Department of Health and Family Services and several other organizations, maternal-child health disparities in Milwaukee are among the worst in the nation.”

Through research, education and community-based programs, the center will address issues that may contribute to the problem. The center will promote broad investigations that encompass biomedical, public health, behavioral and social science studies examining how biology, environment, families, friends and communities affect minority women and their children.

“We want to encourage and facilitate many more investigations into minority health problems, particularly maternal and infant health,” says Johnson-Powell, adding that several research programs examining minority health issues already are under way at the Medical School. “We’re especially interested in helping young minority scientists develop novel research programs that translate broad findings to minority populations. We will provide training programs on how to conduct culturally competent research.”

For research, education and patient care to be culturally competent, says Johnson-Powell, people must understand, value and incorporate the cultural differences of diverse populations as well as examine their own health-related values and beliefs. Cultural competency ensures an understanding of, and appreciation and respect for, differences and similarities within, among and between groups, she says.

The concept of cultural competency has resonated with Johnson-Powell since she lived in Ethiopia immediately following medical school. Ethiopian society consists of some 200 ethnic groups, most with distinct languages. “Interacting with so many different cultures challenged my belief system about how to approach each of my patients,” she says.

Curriculum improvements will be another goal. The Medical School will incorporate aspects of the curriculum Johnson-Powell has developed and taught in her 30 years as a child psychiatrist at University of California, Los Angeles and at Harvard Medical School. She is an expert on the psychosocial development of minority children and their families, and transcultural communication and training. Among other aspects, the curriculum teaches people how to recognize and avoid ethnic and racial stereotyping that can lead to discrimination and inappropriate treatment.

A third initiative will be to develop partnerships with community-based organizations and clinics in Milwaukee. “Through these relationships, we plan to sponsor health-promotion, disease-prevention and early-intervention programs,” Johnson-Powell says. “We also envision the creation of an innovative system of ‘family health agents,’ who would work at the grassroots level with community organizations, as members of the primary health-care team, identifying factors leading to health disparities. Our hope is that these agents will help eliminate the ‘unequal’ treatment that minority communities currently encounter in health care.”

The new center of excellence is a natural extension of the Center for the Study of Cultural Diversity that Johnson-Powell directs. The work of the new center should have far-ranging implications, she says, particularly since the Badger state has the fastest-growing Latino community and the second-largest Hmong community in the nation. Wisconsin also is home to a sizable Native American population.

“These diverse populations, which are increasing significantly each year, make it even more crucial that health-care providers and the health-care system be prepared to interact effectively with these groups, each of which has unique health profiles and help-seeking behaviors,” she says. “The lessons we learn from our work with maternal-child health in Milwaukee should help us address disparities affecting all these groups.”