At the 2023 Minnesota State of Reform Health Policy Conference, several leaders met to discuss solutions to racial and Tribal health disparities.
Erica Lester, workforce development manager for the Minnesota Association of Community Health Centers, said her association has 17 health centers across the state.
“We have some amazing healthcare in Minnesota, but also some of the worst disparities in the nation,” Lester said.
Lester noted how 54 percent of Black Americans who die from heart disease are younger than 65 years, compared to 14 percent for their white counterparts. Panelists agreed that a key area of focus to address health inequities going forward is to assist public and private sector employers with developing and implementing plans of action.
Lester explained how in the past several years, the association has worked on creative solutions to address workforce issues across the association’s health centers.
“One of the biggest problems we’ve seen across our health centers is a massive shortage of medical and dental assistants,” Lester said. “A lot of the schools who had these programs either closed temporarily while the pandemic was going on, or closed permanently because they weren’t getting in students.”
Lester said it’s crucial for the healthcare workforce to reflect the patients served in terms of languages and racial and ethnic backgrounds. She brought up the medical and dental assistant Apprenticeship Program, which provides on-the-job paid training for 12 months for individuals seeking to become a medical assistant or dental assistant.
Online curriculum is included in the program, and at the end of the 12-month period, apprentices may take the Certified Clinical Medical Assistant exam. If individuals pass, they become a certified medical assistant. Dental assistant apprentices are not eligible for a certification and will be considered unlicensed dental assistants.
Antony Stately, PhD, executive officer and president of the Native American Community Clinic, was raised in southern Minneapolis by Ojibwe parents, and has worked in urban and Tribal health since 1997.
“The thing that drives so many disparities for Black and Brown people, especially in the state of Minnesota, which is where my heart and my soul is because I was born here, it is definitely structural,” Stately said. “There is something deeply wrong with the structure in which healthcare at large functions within the state of Minnesota, if not the United States, that significantly disadvantages and creates tremendous disparities—inequities really.”
Stately added how inequities within these communities are driven by poor input about what is happening on the ground, and a lack of investment in the workforce. Stately is a Native psychologist, and said less than one percent of all psychologists in the United States are Native. The Native American Community Clinic is also participating in the medical and dental assistant Apprenticeship Program to recruit more members of the Native community and to provide career support and growth.
“Our patients want to see providers and doctors and nurses and frontline staff that look like them and reflect them,” Stately said.
Michelle Archambault, director of the healthcare market at Genentech, a biotech company, said there is a need for digging into more data and increasing engagement with communities to identify issues and solutions.
“We have been focused on diversity, equity, and inclusion for a couple of years,” Archambault said.
Archambault mentioned how there is a significant cost for neglecting preventative and ongoing care for select populations, which amounts to $1 trillion. She said Genentech is partnering with health systems, payers, and communities to listen, learn, and co-create solutions.
Stately said community organizations are in the best position to come up with solutions that assist their communities. He brought up the issue of white fragility, which is the theory that if too many resources are given to Black and Brown individuals, then they will become wealthier, healthier, and more powerful, and will turn on white individuals.
“What we do as Black and Brown people, is we do a better job of taking care of ourselves, and we also do a better job of taking care of you,” Stately said.