Eliminating Disparities in Health Care
Gregory Talavera, MD, MPH, San Diego State University
The research conducted by Gregory Talavera, MD, MPH explores the culture-specific beliefs that serve as barriers to chronic disease prevention and control. "All levels of government must recognize the need to invest in public health research, one of the only types of scientific research that provides an immediate health benefit to the individuals and communities it serves."
Growing up in a poverty-stricken, Latino community in San Diego, Gregory Talavera, MD, MPH, was motivated to attend medical school by what he saw every day growing up - the vast inequities in access to health care services, which were largely due to cultural barriers. Residents living in his community were families with low incomes, many of whom did not have a strong grasp of the English language. So when it came to access to health care, most families were not getting the prevention and treatment options they needed.
Talavera's approach to addressing these issues was to establish a research center embedded in the local San Ysidro Health Center. The center provides public health training and works with area residents to collect information about their health needs to better map the best course of action for the community as a whole. Additionally, the center provides health education outreach to the community. This outreach enables the center to monitor the educational practices and methods to determine which are the most effective and can be sustained to improve the health outcomes of the Latino population.
Talavera explains, "The key to success is blending science with service - the projects of this health center are ones that will contribute to scientific knowledge, and at the same time provide benefits to the patient, the center, and the community."
Because chronic disease and the lack of appropriate care is the number one problem in the Latino community, Talavera is replicating successful middle-class health programs in the center. One program integrates the treatment of mental and physical health issues, by bringing in a behavioral health consultant into the physical care unit. Patients are screened for indicators of mental health issues such as anxiety and depression. Talavera's research has shown that mental health issues can have a significant impact on biological factors. By addressing them together, Talavera has found greater adherence to treatment, which in turn is having a positive effect on the devastating diabetes epidemic in this community.
Another severe problem facing the Latino population is the exploding epidemic of childhood obesity. Treatment and accurate and relatable information about a healthy lifestyle are complicated by travel and cultural barriers. For example, there is limited access to the services provided at the Children's Hospital which is 20 miles away, and is not a good fit for the community either culturally or linguistically. Complicating matters is the misconception in Latino culture that an overweight child is a healthy child. Familiar with the community and its culture, Talavera and his staff provide families easy access to the culturally and linguistically-sensitive, clinic-based prevention and treatment. "We look at important public health issues on a larger level, rather than the individual level," says Talavera. "Since prevention is hard to measure, it doesn't get the same type of glamour of scientific breakthroughs, but it has an immediate, direct impact on the communities it serves."