Posted on: April 11, 2024 Posted by: Christina Bronner Comments: 1

Upscale interviews Horizon Media WHY Group

Miriam Browning-Nance is the Vice President of Horizon Media’s WHY Group, the agency’s intelligence center of excellence; and Karina Dobarro, is an  Executive Vice President and  managing partner of multicultural at Horizon Media. They both spoke with Tara Merchant, the Upscale Magazine Northeast Bureau Chief, to discuss the Horizon Media ‘Path to Health Study’ which reveals racial health disparities against Blacks in healthcare settings, in the U.S.


UPSCALE: What was the purpose of conducting the Path to Health study? 

KARINA: In a time of ongoing flux – including pandemic aftershocks and record economic inflation – it’s no surprise that Americans face a more complex path to healthcare than ever. Not only do people start out on an uneven playing field, but the barriers they face along the way are far from evenly distributed. That’s why we set out to focus an equity lens on healthcare sector challenges in our report The Path to Health: Shifting and Inequitable Hurdles to Care, illuminating growing and uneven hurdles to care while illustrating steps our healthcare clients can take to mitigate them. Without a doubt, race, ethnicity, and culture play a significant role in both systemic issues and individual advantages/disadvantages throughout the journey. So our follow-up, deep-dive reports have delved into the unique hurdles faced by Hispanic and Black/African American patients, and what inclusive, culturally competent care would look like. 


UPSCALE: What makes this study different from other recent studies about racial inequality in healthcare?

MIRIAM: Since we know no one is just one thing, we took an intersectional approach to healthcare. This allowed us to uncover how each person’s identities (e.g., race/ethnicity, gender, sexual orientation, disability), resources (e.g., finances, education, information, accessibility aids), and responsibilities (e.g., caregiver status, debts, work responsibilities) all come together to shape their unique path to care – by raising or lowering the hurdles they face along the way. This then illuminated unique hurdles that Black and African Americans tend to face – namely, a lack of trust in providers and in the system in general, borne not only from historical, systemic racism but also from individual experiences they and their families have had. 


UPSCALE: What were some of the top line findings from the study? 

KARINA: Almost 2 in 5 Black Americans cite a lack of trust in providers, surpassing financial barriers as the primary obstacle for only this group. This means that every provider interaction is a new opportunity to build trust – so it’s imperative for healthcare orgs to focus on representation and anti-bias/cultural competency training for providers and communicate those efforts clearly. Given that nearly 1 in 3 Black and African Americans feel that healthcare in the United States is not made for them, clearly there’s a major gap in recognizing their concerns. 

MIRIAM: This lack of trust in the healthcare system has real-world consequences in a number of ways. For instance, we found 7 in 10 of those who reported experiencing discrimination weekly feel it negatively impacts their health, with race cited as the top perceived reason for experiencing the discrimination. And of course, when negative interactions with providers stops people from seeking preventative care, that can have very long-term impacts on their health. 

KARINA: The release and uptake of the Covid-19 mRNA vaccine within Black communities is a terrific case study in how to build trust and a great learning platform: 

  • Initially hesitant, Black Americans exhibited a faster decline in vaccine hesitancy compared to Whites.  
  • Three key trust-building strategies emerged from efforts across the country: understanding core values, connecting to the community, and breaking down practical barriers to access. 


UPSCALE: What are some of the differences in the health concerns of Black men versus women, when it comes to health care? 

MIRIAM: Black women often serve as caregivers, face intersecting challenges of racism and sexism, and often find their pain or concerns dismissed, leading to higher barriers in finding trusted providers compared to all other groups.  

KARINA: More than 1 in 3 Black men admit to delaying doctor visits unless it’s an emergency, pointing to the need for communication emphasizing the importance of regular checkups, prioritizing overall health, and breaking down mental health stigma.  


UPSCALE: What can African Americans do or ask, during doctor appointments, to become better advocates for themselves? 

KARINA: Advocacy begins before the appointment is even scheduled: it starts by figuring out which providers and healthcare systems have earned your trust. This might mean looking for those that have implemented efforts like anti-bias and cultural competency trainings, turning to friends, family members, or people in your community for recommendations, or finding locations that have a higher proportion of Black/African American providers. 

MIRIAM: Ensure you’re staying on top of preventative healthcare appointments. And then, throughout the process, speak up! Make sure that your concerns are taken seriously and you’re being heard– and if they’re not, register your complaints. You might help point to the need for further inclusivity efforts and help someone else in your shoes in the future. 


UPSCALE: Thank you very much for your insights and for sharing this critically important information. 


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