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Episode #2009
Help Wanted: Minorities in Health Care
Lewis: Mitchell Lewis/Moderator
Mayo: Dr. Carolyn Mayo
DeShields: Annbec DeShields
Seldon: Dr. Robert M. Seldon III
Lewis: Good evening and welcome to Black Issues Forum. I'm Mitchell Lewis. According to a recent report from the Institute of Medicine at the National Academy of Science, African Americans, Hispanics, and other minority groups are grossly under-represented in the health care workforce. Yet these groups are often the very ones most adversely affected by diseases and other health concerns. Tonight we'll find out if there's any correlation. More importantly, we'll talk about a program designed to help increase the number of minorities entering health care professions here in North Carolina. I'd like to introduce tonight's guests; Dr. Carolyn Mayo is Director of the North Carolina Health Careers Access Program at the University of North Carolina at Chapel Hill. She is also a practicing speech language pathologist. Dr. Robert M. Seldon III is an orthodontist in Huntersville, North Carolina and one of only thirty-two practicing minority dentists in Mecklenburg County. He is also an Adjunct Professor in the Department of Orthodontics at the UNC Dental School. And Annbec DeShields is a Junior at UNC-Chapel Hill who is currently participating in the Health Careers Access Program. And to all of you, welcome to Black Issues Forum.
All: Thank you.
Lewis: But before we get started, let's take a look at the numbers to help us get an idea of how dramatic the need is out there. These are provided by the Cecil G. Sheps Center for Health Services Research at UNC-Chapel Hill and the 2001 US Census Data. In 2001 there were close to 16,400 physicians practicing in North Carolina. Only about five percent of those were African American and about one percent were Hispanic-Latino. Out of nearly 7,500 registered nurses, a little less than nine percent were African American and less than one percent were Hispanic-Latino. In terms of mental health, out of 1,541 psychologists, less than five percent are African American. And in the field of dentistry there are more than 3,300 dentists practicing in North Carolina but less than seven percent are African American and a tenth of a percent of the entire number are Hispanic-Latino. Dr. Mayo, I'll start off with you. Tell us, what is the North Carolina Health Careers Access Program and what is its mission?
Mayo: The North Carolina Health Careers Access Program is an inter-institutional program of the University of North Carolina. It is a program designed to increase the presence of under-represented youth in the health professions as well as economically and disadvantaged youth.
Lewis: Why is this program so important?
Mayo: Statistics have shown that there is a relationship between the practitioner in the community and the health status of that community. In other words, what we have found and data represents is that the more minorities who are practicing in a community, the better off that minority community is. What is found is that people who look like you tend to provide better service and you therefore feel that you are getting better service,
Lewis: Dr. Seldon, I'll come to you now. You are in a rather unique position being a dentist here in North Carolina. Why did you decide to get involved in dentistry?
Seldon: When I was younger and I had orthodontic treatment, I had a situation where a tooth was stuck up in the bone. And it probably wasn't necessarily the best thing to do, but I was sent to the surgeon to have a bracket put on the tooth and pull it into place. The surgeon was a friend of my father's who is also a dentist. I was asked, "Do you want to watch?" So I actually observed the procedure and was intrigued at that point back in the eighth grade and decided that this was the career choice for me.
Lewis: Now, Annbec, you are a chemistry major. What made you decide to look into dentistry?
DeShields: Well, coming into college I always knew that I wanted to do something in the health profession. I didn't quite know what health profession I wanted to go into. My freshman year I took an interest course on different allied health fields and I also became involved with the North Carolina Health Careers Access Program Ambassadors and through that program I was able to gain experience with shadowing and doing things with dentists and the dental students at the UNC School of Dentistry and so, since then, I've been into dentistry.
Lewis: Dr. Mayo, I'll come back to you. Why is the lack of minority, African American providers, considered a health hazard?
Mayo: First of all, we are trying to make sure that there is parity between the presence of minorities in the health professions and the presence of practitioners based on the populations. In other words, in North Carolina, for example, twenty-five percent of the population are minorities and we want to make sure that in every health profession there is twenty-five percent representation. So just in terms of equity and parity, that's important. The main reason that we push this cause is because again we found that minority presence in communities of color help to facilitate the health status of those communities. In other words, if we have practitioners in those communities that look like, and have the cultural and linguistic components associated with that community, people tend to, first of all, access the health delivery services better. They also tend to like the type of health service that they get from those individuals.
Lewis: Are you working with any other groups on, say, the health disparities issue?
Mayo: We have lots of partners. We have partners such as the North Carolina Office Minority of Health and Health Disparities. We work with the various health sciences schools and in particular at UNC-Chapel Hill, the Schools of Dentistry and the School of Medicine. We also work with the Area Health Education Centers Program and we engage in this partnership because all of us are interested in increasing the health status of the people of North Carolina, as well as the nation, depending on where our students go.
Lewis: One of the programs you have is called the SEP program and I believe Annbec is involved in that as well. Tell us about that program.
Mayo: The SEP program stands for the Science Enrichment Preparation Program. It is a program that is an eight week intensive program for students who are interested in health professions across the board. These students are normally rising sophomores and rising juniors. They have, in other words, completed their freshman and sophomore years. They come to us for eight weeks on the campus. We pay for pretty much everything and they are involved in academic as well as psycho-social enhancement. When I say academic enhancement, I'm talking about the types of courses that they take which includes things like physics, organic chemistry, anatomy, and physiology. Those are some examples. And then we also engage them in psycho-social development. We teach them, for example, how to acquire effective interview skills, how to develop a personal statement. We also engage them in reading, speed, and comprehension because we know that a lot of them have to read a lot when they go into these health professions, a thousand pages a night sometimes. So we do that to make sure that they have an opportunity to have a feeling of how things are when they actually get into these professions.
Lewis: Annbec, how have you been impacted by the SEP program?
DeShields: SEP. I can't speak more highly of it. It was a wonderful experience. We learned so many things and I was exposed to so many opportunities and networking opportunities. I was able to do an internship at the Dental School and shadow an oral surgeon and I was able to see my first oral surgery procedure. And things such as the reading comprehension and skills that I developed; those have helped me so much throughout the rest of the year as an undergrad. And so all of the skills that I've learned from SEP are helping my grades and helping me to become a better student.
Lewis: Were there any type of challenges you faced before getting into the program where this program has helped you out?
DeShields: Well, I needed more help with my science courses. Like she said, I learned about physics and quantitative math studies. And preparing for tests such as the DAT in order to go to dental school, those classes helped so much in like a refresher for math that you hadn't had in a while, or to help you out with taking classes that you will be taking in the semester of your home school. So it helped a lot.
Lewis: Dr. Seldon, I'll get you back into the conversation now. You are also involved in the program as well. When you were making your preparations to get into dentistry school, were there any challenges or stumbling blocks that you faced? What was your approach?
Seldon: I guess the first thing I can say is thank you to people like Dr. Mayo in preparing me because when I first arrived on campus, I immediately sought out opportunities to enhance my chances of getting into a professional program. The first thing I did, actually I met Dr. Mayo's husband first, and that began the process of me doing some research. Then through that, he turned me on to Dr. Mayo and I started working with the North Carolina Health Careers Access Program and participated with SEP. I agree completely with what Annbec had to say because it helped me most from my standpoint with reading and comprehension because it's a lot of reading and a lot of expectations and you need to learn how to pull the right information out of there so that you can at least be able to go sleep at night and make it to class the next day. Also, I would credit SEP, for me, with preparation for the Dental Admissions Test because that summer of intense study where you went every , probably every other day, and still had access to it even in some of your downtime. It helped prepare me to take the test and do well and that was really my major amount of preparation for that test to get into dental school.
Lewis: Dr. Mayo, we've talked about the SEP program, but are there other programs available to perhaps help folk who are at a younger age get interested into the health care field?
Mayo: Yes, through our partnership with the Area Health Education Centers, usually known by AHEC, we work with public schools, charter schools, private schools, around the state, providing students with a workshop, a two hour workshop entitled the Health Careers Information and Enrichment Workshops. And what we're doing through that channel is to expose students very early. In fact, with AHEC they go down to kindergarten. Our program specifically starts at fifth grade but we go K-12 and we are trying to expose these students to health careers early on. There are over three hundred different health careers that are varied in all kinds of techniques and strategies with respect to their education and so we want early exposure to help them facilitate having an informed decision.
Lewis: Have you had any type of tracking as far as the success of reaching these folks at a younger age? Has it helped?
Mayo: It definitely has helped. We have found students who have gone through the program then going on to college and involving themselves in some of these intensive programs. So, yes.
Lewis: So, I understand you also have a summer program that is involved within the program. Tell us about that.
Mayo: You're referring to the Clinical Health Summer Program, I believe.
Lewis: Yes.
Mayo: That program is actually operated by inter-institutional partners as I might not have explained but I'm going to now. We are an inter-institutional program at the University of North Carolina. We have programs located at Elizabeth City State University, University of North Carolina-Pembroke, which is an historically Native American institution, and North Carolina Central University. The Clinical Health Summer Program is conducted by those centers and what that entails is an intense experience in a clinical setting during the summer where students are paid to go to various clinical sites. That could be a private doctor, it could be a comprehensive health facility such as UNC Hospitals or Duke University, and these students stay there for eight to ten weeks. A lot of the students we found have gotten jobs as a result of that even though they're still in under grad school, they get jobs because they've had such a great experience during the summer and the people who have precepted them like them.
Lewis: You've talked about the various universities that are involved. When you really look at it, what specific regions of North Carolina are hurting the most when it comes to having those health care professionals of the same ethnic background? What regions are really hurting in the state?
Mayo: Definitely the eastern part of the state is suffering with respect to the presence of minority populations in that area and the lack of presence of the health profession, as well as the west. I think the central part, as you know, has a lot of resources. A lot of education exists in the central part. But it's the eastern part of the state and the western part of the state, I think, that are suffering the most.
Lewis: We've talked about African Americans, we've talked about Hispanics, and in some parts Native Americans in the area of Pembroke, but are Asians considered in this particular group?
Mayo: Excellent question. The Chinese and the Japanese populations are not under-represented in the health professions. However, the populations of Asians who are from the Vietnam War era are under-represented and we therefore include them in the population that we try to serve and that can include Laotians, Cambodians, the Hmong, etc.
Seldon: Dr. Seldon, let's get you back into this. Being in the health care field, at one time a lot of people would say, "Oh, he's a doctor. He's making a lot of money." Now, as salary goes and, no, we don't want you to quote your salary, but how is it as far as the salary in the health care field? Is it worth being in the health care field as far as the salary is concerned?
Seldon: I would probably try and use this by quoting something that my accountant told me. He says that for the amount of money that you spend investing and becoming what you're trying to become, you need to at least be able to reap the rewards so that it would justify it. So going into dentistry and investing the eleven years of college in terms of being an orthodontist and then also the money that's spent, and I had some classmates who spent over a hundred thousand dollars to become a dentist and sometimes more, it's worth in the end because you do get to reap some benefits and then it does set you apart and be able to provide for your family.
Lewis: Annbec, do you see financial gains or money as a motivator of being in the health care field?
DeShields: In all professions, when you look into it, you want to be financially stable. I think that's everyone's ultimate goal, But my career choice as to become a dentist, I didn't even know what the starting salary was. I just knew it was something that I was interested in, and it was a health profession, and so those were my motivations and the actual amount that they make, it does help, too, but it's not a factor.
Lewis: Dr. Seldon, being one of the few African American dentists in the Charlotte-Mecklenburg area, are most of your clients African American? Is it really working out that way?
Seldon: Right now I would say that my practice has about thirty-five percent minority. But that's taking into consideration that where I am in Huntersville, it's probably about fifteen percent minority. So, I am, I guess, accessing more people percentage-wise in that area.
Lewis: Dr. Mayo, are there any programs for those people who are already practicing in the fields where they can perhaps get mentoring or encouragement along the way?
Mayo: That are practicing in the health field?
Lewis: Yes.
Mayo: If a student or a practitioner is interested in advancing their cause then they could probably also access some of the programs that are available. We have some post-bac programs in this state. The thing that I enjoy the most about being in the area that I'm in, in terms of serving students and the population at large, is that there is extensive partnership and networking among individuals around the state. So, although we may not be the persons that would provide that service, there are post-bac programs in the state that we can at least refer them to as well as the nation. This is a big issue.
Lewis: Dr. Seldon talked about over a decade of training to become a part of this field. For folks who perhaps are thinking about a mid-life career change, would this be something for them to consider?
Mayo: Most definitely. In fact we have a lot of transitional workers who've come out of technology who are looking in the health care field. As Annbec and Robert both said, this is a very stable field. I, for example, as an Allied Health Professional, may not make the money that a dentist or a doctor makes, but I am very satisfied with what I'm doing and I know that I will always be employed there. So I think that a lot of the technology individuals are finding that this is a viable area to go into because there is a great need. The baby boomers, for example, are aging. I'm part of that group. We are going to be very demanding on the health care field to be provided the services that we desire. So this is a stable field, it is a field that's going to be very futuristic with respect to the need versus the supply and so, it's a very good field to go into.
Lewis: Just to back up a little bit. Are there any type of academic standards that one must have in order to get into your program?
Mayo: Into the SEP program in particular?
Lewis: Yes.
Mayo: Yes, the individuals, again, have to be rising sophomores and juniors and this is one of many programs. I'm going to tell you about the linkages that we have. They need a 2.5 grade point average. They should have taken some science courses and they have to write a personal statement as well as have good recommendations. So there are specific criteria for us to use and to have them access our program.
Lewis: Annbec, you'd talked about how this had helped you in other areas but one of the things we talked about earlier was mentoring. Do you feel that you have enough support as far as mentoring you along in the program?
DeShields: Oh, yes. Most definitely. My advisors have been wonderful throughout the NCH CAP program. Currently, I'm the President of the Ambassador Program which is the university arm, student arm, of the NCH CAP program. We've done so many things and it was able to be done because of them. They've always been there to support us with everything that we needed. If we needed supplies or we needed help getting funding, if we needed publicity, they're always there to just help us and encourage us to follow our goals and to try to do things that make us better applicants. They've always been there and provided that for us.
Lewis: Dr. Seldon, how important was mentoring, as you went through the program, and how important is it now that you're out of the program? Well, not really out of the program but now that you have completed it?
Seldon: Mentoring started from the very beginning and I think it's just setting a pattern and being able to follow what other people did so that you can reach that goal and it's carried over now where Dr. Mayo can call me or other administrators at the school and I'll mentor or have different students come and shadow me at work, whether I'm at the Dental School or in Huntersville. So it's very good for me because I enjoy giving back to them because there were so many people who were so willing to give information to me and help me along the way that it's the least that I can do.
Lewis: And now that you're at that point, you're an orthodontist, what is the next step for you?
Seldon: My long term goal is probably to eventually go into academics full time. Right now I'm having a part time relationship with the Dental School, but eventually, maybe when I'm fifty, in a few years.
Mayo: That brings up another point. There are going to be faculty shortages in the health sciences and so Robert is a prime example of someone who we're looking for who can take the clinical practice and move it into academia because a lot of us are retiring in the next five to ten years.
Lewis: If folks want to know more about the program, what do they need to do?
Mayo: You can call us, contact us at 919-966-2264 and we do have a website also.
Lewis: And I'll start with you , Annbec, what advice would you give to people who are wanting to get involved in the health care field?
DeShields: For those who want to get involved in the health care field, I would strongly encourage them to go out and volunteer, get exposure to all types of health career fields. They're so many out there and people don't realize. They just hear about being a medical doctor or being a dentist and that's even rare so I think that going out and getting exposure to other things is very important. And also to volunteer in your community. With the NCH CAP program we were able to put on a huge community outreach program called Health On the Block last year and it was very, very successful. So things like that and being a mentor to other students is important.
Lewis: Dr. Seldon, any advice?
Seldon: My biggest advice would be to be proactive from the standpoint of taking the time to research your field. If you don't know exactly what you want you want to do, then programs like SEP are perfect for you because you're going to meet people from pharmacy, chiropractic medicine, dentistry, what have you. So you need to find out what the people actually do and not just think the only way you can be a doctor is to be a physician. There are so many other opportunities out there for you.
Lewis: And we'll have to stop it right here. Thank you so very much for sharing your information with us. And if you would like more information about the North Carolina Health Careers Access Program or a transcript of tonight's show, visit us online at unctv.org/bif or call us at 919-549-7167. We'd like to tank you for watching tonight and invite you to join us each and every Friday night at 9:30 for information on the issues that matter. For Black Issues Forum, I'm Mitchell Lewis. Good night.
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