AMEN 2008: Linked for Service

Adventist Medical Evangelism Network (AMEN)

AMEN 2008 Plenary Sessions

Naren James

Playing it Safe or Accepting the Adventure

Allen Lloyd

Knowing and Following the Lord’s Will

Roger Miller

Lift Up Your Eyes

Robert Spady

A Church/Clinic Experiment: Lessons Learned -- Challenges and Where to Go from Here

Doug Batchelor

Healed and Cleansed

Richard Hart

AMEN 2008: LLU Student Mission Reports

James Kyle

The Last Call

I've had the wonderful pleasure of combining both my preaching ministry with a medical ministry.

I knew that on a Sunday morning after breakfast and before discharge that I needed something that would hold people's attention.

So I decided to combine an apocalyptic portion and a medical portion.

So the last call, We preachers always use things like the last call.

And this gets, what is he really talking about?

But we're really gonna talk about the health ministry and the social determinants of health.

I hope if I'm successful today to make you a little uncomfortable.

I remember 1 preacher told me once he said your role is to go and bring comfort to the afflicted and then to afflict the comfortable.

So I don't know if you're afflicted or comfortable with this 1.

Either way we're going to try to work with you.

I want to talk to you about why the equally created die unequally.

Since 2004, the Institute of Medicine has essentially acknowledged the existence of racial and ethnic health disparities in our society.

As physicians, Depending on where you've trained, you've seen the outcomes of these disparities in your residency training programs and your fellowships.

Where patients in certain communities from certain ethnic groups will have significant problems.

These disparities commit America's minorities to having excess burdens from disease, morbidity, mortality, and this excess burden of disease is also accompanied by shocking disparities in the treatment and the outcomes in these patients.

Some of the major studies that have been done in this area have been seen in the book, I think it was put out in 2004, called Unequal Health.

It was the Eye Institute of Medicine report.

And essentially the book, when it first hit was somewhat controversial.

The Bush administration sequestered the book for about 6 months before it was actually released.

So those who had a chance to read the study were coming out talking about the study.

And what they found out is that racial and ethnic minorities in this country die of disproportionate numbers of almost every disease you can imagine.

Hypertension, diabetes, heart disease, cancer.

At rates that are significantly higher than their white counterparts.

And it begins to make us ask some kinds of questions, like what's going on in the community that causes these high rates of disease and death.

They also found out, even when those patients present for treatment, that their treatment options are handled disparately by the medical profession, which means that an African American, as a matter of fact, there's a great study that was done, they took an African American and an Anglo man and they gave them the same biography, these are actors, they gave them the same kind of biography to take into the ER and they went in complaining of left sided chest pain, crushing, radiating to the neck, down the arm.

They were both told that they were engineers, trained at the same kind of Ivy League schools, similar income, similar insurance, and they found that on average the white patient more than 3 or 4 times was offered appropriate care as compared to the black patient.

No 1 thought that they actually needed to have a coronary artery angiogram.

Now let's look at health care disparities in their broader context.

Health disparities are experienced in a context, in a broader context than most public health practices fully address.

The excessive burden of disease that characterizes both black and Hispanic and other minorities in particular may be attributable to medical causation.

But disparities need to be understood as a mosaic.

Health disparities are not an isolated phenomena, but are created in a mosaic of complex interactions within the natural, political, social, and economic environment.

I wish we could live outside of all those, but all of those affect us.

So what's going on on Wall Street right now affects everybody.

Have you looked at your 401k plan recently?

Have you thought about the value of your house?

Have you looked at what's going on in the state of California in terms of its budget or many other states?

Significant progress in eliminating health disparities will not occur in a vacuum, but will be accomplished when we challenge the environmental determinants of health.

In this room are probably a collection of some of the best lifestyle physicians and practitioners in the world.

But what we need to do cannot be done from the context of an individual practicing one-on-one.

To deal with health disparities, you have to actually begin to coalesce and work with others in our discipline and outside of our discipline to make changes in the communities in which we serve.

Let's talk about some of the social determinants of health.

We all know that being poor is not good for your health.

That's why all of us do our best not to be poor.

Poor people have a higher burden of disease, higher burden of illness, live in worse housing, have poor access to good nutrition, and therefore all of the side effects of being exposed to those environmental factors are higher.

Racism is a factor in this country in terms of health disparities.

Try attending an inner city urban high school and then apply to college.

It's going to be tough to get into any college because the average child coming through most inner city urban high schools probably only reads at a sixth or seventh grade level upon graduation.

You know, we tell people all the time, education is your option.

Well, education is the option if you're in a school that actually is committed to your educational success.

If you're in a school that's only committed to moving you through, then you're not going to have much of an education.

High levels of incarceration, we're going to talk about that later, but in minority communities there are large numbers of people who are incarcerated.

And these incarcerated individuals are not only removed from the community, but also exposed to a whole new spectrum of disease while in incarceration.

And then they come back into the community.

1 of the things that we find in high levels of incarceration in poor communities is that this has also affected the spread of HIV AIDS.

Here in the state of California, you cannot pass out condoms in state penitentiaries to inmates.

The reason you can't, because the state of California passed a law that has prohibited any form of sexual contact between men in prison.

Men have sexual contact in prison not because they are gay, it is sex of convenience.

So the state of California said you can't pass out condoms because we don't allow these men to have sex.

You mean you've got a prison full of people who are in prison because they have no respect for the law and then you pass the law that says they cannot have sex while they're in prison and you expect that those people who are in prison will obey that law while they have disobeyed all other laws that got them into prison in the first place.

And so these men come out of prison infected with HIV, but they are essentially heterosexual.

And so they take the disease back into communities and infect women, who then infect children.

And so incarceration for minority communities has a major impact upon the HIV spread in those same communities when these men come out of jail.

Low self-esteem is another social determinant.

When people don't feel good about themselves, when their image about themselves is negative, they have negative habits.

If you don't care about yourself, then you don't care about others.

So why would I hesitate to shoot you in a drive-by when I don't think I'm going to live past my 16th birthday anyway?

Urban overcrowding, I'm sure you've seen studies about the impact of urban overcrowding in terms of health status.

When you put too many people in too close a proximity to each other, you just begin to create a lot of stress and spread infectious diseases that are very communicable.

Malnutrition in poor communities is not the same as you see malnutrition in other countries.

Malnutrition in America for the most part is calorie, caloric excess.

It is a great availability of food to the masses and especially poor food and junk food.

Inside most poor communities, you can always find McDonald's, a Jack in the Box, a liquor store on every corner.

It's hard to find an actual supermarket that has groceries and vegetables and fruit that are available at good prices.

So when you take a patient in your office, if you're office, if you're having a patient who are coming from poor communities and you give them a lifestyle prescription that included good nutrition and diet, when those folks go back into the communities where they came from, they're not going to find any of what you've asked them to find accessible at a price that they can afford.

So let's look at the desperate environment that some of the patients we are going to deal with live in.

We talked about poor education and a dysfunctional school home nexus leads to dropouts.

There's a school about 100 miles from here in Los Angeles called Crenshaw High.

Crenshaw High has a dropout rate somewhere around 50 to 60% of its students who start as freshmen drop out before they become seniors.

Students who drop out are more likely to live poor and students who drop out of school are more likely to become arrested because they have no education, they have no way to earn a living, what do you expect them to do?

And they will tell you, well crime's all I had as an option, So I slung drugs for a living.

Poverty spawns malnutrition, obesity, isolation, violence, and overall poor health status.

Let's look at race disparities in education.

White adults were more likely than blacks and Hispanic adults to have a college degree.

Series

AMEN 2008 Plenary Sessions

The Last Call

Transcript

Parent Series

Parent Conference

Sponsor

Recorded

Mark Finley: Medical Evangelism

Medical Evangelism, Part 2

38m

Track 1 Seminars

Tools for Soul-Winning Health Expos, Part 2

47m

You Can’t Sell It, If You Don’t Stock It

29m

AMEN 2013: Plenary Sessions

Remote Area Medical: Volunteers Mobilizing Healthcare & Conference Summary

47m

AMEN 2013: Breakout Sessions C

Keys to Successful Comprehensive Health Ministry in the Local Church

59m

Plenary

The 6th Competency: Systems-Based (Spiritual) Practice

53m

Pastor/Physician Team

Spiritual Intervention in Medical Practice: Why, Who and How

1h 1m

Plenary

Essential Elements of Effective Health Ministry

47m

Dwayne Lemon Revival

God’s Great Desire

58m

The Example of Christ as the Great Physician

52m

Health Ministry in Church

31m

Breakout Sessions C

Choosing a Specialty and Finding a Residency

57m

Sound Doctrine