Thursday March 5, 2020
GREEN BAY - Bellin Health Systems and Green Bay's Somali community are working together to remove barriers to health care after data collected by Bellin indicated Somali patients were less likely to be up to date on cancer screenings and diabetes testing than English-speaking patients.
Bellin found only 40% of Somali-speaking patients in Green Bay are up to date on their breast cancer screening and only 47% of Somali-speaking patients were up to date on their colon cancer testing.
Not only does that mean less than half of Somali-speaking patients are up to date on cancer screening, but that Somali-speaking patients are less likely to be screened compared to English-speaking patients. Bellin found 85% of English-speaking patients are up to date on breast cancer screenings, and 80% of English-speaking patients are up to date on colon cancer testing.
Somali-speaking patients are also less likely to be up to date on blood tests for diabetes (63%) than English-speaking patients (72%).
Mahamed Rage Mahamed is a co-founder of Community Services Agency Inc., the nonprofit which serves the Somali community in Northeast Wisconsin. Bellin and COMSA have partnered to do community health outreach.
COMSA estimates about 2,500 Somali-speaking individuals live in the Green Bay area. The United Nations High Commissioner for Refugees indicates in its country profile for Somalia more that refugees have been displaced by two decades of armed conflict, as well as environmental challenges like drought. In its Refugee Health Profiles, the Centers for Disease Control and Prevention indicates more than 1 million Somalis live outside of Somalia.
Mahamed said language barriers and unfamiliarity with local health systems are key barriers to care.
"Access to health is very important to our community," Mahamed said. "Proper and quality health is very important. There's a lot of issues in the community, as you've listened here, that is a barrier: mainly language is a barrier."
Mahamed noted community members also may have experienced vastly different health care systems in the places they have lived as refugees or in their home country. They are learning how to work through the private health system and insurance systems here.
"Understanding how the health care system works here is also a huge barrier, especially when people come here as newcomers," Mahamed said.
Bellin stepped up its data collection regarding race, ethnicity, preferred language, and other dimensions of identity at some of its locations, including the downtown clinic within the past month. Data collection now includes patients' ethnicity, and patients' preferred language will be updated more frequently. Bellin calls this data "REAL (race, ethnicity and language) data."
The initiative stemmed from the work of Dr. Michelle Minikel, a family medicine physician who has been serving Somali patients since she started at Bellin's downtown Green Bay location more than 4 years ago. She analyzed what race and language-based data Bellin did have and advocated for a more thorough collection of data.
Bellin and COMSA hosted an event Saturday at the Green Bay mosque to inform the community about how cancer screenings and tests for diabetes are conducted. After the presentation, Bellin collected feedback on how to better serve the community. About 65 people attended.
Said Hasan, a COMSA co-founder and an interpreter at Saturday's event, said the health disparity numbers uncovered by Bellin's study did not surprise him.
He said community members have previously spoken with COMSA about their challenges with accessing health care. Among those challenges: the Somali community does not have a health care navigator.
"You go to Minnesota, you will see Somali-speaking doctors, nurses, in health facilities," Hasan said. "In Green Bay, to me it's not that surprising to see numbers like that because we don't have representation in the health community."
Hasan expressed optimism for improvement on that front. There are Somali students attending Bellin College in Bellevue, and the Somali community encourages its youth to take courses that may prepare them for a career in health care.
Attendees at Saturday's meeting split up into groups to talk about access to pharmaceuticals, diabetes testing, mammograms and colonoscopies. There were two sessions of discussions, so each attendee could ask questions and give feedback on at least two topics.
Among the concerns was a language barrier at the pharmacy. Bellin representatives agreed language is a barrier at the pharmacy and said Bellin is working to address this.
Another common concern was the need for faster appointment scheduling. Community members said when they need an appointment they sometimes have to wait weeks or months for the next available appointment time.
"We realize this is a problem and we are working to improve the situation," Minikel told attendees. Minikel recommended they tell the office when they call for an appointment that they need a same-day appointment. Minkel also said they may be seen sooner if they're willing to travel to a Bellin site other than downtown.
Bellin is working on several initiatives to address the disparities they identified.
"Things like getting walk-in mammograms, so that people don't need an appointment; trying to improve our access at the clinic so you don't have to wait months to get an appointment," Minkel said. "We're trying to get more access to interpreters for all different experiences with health care, including in the pharmacy."
Hasan said community members gave positive feedback to Saturday's event around health. People also expressed interest in brainstorming for future community health conversations.
"What I took out from the conversation is that we need education. We need to educate the community about prevalence of breast cancer, colon cancer, and also how they control their diabetes," Hasan said.
Hasan said COMSA and Bellin intend to develop a Somali-language survey based on what they heard Saturday to further research disparities and ideas to improve access.
Contact Nusaiba Mizan at (920)-431-8310 or [email protected]. Follow her on Twitter at @nusaiblah.