Empowering African Americans to make informed end-of-life decisions
Research shows African Americans are often unaware of options for hospice or palliative care and, therefore, less likely to access beneficial end-of-life options.
Dr. Delicia Pruitt, director of the Family Medicine Residency Program at Central Michigan University, has watched this play out in her own family and through observation when she started in private practice. While her white patients often had wills and power of attorneys established, her African American patients didn’t.
“They really didn’t want to discuss advance directives,” she said. “When we started talking about hospice, there was a lot of misunderstanding.”
With a $25,000 grant from the Blue Cross Blue Shield of Michigan Foundation and additional funding from CMU Educational Partners, Pruitt has developed an end-of life curriculum targeted toward African Americans that provides culturally relevant information about topics such as advanced directives, hospice and palliative care and wills. She wants to change the narrative about what it means to die well, particularly in the African American community.
The disparity in understanding and access has many causes but Pruitt pinpoints a cultural reluctance to discuss death as a main factor. A historical mistrust of the medical system attributed to atrocities such as the Tuskegee study and current disparities in treatment that lead to worse outcomes for African Americans also contributes to attitudes about end-of-life care.
“Addressing disparities in health care is an important part of the mission of the Blue Cross Blue Shield of Michigan Foundation,” said CEO and executive director Audrey Harvey. “We’re excited to see the outcomes of Dr. Pruitt’s work and believe providing education on end-of-life care options can make a big difference for families facing difficult decisions.”
Learn more at mibluesperspectives.com/endoflife
Supporting mom and baby in the opioid crisis
Infants exposed to opioids in the womb live in a state of overdrive as they go through withdrawal. The smallest noise can set off their high-pitched cries. Too much light can irritate them. They’re often hard to console.
In Michigan and across the country, the prevalence of babies born physically dependent on opioids – called neonatal abstinence syndrome – continues to grow. The smallest, most vulnerable population impacted by this public health crisis now accounts for about eight of every 1,000 births in Michigan, as of 2017.
For health care professionals, early pregnancy is a critical time to reach women with a substance use disorder, and evidence indicates medication-assisted treatment is the best way for both the mother and child to have the best chance at success.
Confronting the issue takes creative thinking and unconventional methods. For doctors and nurses on the front lines, finding ways to drive better outcomes will change the lives of vulnerable babies, their families and communities.
To help health care providers address the growing crisis, Blue Cross Blue Shield of Michigan, Blue Cross Blue Shield of Michigan Foundation and the Michigan Department of Health and Human Services funded local innovative solutions through a new grant program called Addressing Perinatal Opioid Use Disorder. The program supports organizations participating in one of 10 Regional Perinatal Quality Collaboratives to improve maternal and infant health.
Grant recipients include:
- RPQC Region 1: War Memorial Hospital, Sault Ste. Marie
- RPQC Region 2: Munson Medical Center, Traverse City
- RPQC Region 4: Kent County Health Department, Grand Rapids
- RPQC Region 5: Michigan Health Improvement Alliance, Bay City
- RPQC Region 7: Sparrow Hospital, Lansing
Learn more at mibluesperspectives.com/NAS
U of M researcher tests beliefs about sickle cell traits
Sickle cell trait occurs in about 8% of African Americans in the U.S., although only about 20% of affected individuals know they have it. It’s long been thought of as a benign condition, with some exceptions. Dr. Sarah Reeves, a research assistant professor at the University of Michigan who studies sickle cell disease, wanted proof. Turns out, there really wasn’t any. With support from the Michigan Department of Health and Human Services, Reeves assembled an investigative team to find some. “How do we know it’s no big deal?” she asked. Grant funding from the Blue Cross Blue Shield of Michigan Foundation was used to kick off research. She compared health outcomes and health services utilization among children with sickle cell trait, sickle cell anemia and normal hemoglobin. The team looked at whether having sickle cell trait suggested a higher rate of health care use or symptoms. “These kids (with sickle cell trait) do not seem to be at a higher risk, which is good,” Reeves said, noting that further study is needed. The findings seem to validate an accepted notion about sickle cell trait – that it might not be as detrimental for those who have it. Reeves has her sights set on more work to raise awareness of sickle cell trait, particularly with how to let people know they have it, what that means to the health of potential future children and steps they can take to make informed decisions about family planning.
Learn more at mibluesperspectives.com/SCT