Dr. JoAnn Yanez on KCAA 4/14/21

Dr. JoAnn Yanez, AANMC Executive Director, joins KCAA’s NBC LA affiliate On the Brink to discuss health disparities in the medical systems and advocating for your health.

 

Full Transcript of Interview Below.

Topics Include:

  • Health disparities in the medical systems
  • Advocating for your health
  • Diversity in naturopathic education

Erin Brinker:
Welcome back. I’m Erin Brinker.

Tobin Brinker:
And I’m Tobin Brinker.

Erin Brinker:
And we are On the Brink, the morning show on KCAA AM, 1050 FM 106.5 and FM 102.3. And I am super excited to welcome back to the show Dr. JoAnn Yanez. She’s executive director of the Association of Accredited Naturopathic Medical Colleges and the chair of the Academic Collaborative for Integrative Health. She also serves on the Integrative Health Policy Consortium Education Committee, American Association of Naturopathic Physicians Board of Directors, and numerous professional committees. She joins us once a month to talk about all things related to just living well. Dr. Yanez, welcome back to the show.

Dr. JoAnn Yanez:
Hi, good morning. How are you?

Erin Brinker:
I’m doing really well. How are you?

Dr. JoAnn Yanez:
I’m okay. Day 5,795 of the pandemic.

Erin Brinker:
Oh my goodness. Doesn’t it feel like that? It really does. And my sense of time is so distorted. The normal typical milestones like seeing people’s offices decorated for Valentine’s Day and then St. Patrick’s Day and all of that is missing this year and for the last year.

Dr. JoAnn Yanez:
I know.

Erin Brinker:
Just crazy.

Dr. JoAnn Yanez:
I know. Well, on a serious note the pandemic has also raised awareness of the health disparities that we have in our country. And one of the things that we’re tackling in naturopathic medical school right now is how to teach our students about these health disparities and how to look for them, how to help prevent these inequities that we’re seeing in the medical system. The pandemic has not impacted everyone equally.

Erin Brinker:
What do you do? I mean, obviously, there are plenty of places in the inland empire and the high end low deserts where we see these. You see the stark contrast of people who have the means to have good healthcare and people who don’t. And so it is right in front of our face here.

Dr. JoAnn Yanez:
It is. And even just talking about healthcare coverage: there was a study in 2017 that looked at healthcare coverage for Hispanics, Latinos, and African-Americans, and 16% of Hispanics were insured compared to about 6% of non-Hispanic whites. The number was about 10 or 11% for African-Americans compared to that 6%. Health coverage is an issue. Health outcomes are an issue. When we look at infant mortality, the infant mortality is about double for Black Americans than it is for white Americans.

Erin Brinker:
Why? Is it nutrition?

Dr. JoAnn Yanez:
No-

Erin Brinker:
Is it access to good healthy foods? What … Wow.

Dr. JoAnn Yanez:
No. Again, when you look at … It’s so multifactorial, and part of it can be socioeconomic factors. There are direct correlations to socioeconomic issues accounting for part of the issues that people see in health care. But then there are also disparities that come from a long and not so wonderful history in medicine with medicine having a very long history of not treating people equally. Over the past year or so. I’ve been educating myself a lot more on the history in medicine that we weren’t necessarily taught.

Dr. JoAnn Yanez:
We heard about the Tuskegee experiment, and we heard about other atrocities, but there are also studies that have been done with doctors where physicians are less likely to give pain medicine to Black Americans. There are others… There’s maternal mortality that Black women are more likely to die in childbirth. And there are just varieties in the treatment of people in the health care system in addition to the disparities that we see socioeconomically, as well as with healthcare coverage and preventive services. And so it is not just one piece of a puzzle of, well, ‘people just need to eat better’ or ‘get more prenatal care’ or whatever. It’s not that simple.

Erin Brinker:
This is unconscionable. I mean, medical care is medical care. I do know that, meaning everybody should have the right to it. We all have human bodies, right? We all come to the doctor with the same physiology, or the same basic physiology. I know things are different from person to person. And the thought that … I mean, I know it’s true that people are getting different care based on skin color or socioeconomic level … that has to end. I do know that, and I’ve seen studies where women are very often taken less seriously when they talk about pain or issues than men are, and that’s even worse if you’re a woman of color.

Dr. JoAnn Yanez:
Yes. I think that there are disparities that come from a history of racism where with people of different ethnic and racial and backgrounds, there were beliefs that they felt less pain, that they didn’t require as much pain medication. And some of that comes back from our history with slavery, where slaves when they were receiving medical treatments, sometimes brutal medical treatments, didn’t feel that they could complain, that they would be beaten if they complained about pain, so they just bore it.

Erin Brinker:
Oh my goodness.

Dr. JoAnn Yanez:
And so there is a very long and I want to say ugly history of racism and racist practices in this country. And unfortunately, there are microaggressions that occur. I think of my uncle that 10 years ago, a Hispanic American male who had suffered a stroke. And when I was in the hospital, even just basic things of how doctors explain treatments and things to patients – the medical team there was working predominantly with my cousin and was explaining, “Oh, okay, well we’re going to do this. We’re going to bring your dad onto a floor.” And my uncle had had a massive stroke and his wishes were to not have any extensive treatment to prolong his life. And that was his wish. And my cousin didn’t understand that ‘moving onto a floor’ meant putting a feeding tube in, and that was going to be ‘moving onto a floor of a nursing home’. There was a lot lost in translation. And I said, okay, I looked straight at the doctor. I said, “Okay, number one, get your ethics person here on the floor. Number two, you need to explain in really plain basic English what you were about to do to my uncle and what you’re planning to do.” And as soon as they did that, my cousin obviously had to step up and say, “No, that’s not what my dad would have wanted.” But had I not been there to advocate, things would have turned out very differently. And my cousin would have been in a horrible situation realizing what happened after the fact.

Erin Brinker:
I’ve got to be honest. I wouldn’t have known what that meant. They didn’t ask. They didn’t ask him if he had an advanced directive? Nobody took the time to find out his wishes.

Dr. JoAnn Yanez:
No.

Erin Brinker:
That’s inexcusable.

Dr. JoAnn Yanez:
I think at the end of the day- and people in the medical system, this isn’t a rail against the medical system. It’s just a recognition that in medical education, we need to do more to help bridge the education gap, help bridge the knowledge gap, help bridge the communication gaps. And that doesn’t even account for language barriers; people who come in with differing levels of knowledge of the English language.

Dr. JoAnn Yanez:
And so we really just have to do more. And so in naturopathic medical education – that’s where I come from – we’re working right to really look at the curriculum from soup to nuts, and what needs to occur in our curriculum to help train our doctors to be more aware of the health disparities that they need to look for, and how to address patients in a way that is equitable and fair and promoting autonomy and health. And so there is a lot of work to do in the medical system. And I think that recognizing the problem is the first step.

Erin Brinker:
Well, I really, really appreciate the sensitive way that you have talked about this subject. And it is very, very important. Every human being deserves dignity in the care that they receive, and they deserve to be treated the same. I mean, you go in with an ailment, you need to be treated the way that anybody else going in with that ailment is treated.

Dr. JoAnn Yanez:
I think for starters though, is patients recognizing if they are feeling like there is the potential for inequity. Speaking up often in some cultures, there’s a deference to authority figures, and we’ll see that where certain populations may not feel like they can challenge necessarily the opinion of a doctor, where they just have to take it. And even if they think it’s wrong. And so I encourage patients to be advocates, to speak up … and to make sure that they’re heard and they feel listened to. I just want to make sure that people advocate for themselves.

Erin Brinker:
Well, Dr. Yanez, this has been very, very informative. How do people find you and follow you and learn more about the Association of Accredited Naturopathic Medical Colleges?

Dr. JoAnn Yanez:
So we are at aanmc.org. We have an upcoming event on Thursday talking about gastrointestinal disorders and how to have a healthier gut, gut floor, and gut bacteria. We’re all over the internet. We’re all on social media as well.

Erin Brinker:
It’s always a treat to have you on the air. Thank you so much for joining us today.

Dr. JoAnn Yanez:
Thank you for allowing me to speak. I appreciate it.

Erin Brinker:
And have a great week. With that, it is time for a break. I’m Erin Brinker.

Tobin Brinker:
And I’m Tobin Brinker.

Erin Brinker:
And we are On the Brink, the morning show on KCAA. We’ll be right back.

 

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