When Dr. Kim Rhoads first set up Umoja Health Partners in San Francisco in June 2020, she didnt know how quickly her volunteer collective would go from providing information about COVID-19 to setting up testing and vaccine sites for communities of color facing disparities in the pandemic response.
Two years later, Umoja a word that means unity in Swahili now counts close to 60 community partners and offers other types of vaccines for monkeypox and the flu, along with screenings for patients who may be at risk for cardiovascular disease, diabetes and colon cancer, at its pop-up clinics.
Catering to African American patients but open to all, the community-based approach is crucial in reaching vulnerable populations that continue to face discrimination in health care, Rhoads said.
Discrimination in health care is just like discrimination that happens outside of health care, said Rhoads, a UCSF professor and colorectal surgeon who now focuses her research on cancer disparities and community care. Its horrible, but with health care, peoples lives are literally at stake.
Illistine Banks fills bags with information about breast cancer, colorectal cancer and diabetes along with gift cards while working with Umoja Health Partners during a community event in San Francisco.
Life-and-death stakes are at the heart of a study released this month by the California Health Care Foundation.
Conducted by Evitarus, a Black-owned public opinion research firm in Los Angeles, the study surveyed 3,325 African American adults across the state from March 5 to May 8. One in 3 reported being treated unfairly by a health care provider because of race.
The three-part study, which also ran 18 focus groups and interviewed 100 Black Californians, said women, LGBTQIA+ individuals and those with mental health conditions reported more frequent experiences with racism and inadequate pain treatment than other Black Californians.
The survey also found that Black Californians are highly intentional about their health, with 77% putting a great deal of effort into getting appropriate screenings or preventative care, while 79% said they focused on their mental health.
Dr. Vanessa Grubbs started nonprofit Black Doc Village in April to combat discrimination faced by Black health care providers.
There were very high levels of engagement with protective strategies, even for folks that had not experienced racism and discrimination, said Shakari Byerly, principal researcher at Evitarus.
Byerly said everyone should seek preventative care, but the sheer number of Black Californians who do underscores how providers have to be more proactive because of past discriminatory experiences.
Numerous studies show that several contributing factors create disparities in health care, such as living in communities with environmental problems, poor treatment at hospitals and medical centers, and distrust, which Rhoads says is a valid response to past untrustworthy behavior by the medical establishment. A recent Pew Center study stated that Black adults say less access to quality medical care where they live is a major reason why Black people in the U.S. generally have worse health outcomes than other adults.
Rhoads, who lives in Oakland, said this is why its important to meet people where they are instead of expecting them to come to you. Whats also lacking among medical institutions is connection, which is crucial in eliminating disparities. Setting up pop-up clinics in neighborhoods that are often neglected is a way to possibly mend relations and build trust, she added.
Cassandra Robertson (left) of Umoja Health Partners applies a bandage to the arm of Seana McGee after administering a COVID-19 booster shot during a health fair at Hayes Valley Playground in San Francisco.
A recommendation of the California Health Care Foundation study was to expand community-based education and advocacy for residents, which Umoja Health is doing through five dozen community partnerships with local clinics, places of worship, school districts and local governments. The volunteer-run collective hosts pop-up clinics and educational drives almost every week in San Francisco, Alameda and San Mateo counties.
Other recommendations included increasing Black representation among health care providers, holding the health care system accountable, and developing more holistic approaches to health care.
Dr. Vanessa Grubbs runs Black Doc Village, an Oakland collective that is trying to increase representation by advocating for Black trainees and physicians facing workplace discrimination.
Black residents make up 5% of the residency training programs, but account for 20% of dismissals, Grubbs said. The point of Black Doc Village is to increase the Black physician workforce so that we can improve the health of the Black community. We dont want to be catching people as theyre falling off a cliff but to actively move them out of harms way.
Cheryl Bass (left), Illistine Banks and Wilma Batiste, chair of the UCSF Abundant Life Health Ministry Network and member of Neighborhood Baptist Church, fill bags with information about breast cancer, colorectal cancer and diabetes along with gift cards in San Francisco.
Grubbs said Black physician residents are subjected to disciplinary actions and microaggressions that their white counterparts dont experience. She said Black residents can face disciplinary action over the most minuscule of issues such as dressing or speaking differently or wearing their hair a certain way.
There is a lot of work to be done, and it will take time to make processes more equitable, Grubbs said.
Rhoads believes small but consistent steps are key in making headway for Black patients. Most of her volunteer staff members are from the communities they serve, which is a way to make medical care less clinical and transactional, she said.Having a community participate in its own solutions through an active dialogue shows care, she said.
Umoja is a method, Rhoads said. It is a method of amplifying community voices and holding public health institutions accountable.
Shwanika Narayan is a San Francisco Chronicle staff writer. Email: shwanika.narayan@sfchronicle.com Twitter: @shwanika
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