Dr. Karen Winkfield
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A Journey into the Wild Blue Yonder...

1/1/2013

8 Comments

 
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There is a part of me that cannot believe I am actually starting a blog.  First of all, I can barely use my iPhone, so the whole concept of websites, blogs, Twitters, and Flickrs is completely foreign.  Indeed, learning how to manipulate this social media stuff is going to be tantamount to learning a new language.  So some may ask, what possessed me to embark upon this journey?

For years, I have been obsessed with understanding why some communities are more greatly impacted by disease than others.  Now truthfully, I was quite ignorant about the unequal burden of disease until I began working with poor and under-served communities in Durham, NC while I was in medical school. It was only through that experience that I realized that some communities have poorer overall health and worse treatment outcomes than other communities. These differences are known as health disparities.

So as a medical/graduate student, I decided that, in addition to curing cancer, I wanted to make sure that everyone had equal access to healthcare and we would no longer have underserved populations in the U.S. 

I now laugh at my naiveté, but these musings helped to fuel my current passion for community outreach and education.  You see, I wanted to know why health disparities existed.  So, as any good scientist would do, I formulated a hypothesis, developed a research strategy, and began exploring.  However, I quickly realized that healthcare disparities are a very complicated issue.  It was very difficult to differentiate between the biologic and social determinants of health.  In other words, how much of the problem is nature versus nurture??

I realized that my hypothesis-driven approach was not an appropriate way to address this problem. Instead, I needed to immerse myself in these under-served communities in order to understand them better.  This is where my training as an ethnographer comes in. 

A what?!?!? 

In 1989, I spent a summer at Northern Arizona University studying ethnography.  According to Wikipedia, ethnography is “a qualitative research design aimed at exploring cultural phenomena… It observes the world from the point of view of the subject (not the [observer] ethnographer).”  Essentially, I learned how to observe people and be a good listener.

In order to answer questions related to a community’s health and well-being, one MUST take time to fully understand the environment, the background, and the current mind-set of the individuals who make up that community.  In other words, it is impossible to fully understand health care disparities unless one takes time to actually go and talk to the members of each community exhibiting poor health outcomes!!!

So that is what I do – I go into communities and simply watch and listen.

Tedious work, to say the least. Rewarding?  Yes – but tedious.  How can I develop a larger platform – one that will enable hundreds, or perhaps thousands, to provide insights into their communities?!?!?

Several months ago, I visited Abundant Life Church in Cambridge, MA.  I was invited to speak to their youth as part of a Back to School Celebration and decided to attend the entire service, instead of racing from an abbreviated visit to my home church in Boston.  After living, working, and worshipping in Boston for over 6 years, I was impressed by how engaged this congregation was with its community.  After I delivered my short dissertation to that morning's attendees, I had a lengthy discussion with Pastor Larry Ward and shared my vision of a spirited discourse on community health.

He told me that my opinions and expertise were important and valuable, and suggested that I start blogging.  He also recommended the book “Platform” by Michael Hyatt. Now I must confess, I haven’t read the book – YET.  But his words resonated with me.  And even though I was at first frightened by the prospect of putting my opinions out there on the blogosphere for all to view (and comment upon), I realized that this was something I NEEDED to do.

So, here I am.  Will you take this journey with me??  Let’s learn from one another. Help me get to know the heart of the community!!

I welcome you to my blog: A C.L.E.A.R. Conversation on Health.
Each week, I will post an article related to one of the C.L.E.A.R. health topics listed below:

Community– Building and maintaining a healthy community.
Literacy – Health Literacy 101: Understanding and using health information
Equity – Health disparities: closing the gap
Advocacy – Ways to advocate for yourself, your family, and your community
Responsibility – Taking personal responsibility for your health

The posts will be infused with comments related to my own personal health challenges, along with thoughts on how I handle the chronic illnesses of my husband and daughter.     
  
The goal is to educate one another, so it is my hope that each visitor to this site will feel free to offer their commentary, insights, thoughts, and comments. If you have success in maintaining a healthy lifestyle, please share!!  Are there barriers that currently impact your health?? This forum may enable us to find solutions together. So please tune in each week and comment freely.  My only request is that posted comments remain respectful and profanity-free.

Thank you in advance for your participation. I pray that 2013 is a great year of exploration for each and every one of us!!

One Drop of Knowledge Can Ripple through an Entire Community.
Yours,
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8 Comments
Charvon Davis-Pierce link
1/1/2013 09:23:17 pm

Hello Dr. Karen,
What a great blog. Health disparities has been a long time argument of mine that gets a great deal of "lip service" from authoritative figures but no solutions. I work with the Witness Project, a cancer awareness organization for women of color and health disparities is what we talk about constantly. Keep up the great work!

Reply
Dr. Karen
1/2/2013 09:35:41 am

Hi Charvon. Thank you for being the FIRST responder!! And thanks for your service to the community!!

I am in complete agreement -- too much talk and too little action. The statistics about health inequities are alarming. Interesting that so much money has been poured into studying health care disparities, but not much has changed (will discuss my thoughts on this in a future blog). We need to start developing effective programs that are tailored to specific communities. Would love to hear more about your work with Witness Project. Also, DrKarenWinkfield.com has a community resource page; if you’d like to post info about the organization, please send me a private note by accessing the form on the “About” page.

Reply
Penni Urquhart
1/1/2013 10:17:43 pm

Thank you for sharing your knowledge Dr. Karen! I'm looking forward to reading more from your blog! I've come to believe that much of the disparities are due to the brokenness of our healthcare system and that we don't have basic healthcare provided for every citizen. Some people think it's socialist talk, but I think if you remove the label, it's what we need to help close the gap. Lots of other factors, I know, but don't you think that's a major one -- access to decent healthcare?

Reply
Dr. Karen
1/2/2013 09:55:29 am

Very interesting post, indeed! Well this is a loaded question. I certainly look forward to sharing my thoughts about healthcare systems and access to care. As you know MA has had universal healthcare since 2006. We have seen our uninsured rates drop from 9% to ~1.3% since inception. Yet, there has been little decrement in outcome disparities over these 6+ years. Granted, there is a lead-time before some healthcare improvements are seen. However, I have patients who have WORSE health now that they have "insurance" than they did when they were covered by Medicaid. We need to clearly define what access to healthcare is. Insurance does NOT equal access!! But I agree that providing basic care is a step in the right direction.

Reply
Vickie Washington
1/2/2013 04:49:45 am

Hi Karen,
As always I am totallly impressed by you. I think this is a great forum to hear from a highly educated, down to earth black female. I know you have a lot of insight to give to people period, no matter male, female, white, black, brown, or whatever.
I also have worked in the medical field for the past 37 years and have seen some disparities that would make you cry. I recently was involved with a patient where preventive care, not on the part of the patient but on the part of insurance, would have possibly saved his life. There are so many areas that cause disparities and education is the first step to change. Go forth and lets make a change. I am looking forward to reading more of your comments and your readers comments. Thanks for stepping out into new frontiers for you.

Reply
Dr. Karen
1/2/2013 09:59:48 am

Vickie!
Thanks for your post -- I hope it will not be your last. You have way too much to add to the discussion. Look forward to our conversations.

Reply
Jeannine Miller
1/2/2013 05:36:23 am

I definately should have my husband Joe as well read your blogs and he may want to ask you a few questions about his health. Thanks for inviting me to share in your journey.

Reply
Dr. Karen
1/2/2013 10:02:45 am

Thank you for visiting the site!! I hope Joe will join in the discussion. But he can send me a private note any time by accessing the message form on the "About" page.

Reply



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