When Dr. Miyong Kim moved from Korea to the United States with her newborn baby, she experienced some difficulties navigating the health care system. Overwhelmed by the complicated web of specialists, insurance deductibles and physician referrals, she found herself wondering how other people adjust to the acculturation process. Thus began her
decades-long career in public health, a fulfilling journey that took her from Johns Hopkins University to UT Austin, where she serves as a professor of nursing and associate vice president for community health engagement in the DDCE.
Why should bridging health disparities be a national imperative?
We, as a country, have the most health expenditures among developed nations, but we do not have the best health indicators. In fact, compared to other developed countries, we’re doing very poor. There’s a huge gap between those who have access to care and those who don’t. And unfortunately, we have a huge population that is lacking access.
How are social determinants of health root causes of health disparities?
The Institute of Medicine has defined these determinants as “conditions in the environment in which people are born, live, learn, work, play, worship and age that affect a wide range of health, functioning and quality-of-life outcomes and risks.” Improvements in social and physical environments to promote good health for all must therefore include not only access to quality health care, but also strategies for education, childcare, housing, business, law, media, community planning, transportation and agriculture. Wealth, for example, is a strong predictor of health in the United States because it provides critical social benefits that are strongly associated with health outcomes
Could you tell us about your new Community-Based Participatory Research course?
Through CBPR, we seek to understand local communities and cultures to gain a better sense of how they are accessing health care services. This research will then inform later
intervention utilizing community member feedback and partnerships. We’ve recently launched a new graduate-level class on CBPR that connects students from all disciplines with community organizations. Together, they develop collaborative service projects to meet the needs of underserved residents.
Do you have any new developments in the works?
Recently we received some funding from the Michael and Susan Dell Foundation to do workforce analysis of community health workers (CHW), an important workforce for underserved communities. As lay health workers, they are often peers from patients’ communities. People respond better to others in their own community who understand their struggles and their intimidation of the health care system. These workers would serve as navigators, guiding residents through the system and strategizing ways to meet
their needs. It’s a way of integrating social work, medical care and behavioral coaching. The goals of our project are to include the workforce assessment (highlighting workforce and reimbursement opportunities at a state level), to develop the CHW Education Institute, and to assess the effectiveness and financial efficiency of CHW engagement
in health prevention and promotion, as well as chronic disease management at the community level.