The University of Maryland School of Medicine has established the Center for Health Disparities to help identify and eliminate ethnic, racial, geographic and socioeconomic differences in the diagnosis and treatment of illness, and to promote equal access to healthcare. The Center for Health Disparities will coordinate patient care, research, education and outreach initiatives in Maryland’s underserved urban and rural communities, including African Americans, Native Americans, Hispanics and low-income whites. The Center was announced in a news conference in Health Sciences Facility II on Wednesday July 28, 2004.

Funded by grants from organizations such as the National Institutes of Health and the Maryland Cigarette Restitution Fund, the center’s community-based initiatives will target cancer, diabetes, kidney diseases, glaucoma, and other diseases that disproportionately affect minorities and the poor. A University of Maryland health survey of more than 5,000 adults in Baltimore City, Western Maryland and the Eastern Shore is helping to set future priorities for the center.

“We have identified serious health disparities and previously undocumented cancer risks,” says Claudia R. Baquet, M.D., M.P.H., Associate Dean for Policy and Planning and Director of the Center for Health Disparities. "The survey found that smokeless tobacco use among adults in Western Maryland was significantly higher than the national average, but only 28 percent of those surveyed had ever been screened for oral cancer," says Dr. Baquet. Survey results will be provided to the Maryland Department of Health and Mental Hygiene and to local health officers.

The University of Maryland survey revealed health disparities and barriers to care in Maryland's urban and rural communities. For example, of the smokers who were surveyed, 28 percent reported they had never been advised by a doctor, nurse or other health professional to quit. Ninety-three percent of Baltimore City smokers had never been referred to a cessation program or class to help them quit. In addition, 80 percent of African Americans and half of the whites surveyed were not familiar with the concept of a clinical trial — a research study in humans that tests a new treatment or prevention method.

“Health disparities threaten the lives of our minority, ethnic, urban and rural populations,” says Donald E. Wilson, M.D., M.A.C.P., Vice President for Medical Affairs, University of Maryland and Dean of the School of Medicine. “Depending on race, geographic location or income, patients with similar symptoms may be offered different therapies and may have different outcomes,” says Dean Wilson. Survey findings include:

Cancer Risk

• In Western Maryland, 5% of the adults surveyed use smokeless tobacco — a rate significantly higher than the national average of 3%. By comparison, self-reported smokeless tobacco use is .6% in Baltimore City and 1.5% on the Eastern Shore.
  
  
• 72% of the survey participants reported that they have never been screened for oral cancer. 86 % of African Americans surveyed said they had never been screened for oral cancer.
  
  
• 46% of respondents over the age of 50 said they never had a sigmoidoscopy or colonoscopy to test for colorectal cancer. 35% of men, including 45% of Baltimore City men over age 45, have not had a PSA (Prostate Specific Antigen) blood test to screen for prostate cancer.

Cost and Barriers to Healthcare

• 12% of those surveyed said they could not see a doctor when they needed to at least once in the last year because of the cost. Of those reporting they were uninsured, 48% said they could not see a doctor when they needed to at least once in the last year because of the cost.
  
  
• 7% of those insured through work, and 13% of those who were self-insured reported they could not see a doctor when they needed to at least once in the last year because of the cost.
  
  
• 7% of Medicare recipients and 27% of Medicaid recipients reported cost was a barrier to care in the last year.

The Center for Health Disparities will oversee and coordinate the University of Maryland School of Medicine’s statewide and national efforts to reduce health disparities. Through research and technology, education, patient care and community service programs, the Center will seek to reduce geographic and socioeconomic barriers to health care.

Center programs include:

The University of Maryland Statewide Health Network (UMSHN):

The UMSHN supports a wide variety of cancer and tobacco-related disease prevention and control activities. Funded by the Maryland Cigarette Restitution Fund, the UMSHN also provides access to continuing education programs for health care providers, and promotes cancer screening, early detection, and the latest treatment programs. Community and health professionals also provide education on clinical trials.

The University of Maryland Comprehensive Center for Health Disparities Research, Training and Outreach:

This center fosters health disparities research on renal and eye disease, cancer and mental health. The goal is to reduce and eliminate health disparities through technology and translation of research advances from bench to clinic and clinic to community. This partnership with the University of Maryland Eastern Shore is funded by a $4.7 million grant from the NIH.

The Maryland Area Health Education Center Program (AHEC):

With centers in Baltimore, Western Maryland and on the Eastern Shore, AHECs provide another important health resource for the underserved. In their senior year, School of Medicine students have required training in an AHEC to help them understand the special health needs of these populations. In addition to the instruction they receive at the AHEC site, the medical students spend time working side by side with doctors and other health care professionals who are already practicing in rural communities.

University of Maryland’s telemedicine network:

Real-time video and computer links enable physicians around the state to confer with University of Maryland physicians, allowing the transmission of diagnostic images and treatment data. University of Maryland physicians can diagnose eye disease and stroke, and monitor radiation therapy for cancer patients in rural communities. Home telehealth monitoring for Medicare patients with congestive heart failure and other chronically ill patients is occurring in Baltimore City and will soon commence in Western Maryland.