FACULTY PRACTICE FOCUS: REDUCING THE HEALTH IMPACTS OF POPULATION-BASED DISPARITIES

Purpose:  The symposium describes selected faculty practice strategies developed to address health impacts of population-based disparities in prenatal care, mental health, oral health and access to quality care.  The aims are to prepare students to understand rural and underserved clients in context of community while practicing innovative and collaborative practice approaches to reduce health effects of disparities.

Background:  The family nurse practitioner and nurse-midwifery education programs at UNM College of Nursing share the mission to prepare graduates to serve rural and underserved populations who bear a disproportionate burden of disease associated with poverty, rurality and Native and marginalization.  The University of New Mexico assumes responsibility to address the workforce disparity in the state where only 37% of nurses are bachelors-prepared, half the Institute of Medicine target and its primary care advanced practice programs strive to close the access to services gap.  Diversifying the nursing workforce to more closely mirror New Mexico’s communities is a shared faculty value.

While rich in diverse cultural heritage and natural beauty, New Mexico’s households have a median income greater than only four other states according to the American Community Survey.   Marked health status and health care access disparities persist alongside poverty and marginalization.  Endemic levels of diabetes and its associated health conditions impose risks and morbidities throughout the lifespan. 

Brief Description:  The symposium presentations describe practice approaches to disturbing disparities for New Mexicans. 1) Ranking in the lowest 5% of all states in the proportion of women receiving prenatal care in the first trimester.  Additionally, less than one third (32.7%) of women giving birth have adequate care, as measured by the Koetelchuk index.  2) An estimated 30% of women suffer from perinatal depression, a descriptor that goes in hand in hand with the Annie E. Casey Foundation ranking of 48^th in Child well-being.  3) Dual oral health disparities of inadequate access to dental care (the dentist to population ratio is one third of the federal standard) and concentration of dental disease in lesser-advantaged populations affect New Mexicans. 4) Overall access to primary care services at 214/100,000 doctor to population ratio falls well below the U.S. mean of 248/100,00.  Access to patient-centered and culturally safe services for lesser advantaged patients has received no attention.

The practice based teaching and learning environment where faculty and students engage in innovative programming to address the health impacts of disparities.  The practice is situated in a majority-minority county that mirrors population and health disparities found across New Mexico while being commute-accessible to main campus.

Key methods prominent in the symposium presentations include group care partnership with Community Health Workers, integrated nurse provider mental health services, community and inter-professional academic partnerships and advancing culturally-sensitive patient-centered care that addresses economic and social determinants of health and access.  

Outcomes: the faculty presenters in this symposium share educational, patient care and practice innovation outcomes focused on reducing New Mexico health disparities.

Author acknowledges funding support from HRSA # D11HP18976 and HRSA # UD7HP 25045