Penn State Health diabetes specialist: 'Individual choice' is key to addressing health equity

Deciding to go on a journey is as important as the journey itself.

April 17, 2024Penn State Health News

That's the advice of Christy Gehman, a registered dietitian with Penn State University Health. Diabetes Care and Education Experts wanted to know how potential inequities in access to diabetes care and diabetes technology could have a significant impact on minority health outcomes.

Contributing to the local community Penn State Health Lime Springs Outpatient CenterGehman began her journey by educating herself on research about diabetes care disparities, how personal biases can affect access to care, and recommendations for ensuring all patients have access to diabetes technology. Other factors that can affect equal access to health technology include financial resources, environment, access to food, geography, social networks, legal status, and education.

Her efforts have allowed her to share her experiences with others, focusing on ways to address inequities in diabetes care and education.

Uncovering hidden biases

“When I speak with team members, other clinicians and educators, I talk about my own decision to explore issues of diabetes education and access to technology,” Gehman says. “Sharing it with others forces people to think about their own implicit biases and shows how important it is to make a personal choice to explore this decision.”

This type of communication involves learning, self-reflection and a commitment to honesty. “This requires taking the time to think about potential personal biases, but also to dedicate the time necessary to work with patients who are not native English speakers or who may take longer to make decisions as a family because of their culture,” Gehman said.

“Techquity” is about ensuring that patients of all backgrounds, races and cultures have equitable access to medical technology. The first step is educating health care providers and communities about possible inequities in access to technology and making the conscious choice to be honest with yourself about biases, she says.

Open to other perspectives

“The second step is acknowledging other people's experiences,” Gehman says. “We tend to see things through our own experiences, our own filters. We need to listen to people who come from different backgrounds, who may see our care and how we treat patients as very different from their own experience.”

Finally, the journey also includes advocacy: Teams should commit to discussing scenarios that address potential inequities and help patients understand each other and patients from different cultures, and take the time to practice these skills, she said.

Breaking down barriers to healthcare

Gehman's recommendations are consistent with those promoted by the Association of Diabetes Care and Education Professionals:

• Making the most of diabetes technology for all patients
• Providing education on device payments and health access
• Screening for barriers that at-risk individuals may face
• Participate in training on bias of all kinds
• Share stories of inequities and efforts to address them with other clinicians and those making health care decisions.

The association is asking its members to help raise awareness of these issues and expose barriers and discrimination to effective self-care, she said.

Gehman praised Penn State Health's efforts to address health care disparities. “I'm grateful for the opportunity Penn State Health provided to learn about and develop an awareness of diversity, and I'm grateful to work with a team that strives to be self-aware and treat all patients with compassion,” she said.

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