On Friday, Oct. 23, the University of Connecticut’s Community Outreach Dialogues welcomed Dr. Sunil D’Cunha to lead the conversation “Racial Inequities in Healthcare.” The discussion, which took place over WebEx, focused on the prevalence of racial injustices in today’s healthcare system and concentrated on federally qualified health centers (FQHCs), access to healthcare regarding homelessness and specific issues of inequity relating to COVID-19.
Dr. D’Cunha has over 30 years of medical experience working throughout Connecticut. He currently works at the Charter Oak Health Center, a FQHC located in Hartford. Charter Oak serves about 20,000 patients with 98% below the poverty line, according to Dr. D’Cunha.
Dr. D’Cunha opened up the conversation by describing exactly what a FQHC is, who it is meant to serve and how it functions. The purpose of a FQHC is to provide high quality primary care in a culturally appropriate manner to anyone seeking said care, despite limitations such as cost or language. These nonprofit healthcare practices are located in marginalized areas and offer “sliding fees” to provide care even to those who can’t traditionally afford it.
According to Dr. D’Cunha, there are 1,400 FQHCs around the country and 110 specifically in Connecticut. About 6.6% of the population in the state uses FQHCs. A major aspect of FQHCs are the translation and transportation services they provide to further ensure anyone in need of care is able to access it.
At Charter Oak specifically, doctors partake in health education and social services along with providing top primary care. According to Dr. D’Cunha, a major aspect of health education at Charter Oak is ensuring patients are able to advocate for their own health. One way they do this is through the Board of Directors and Community Advisory Council. Both entities are mainly made up of patients and allow for even more direct doctor-patient dialogue.
COVID-19 has greatly affected the way in which Charter Oak and other FQHCs across the country function. So far, the clinic has tested over 8,000 people for the virus with a 3% positivity rate. The racial breakdown of this positivity rate was especially telling within the context of racial inequity in the healthcare system. Of the 3% positivity rate, 2.7% self-identified as Black, 7.5% self-identified as Hispanic and 1.7% self-identified as White, according to Dr. D’Cunha. He explained that disparity in healthcare has always been around, but COVID-19 has just brought the issue to the forefront of national attention.
“You’re as healthy as the zip code you’re born in”
“You’re as healthy as the zip code you’re born in,” Dr. D’Cunha said.
One of the biggest changes Charter Oak had to grapple with due to COVID-19 was the switch to telehealth. This was especially difficult considering many of their patients don’t have access to the technology needed for telehealth, highlighting yet another major disparity within the healthcare system.
This is especially hard for the homeless population that usually uses the clinic. Dr. D’Cunha explained how before COVID-19 hit the U.S., he would go to the South Park Inn homeless shelter twice a week to provide treatment. Charter Oak and the city of Hartford have tried to come up with creative ways to make sure everyone is still able to get the access they need. For one, the city of Hartford has set up “hot spots” throughout the city so anyone can have access anywhere. Furthermore, Charter Oak itself has been open for in-person care. Located just a mile from the homeless shelter, patients are able to walk over.
“I think today’s event went really well; I was excited to speak with Dr. D’Cunha regarding his experience with Federally Qualified Health Centers and racial inequities in health care,” Grace Burns, a fifth-semester finance major, said. As Dialogues Program Director for UConn’s Community Outreach, Burns organized the event. “Amidst the current geopolitical climate, healthcare from an intersectional lens is at stake. It was eye-opening to begin a constructive discourse about how both economic and racial disparity are directly linked to a lack of sufficient healthcare both in Connecticut and across the country.”
Lucas Knight-Vezina, a fifth-semester secondary education English major, also learned a lot from the event.
“With the pandemic and racial inequality we have been seeing in our country, it is critical to be confronting what we know about the American healthcare system with brutal honesty and acknowledge the social determinants of health.”
“I joined today’s panel because I will be leading the Healthcare Access and Education Alternative Break this spring,” Knight-Vezina explained. “With the pandemic and racial inequality we have been seeing in our country, it is critical to be confronting what we know about the American healthcare system with brutal honesty and acknowledge the social determinants of health.”
Dr. D’Cunha closed out the conversation by describing his vision of FQHCs as a means for working toward justice in terms of the racial and class inequities in the healthcare field. By not only offering treatment to anyone who needs it but also educating their patients on how and when to be advocates for their own health, Charter Oak and other FQHCs around the country are working to lessen the common disparity in the healthcare system.