“As a Black female occupational therapist, the intersectionality between identity and profession has played an important role in shaping me both personally and professionally. It has provided me with the opportunity to gain a deeper awareness and understanding of the inequalities African Americans and other minorities experience within healthcare. In my experience, I have seen a lack of black representation within the profession. I believe that improving diversity within health care is one important step in addressing health disparities amongst African Americans.
Health disparities within the African American community are a longstanding and complex issue. African Americans traditionally experience higher rates of chronic disease and have less access to quality health care services impacting early detection and timely treatment of chronic health conditions. While there are uncontrollable risk factors that impact the prevalence of chronic disease amongst African Americans, systemic inequalities within the health care system play much too big of a role in the access to quality care, timely diagnosis and treatment, and proper surveillance of symptoms.
These facts remain true within the Tourette’s community. African Americans are underrepresented within the Tourette community because of various factors including structural inequalities within the health care system, implicit bias amongst health care providers, and general lack of education and awareness in communities that serve African Americans. Decreased access to quality health care because of geographic location, insurance barriers, and financial constraints makes early detection and diagnosis very difficult. Unfortunately, African Americans experience these barriers way too often when seeking appropriate care. It makes the role of health care professionals serving this population even more vital. It is important to provide the highest level of quality care through proper screening, early diagnosis, and giving appropriate medical treatment and resources to limit the social and emotional challenges that can so greatly impact the quality of life for those with Tourette’s.
Health care professionals must acknowledge that disparities exist amongst minority populations and practice culture competence when providing care if we want to work towards closing the gap. If a patient’s symptoms are misperceived because of implicit bias and dismissal of symptoms, we risk misdiagnosis and missed diagnoses, leading to medical mistrust and negative health consequences. This is especially true as it relates to the diagnosis of Tourette’s Syndrome as common comorbid neuropsychological conditions such as Attention-Deficit Hyperactivity-Disorder (ADHD), Anxiety, and Obsessive-Compulsive Disorder (OCD) are oftentimes present and can be more impairing than tics. Like with Tourette’s Syndrome, these conditions are less likely to be diagnosed in African Americans and are oftentimes written off as behavioral versus neurological in nature. Identification of comorbid neuropsychological conditions provide important information for ruling in the diagnosis of Tourette’s and for delivering needed treatment options.
Here’s where I believe there is opportunity to make positive changes—through advocacy, education to increase awareness, and fostering a culture of support and inclusiveness. I am motivated to be part of the solution, first by representing diversity within the profession but also by being an advocate for every patient served and participating in community engagement opportunities to raise awareness of health concerns within both the African American and Tourette’s community. Reducing health care disparities amongst African Americans in the Tourette’s community requires a concerted effort from every single one of us. Together, health care professionals, educators and individuals within the Tourette community can work towards reducing inequities by continuing to raise awareness and advocate for systematic change.” – Roshawnda Wynn, MS, OTR/L
