WINSTON-SALEM, N.C. (WGHP) — Believe it or not, where you live, work and your income are all factors that can contribute to your health.

Researchers here in the Triad are dedicating their time to looking at these factors and how they impact communities of color.

The Maya Angelou Center for Health Equity at the Wake Forest school of medicine is devoted to learning the ‘why’ behind large gaps in access to healthcare.

Associate Director, Dr. Allison Caban-Holt says the staff at MACHE focuses on different disparities in health and reaching out to underserved and marginalized populations.

“Many of the inequities that we see in healthcare and health are related to things called the social determinants of health. That’s where you live, that’s where you work, that’s where you get your medical care, it’s your environment. Many of those things have an effect on how healthy you can be,” Caban-Holt said.

Only 30% of health outcomes are due to genetics. The other 70% are a combination of environmental factors, individual behaviors, and lack of access to quality healthcare.

“If you’re working in an environment where even if you have access to healthcare that it’s too expensive for your income or that even if you want to go to the doctor well you have to take two hours out of your day but you’re going to lose two hours of income, you can’t afford to do it, so is it really access?” Caban-Holt said.

Research the center has done shows that inequities in healthcare due to social determinants of health mostly impact lower-income, communities of color. 2019 data from the National Center for Health Statistics shows the life expectancy for Black people was 4 years lower than their white counterparts. It dropped even lower after the COVID-19 pandemic.

Social determinants of health can also exacerbate certain genetic diseases that disproportionately impact people of color.

“Prostate cancer is one. There is Alzheimer’s disease, heart disease, diabetes, infant mortality, there are a number of conditions for which African Americans and American Indians are disproportionately affected negatively as compared to their white counterparts,” Caban-Holt said.

Staff at MACHE says people in underserved communities should also participate in research studies to help to document and properly address disparities in healthcare.

“As patients, sometimes certain diseases, certain conditions, we are not getting treatment,” Caban-Holt said. “With Alzheimer’s disease, we are twice as likely to develop the disease and we’re very overrepresented in who has the disease but underrepresented in the areas of research that are going to lead to the cures and treatments of that disease.”

Decades of racism in healthcare, lack of diversity in providers and various stigmas have built distrust in communities of color. One infamous example was the 40-year-long Tuskegee Experiment in which hundreds of Black men were used as test subjects — without their consent — to study the effects of syphilis, under the guise of getting free treatment for “bad blood.”

That experiment and others are the reason why many people of color are apprehensive about participating in research studies or going to the doctor for annual checkups. 

Step one is building back trust in communities of color. Staff at the Maya center does that by getting out in the community. They go to events, distribute literature and make sure people know they are there as a resource.

Step two is working on ways to make healthcare more equitable and accessible.

“We sometimes hear people throw out equity and equality. So equality is when everyone gets the same thing. So everyone gets the same amount of something. But that doesn’t take into account the fact that some people may need more. Or some people don’t need as much of a particular thing,” Caban-Holt said.