Dr Eugene Tull discusses diabetes research
conducted in the USVI

Participants listen to panelists
Photos by Susan Mann

ST THOMAS, USVI: A two day conference, the second annual "Cultural Diversity and Health Disparities in the Virgin Islands: Challenges for the Health Care System," was held on October 5 and 6 in Charlotte Amalie.

While attendance was comprised of mostly islanders, a few stateside medical providers were also present for the meetings. The conference was sponsored by the UVI Caribbean Export Center; the term 'Export' is an acronym for the lengthy title, "Excellence in Partnerships for Community Outreach, Research on Health Disparities and Training."

The (US) National Center on Minority Health and Disparities has funded a total of 60 Export Center Projects in universities across the United States. The conference focused on the key reasons why USVI residents don't have access to adequate health services, especially preventive care.
 
One primary issue in the Virgin Islands is health insurance. Approximately 26,000 Virgin Islanders are uninsured, with a total of 15,000 being gainfully employed.

Senator-at-Large, Craig Barshinger, made the following statement about a health insurance bill he is sponsoring on 10/06, "We must provide every Virgin Islander with the dignity and security that comes with having a Health Insurance card. Bill 26-0194 will bring us universal insurance for all employed persons in the near future," and, "That is just the first step on the road to truly universal health care for all Virgin Islanders."

Barshinger, who heads the Legislative Health, Hospitals, and Human Services Committee, is running for re-election next month, facing competition from popular native islander, UVI, 4-H Extension Educator, Carmen Wesselhoft. He has been spearheading the bill for several months.              
 
Approximately 76,000 USVI residents do, in fact, have health insurance. However, in spite of having help with the cost of medical care, residents are still often reluctant to obtain it. Information transmission and communication differences between medical providers and patients, is one of the primary reasons.

A local physician who asked to remain anonymous told Caribbean Net News that about fifty percent of her patients are native islanders and fifty percent are individuals who are of European descent. When asked to describe the difference in how she communicates with the two groups, she responded with, "That's the problem, I don't change anything. I talk with them both the same way; I don't understand that much about this culture, it's like a different world."

Statistics made available by conference presenters indicated the leading causes of death in the US Virgin islands are: heart disease, high blood pressure, obesity, and stroke, followed by diabetes and cancer.

Among the various research projects the Export Center has completed to date are: a church-based diabetes care survey on St Thomas, a study of breast cancer risk communication and risk management between patients and medical providers, a study on the knowledge, attitudes, perceptions and decision-making of pregnant women of African heritage at risk for, or living with HIV/AIDS, and a study of health status and access to health care among African American and Afro-Caribbean women in Cleveland, St. Thomas and St. John.

Appropriate community health screenings, which also allow the University to gather data about the service needs of the public, have resulted. The Florida/Caribbean AIDS Education and Training Center will provide HIV/AIDS Training on St Thomas, St John, and St Croix during the month of October.
 
According to Paul Chwedyk, Editorial Manager of the publication "Minority Nurse", federally designated minority groups are drastically under-represented in the field of nursing. In 2004, 88.4% of all registered nurses were white, 4.6% were black, 1.8% were hispanic, 3.3% were asian/pacific, 0.4% were native american, and 1.5% of two or more races.

There is no specific data available on the percentage of blacks who are of Caribbean descent.

The nursing program at UVI is in a unique position to provide nursing professionals of Caribbean descent to the US Virgin Islands since the majority of nursing students in the program are island residents. 

Dr Gloria Callwood, Chair of the Nursing Program at UVI, informed Caribbean Net News that the retention rate, the percentage of students graduating from the four year BSN program, is 81 percent, with 53 students currently enrolled in the clinical training sequence. The BSN program was established in 1981. A two year nursing degree program is housed on the St Croix campus.

A total of 138 nurses have graduated from the BSN program since 1995. When asked how many of those graduates remained on the island, Dr Callwood stated, "If the hospital had attracted and retained the 138 nurses graduated since 1995, the shortage would be minimal. There are many factors at play here, including incentives, or lack there of,  to begin work at the hospital and to stay... some are attracted to practice on the mainland for reasons as varied  as the number who chose to go there."
 
Research presented on the final day of the conference by Dr Eugene Tull, a nationally recognized expert on Type I Diabetes, indicated that VI residents being most adversely effected by mainland customs, such as regular, fast food consumption are those residents under 30 years of age, who were born on-island.

This contributes to development of insulin resistance, and finally diabetes, and its inherent life-threatening conditions.

Dr Angela Ford, Assoc. Director of the Center for Minority Health at the University of Pittsburgh, and founder of the Black women's health promotion network, offered suggestions about how to provide health prevention services in non-traditional community settings, as a way to reach woman who do not see medical providers for preventive care.

Twenty-seven percent of USVI residents do not have health insurance, a far worse statistic than evidenced by the mainland where the total is 15.9 percent. The "Center on Budget and Policy Priorities," recently released data on the subject, which states that 46.6 million Americans do not have health insurance, up 5.4 million from 2001, including a total of  8.3 million children.