- 2 days ago
In this month’s Stay Well Health Chat, Virtua Health’s Dr. Arleen Ayala-Crespo discusses women’s health equity, routine care, trust, and the importance of taking the first step toward better health.
Category
📚
LearningTranscript
00:02Hi, I'm Nicole from 92.5 XTU and I'm Marissa from the Preston and Steve show and welcome
00:07to another edition of the Stay Well Health Chat with Virtua Health.
00:11And we are so excited to welcome, hopefully I'm saying this right, Dr. Ajayah Crespo,
00:17right?
00:18Ajayah.
00:19Ajayah Crespo.
00:20Ajayah Crespo.
00:21Your first name is beautiful.
00:23Arlene, thank you so much for joining us today.
00:26Thank you for having me.
00:27Well, Dr. Crespo is a board certified OBGYN at the Center for Women, Willingboro and Voorhees,
00:34providing a professionalized, personalized approach to pregnancy care, gynecology and lifelong
00:40wellness.
00:41Something all of us women need and we have a lot to talk about.
00:44She's passionate about improving women's health, maternity leave access and health inequalities.
00:50Thank you in advance for everything that you do for women around our region.
00:56Today we are talking about a very important topic, women's health equity.
01:01But before we get into equity, we're going to start with just women's health, which is
01:05obviously so important.
01:06We know women who are juggling multiple priorities.
01:09They are busy taking care of their children, their spouse, their parents, and they sometimes
01:14put their own health on the back burner.
01:15We talk about this a lot.
01:16So what are some of the most important things that we should be making time for?
01:23So you guys hit the nail on the head with that.
01:26Definitely.
01:27Definitely.
01:27We as women have way too many hats to carry.
01:31So we're parents, we're children, we're taking care of our parents, we're spouses.
01:37We also work.
01:39We're in the workforce.
01:39And we completely forget that if we do not have our battery at a hundred percent, we truly
01:49cannot give a hundred percent of ourselves.
01:51So we want to be a hundred percent and that includes our health.
01:58So that is a lifelong journey.
02:01So going to the doctor and taking care of your health and prioritizing your health is
02:06a lifelong journey.
02:07And it may start with your first visit to your, you know, to your pediatrician.
02:12And then as you grow as an adult in women's health, specifically going to your gynecologist
02:18and having your first pap smear, um, then becoming pregnant in the reproductive years,
02:24if that's something that you're interested in and then getting prenatal care.
02:28So all of these things are extremely important.
02:31And then as we transition, you know, some of us are getting a little bit older as we transition,
02:36then there's menopause and it is a lifelong journey.
02:39And hopefully you can create a partnership with your doctor so that we're there for you.
02:44Absolutely.
02:45All right.
02:46So that's where the journey should begin, but for not everybody, we're not all there.
02:51And I'm saying we, cause I'm one of those people that are not the best at this.
02:54And this is why I love these conversations because all need reminders and we all need
02:59to look out for each other.
03:00Um, so that's the bigger conversation around health and where health equity comes in.
03:05Health equity seems to be gaining traction.
03:07Um, it's become a bit of a buzzword in the community.
03:11So can you explain what health equity is and why it's so important?
03:14Yes.
03:15So I'm going to give a little example about how, what is health equity and how it's different
03:20from equality, which I think people just assume is the same.
03:24So I have 10 candy to give and I have 10 people to give this candy to.
03:28If I give one piece to each person, that's self equality.
03:32That is equality.
03:33I'm giving each person the same.
03:35But when you take into account equity, you're looking at that.
03:39We do not all start at the same spot that some people may have five candy that people
03:44may have to, and that's people may have none.
03:46So when you distribute that evenly so that everybody is finishing at the same spot, that is equity.
03:55And there are many things that make equity not attainable at this moment for people.
04:02And that may be limitations to getting access to care.
04:07So socioeconomic status, lack of insurance, lack of transportation.
04:12But there is some, a very important part that we as physicians play.
04:17And that is bias.
04:18And I feel like a lot of people don't realize how we have an implicit bias and whoever thinks
04:25that they don't is just completely wrong because we all do.
04:27We all have this kind of predisposed conception about somebody based on just what we're looking
04:34at and not on the actual person.
04:36And sometimes that can be because of somebody's color, because of somebody's status, because
04:41of where they went to school.
04:42And understanding that that bias exists and that we realizing that we have it is actually
04:51so important in making sure that we create equity.
04:55So what are the repercussions that can come from not following up on the health equity?
05:01Yeah.
05:01In regards to delayed care, like if you wait too long.
05:05Yeah.
05:06So I think this is especially important because we know that delays in care then are going to
05:13translate into misscreenings, misdiagnosis, delayed diagnosis and worse outcomes.
05:19So it's not the same, for example, to catch somebody in stage one breast cancer.
05:25You're not going to have the same outcomes as somebody that was caught at stage three breast
05:29cancer.
05:29The same goes for, you know, cervical cancer.
05:33And there are things that we routinely can screen for that if we catch early enough, we can
05:41make a significant difference in those outcomes.
05:44And I think that that's where that health equity and making sure that patients get to
05:51care is so important.
05:53At Virtua, the care for women specifically is all encompassing.
05:57Could you talk about that a little bit?
05:59Specifically Center for Women where, you know, I offer services.
06:03We offer, like you said, wrap around care.
06:06So that is going to include a social worker, nutritionist, help with financial services.
06:14That is all going to be included in the care that we provide.
06:20So I think that that's kind of what I love about working specifically for Center for Women
06:24is that we can help, truly help with those barriers.
06:28Yeah.
06:29And you really love where you work.
06:30You can just feel it, feel the screen.
06:33Yeah, absolutely.
06:34So special.
06:35When we look at our own region, we can actually see how these barriers play out in real life
06:40in South Jersey and in Philadelphia, the higher rates of preterm birth and complications in
06:46underserved communities.
06:48Black women are significantly more likely to die from pregnancy related causes than white women.
06:54And this has been in the news a lot lately as well.
06:57Can you explain why that is?
06:59Yes.
07:00So taking, for example, somebody who is very high profile like Serena Williams and how she
07:06had to advocate for herself during her birth because she was not being listened to.
07:09So I think a lot of that goes back to the bias and how women of color and women, uh,
07:17non
07:17whites are truly sometimes not being listened to.
07:21Um, they are not being listened to when they complain.
07:24They are not being believed when they say things.
07:27And because of these lack of communication and lack of, uh, understanding and actually listening
07:35to the patient, this is where we're missing stuff.
07:38This is where, where these things can happen, where if we can catch these things early, we
07:45can catch these symptoms early.
07:46But if we are not listening to the patients, if we are not looking for these things, then
07:50this is where these increased risk of preterm birth are going to occur where these increased
07:56risk of preeclampsia or death from preeclampsia, because most of these things can, you know,
08:01death can be preventable.
08:03Um, the other thing is because of that bias, there is this distrust, right?
08:08Like this community doesn't trust us.
08:10They don't want to come to the doctor.
08:11So they seek care late.
08:13They come late where sometimes we've missed that window to identify those issues.
08:19And I feel the other thing is going back to access to care.
08:24They may not have easy access to get to a doctor.
08:27For example, they have children that they have to take care of.
08:31They don't have time to go to the doctor because they have to take care of their children.
08:35And there are so, uh, you know, a single parent, or they don't have insurance or even when
08:40they have insurance, medications are too costly.
08:42So then they cannot afford to be on the medication.
08:44So I feel all of these things kind of just build up to why this health, um, inequality exists.
08:53Yeah.
08:54Well, and I think it's important to talk about too, because like you said, a lot of times
08:58the complications come after the birth, right?
09:00Like you're sent home maybe the next day.
09:02Cause you, your insurance doesn't pay for you to be in the hospital or they kick you
09:05out and then you don't feel good.
09:06And you think, oh, I'm tired.
09:07Oh, I just had a baby.
09:09You don't realize, oh no, my blood pressure is through the roof.
09:12My blood pressure is low, or I might have a blood clot.
09:14A lot of these women don't realize the risk after the birth.
09:17One of my best friends had extremely high blood pressure.
09:19Luckily she went to the hospital right away and she was kept in the hospital for three days
09:23after she was released.
09:24Yeah.
09:24But when you're factoring transportation, when you're factoring after the baby comes home childcare,
09:29and then women, like we started this with, where you talk about, oh, you know, I could
09:34do it.
09:34I'm fine.
09:35It's fine.
09:36Everybody needs me.
09:37You don't realize that complication could even arrive after the birth.
09:40But then how do you get yourself back to the hospital?
09:42There's so many layers to it.
09:44I agree with that.
09:46Like I've had patients that, like you said, go home with a baby with no help, like no village
09:54to, to say it.
09:56And then, you know, they come for their visit.
09:59We identify that they have elevated blood pressures and we want to send them to the hospital.
10:02And they're like, I don't have anybody to take care of my baby.
10:04Right.
10:04So what do I do?
10:05Or I don't, I have this children, my children at home, who's going to take care of them.
10:09And sometimes this is where, you know, things like social worker case managers come in
10:14to kind of help our patients out.
10:16And I feel it's a communication.
10:18You have to tell us what is holding you up so that we can help.
10:22Yes.
10:23Which this is an important question.
10:25So obviously it is so important to have that relationship with your OBGYN.
10:30And you talk about ways how you could communicate, but what are some ways that you can establish
10:36trust with your patients and vice versa?
10:39I think you have to listen.
10:40Number one, you have to listen and you have to meet patients where they are.
10:45And it needs to be completely judgment free.
10:48So you cannot judge somebody for their situation or why they didn't, they didn't get care before
10:53or why they took, you know, 20 years to, to get here.
10:58So the minute that they're here, they're here.
11:01So now I'm taking care of you and I am whatever happened before.
11:05It does not take into account now.
11:08Um, so creating that trust, creating that, um, relationship, the language that you use with
11:16patients is extremely important.
11:18So if you speak in a language that they do not understand, uh, because it's, you know,
11:25high level of complexity, you're talking very medical terms.
11:28The patient is just gonna be like, yes, yes, yes.
11:30But they have no understanding of what happened.
11:33They really cannot follow through.
11:34So one of the things that I like to do with, with my patients is ask them, repeat back what
11:39I just said, repeat these instructions back to me to make sure that what I'm saying and
11:45what they're understanding is the exact same thing.
11:47And that takes time.
11:49So that may take more than a visit.
11:51That may take more than time that we usually have a lot of for a visit, but creating that
11:55trust and creating that partnership.
11:58I think it's so important that you realize that what you should have with your doctor is
12:03a partnership where you do share decision-making, where you come together, um, to choose what
12:10is the best, the best path for you, um, what the best treatment for your problem is.
12:16And I think that that's where we physicians need to do better.
12:20Yeah.
12:21Yeah.
12:21Well, communication seems to be one of the best ways to earn the trust and to get
12:25there.
12:26Um, but you mentioned so many other barriers and is there anything that is out there that's
12:30addressing those barriers that are, you know, between patients and their healthcare?
12:35Yes.
12:35So like I said, you have to tell us what those barriers are so we can help.
12:39So we do make a point of asking if these barriers exist.
12:44Um, and things that we can help out with is, you know, we have social work services.
12:50Uh, we have nutritional services.
12:52Um, we also have, uh, financial services.
12:56One of the things that I truly like about Virtua as an organization is that they truly step up
13:04and they do all these other things to meet people where they are.
13:10So examples is they have this thing called charity care where patients that may not be,
13:16you know, eligible to get, um, state insurance or any kind of insurance for that matter can
13:21get insurance through the hospital.
13:23There is the mobile bands that go to different locations and meet patients where they are.
13:28So if it's a transportation issue, then they can go get their pap smears.
13:32They can go get their mammograms.
13:33It's great because they have access.
13:35And then once they're in, then we can facilitate access to wherever else needs to happen.
13:40Um, there are things like the mobile bands for food.
13:45Food is so important, like, like, right.
13:48Like eating healthy, accessible foods, making healthy foods accessible, which are so pricey.
13:54We know if we go to the supermarket, so these bands bringing this fresh produce from the area
14:00at a super accessible cost to, to patients, to whoever actually wants to go and grab it.
14:05And I think that those are all like things that are very unique to virtual that I truly love
14:11because they truly step up to make sure that these barriers are addressed.
14:20Yeah.
14:20So do you have any advice for people listening?
14:23They might feel anxious or overwhelmed at the thought of seeing a doctor and they're like,
14:27I know we should, but I'm nervous.
14:30Like what, where do I start?
14:32Make the appointment.
14:34Yeah.
14:34Just make the appointment.
14:36I think that that's where you start.
14:37Um, I have so many patients that come to me after five years of not seeing a doctor,
14:4210 years of not seeing a doctor.
14:43Oh, I haven't seen my, uh, a doctor since my last birth.
14:46Uh, that was 70 years ago, something like that.
14:49Um, but they show up and then when you show up, we're going to take care of you.
14:54So we're going to meet you where you are.
14:56We're going to ease any of the anxiety that you may have.
14:59Um, we are going to listen to you.
15:01So make the appointment, make that appointment with your primary care, make your appointment with your OBGYN.
15:07Um, and then we can kind of go into this lifelong journey together.
15:13Well, we can make it easy to schedule that appointment.
15:16We're looking at you right there.
15:18Listening, watching, however you are, uh, taking this in.
15:22Schedule your appointment with the Virtua Center for Women in Willingboro or Voorhees.
15:27All you have to do is call 856-223-7252.
15:33It's 856-223-7252.
15:38Exactly what you heard.
15:39Just make the appointment.
15:40It's the first step.
15:40We make it so easy.
15:42And thank you so much for your openness, your education, your brilliance, and your obviously very calming demeanor.
15:49You could tell you're very passionate about this and a lot of women, I think, feel anxious.
15:54But when they have a doctor like you, you make them want to go back.
15:58Hopefully not too much just for checkups.
16:01I will have them as many times as they want.
16:04Um, but preferably just for checkups because that means you're all healthy and you have no problems.
16:10Exactly.
16:11Thank you again so much.
16:13Yes.
16:14Thank you guys.
Comments