Introductions: Boris Kalanj

Dr. Culbert With a Patient Did you know that more than 50% of patients who seek care at Children’s are nonwhite; 20% speak a language other than English in the home; and greater than 40% are from low-income families, insured through Medicaid?

In this blog, I will write about these and other groups who are often referred to as “underserved” – lacking either in access to health care, its quality, or both.

I will explore some of the social issues that help define Children’s in our community.  You can expect me to write about health care disparities – differences in quality and outcomes of health care due to personal characteristics such as ethnicity, primary language, location, and socioeconomic status.  I will also write about cultural competence and attention to diversity in health care organizations as some of the key methods for reducing disparities.  There are many topics that can be discussed in this context, and I look forward to hearing about issues that particularly resonate with you.

I started at Children’s nine years ago as manager of its then-nascent program of interpreter services.  Over the years, my role has evolved into responsibilities for broader organizational cultural competence.  Currently, as Director of Health Care Equity and Cultural Competence, I collaborate with others to identify, understand and eliminate health care disparities, particularly within care provided at Children’s.

My own background will surely define what and how I write.  I am a social worker by training and have a strong interest in social justice.  I am also an immigrant, born and raised in Croatia during the ’70s and ’80s when it was still a part of socialist former Yugoslavia.  English is my second language.  My bilingual proficiency came in handy throughout the 1990s when Bosnian refugee families – freshly scarred by the war in their homeland – needed an interpreter and other assistance in adjusting to their new life in Minnesota.

A previous position as a social worker for victims of torture made me a witness to both incredible human suffering and incredible human resilience; I also witnessed firsthand the gaps in our systems that prevent us from effectively caring for many vulnerable populations.  And, last but not least, my recent title as “Dad” to two young children has provided me with the daily fuel to keep my ideals alive.

Due to all these and other influences, I admit that thinking of health care as a “business” has been an acquired skill for me.  The way I see it, even though we in the U.S. have succeeded in creating an overall affluent society, we still have a long way to go in creating a society that works justly and equitably for all its members.  Health care is no exception. Despite the current elation I feel at the historic action this week by the House of Representatives in passing comprehensive health reform legislation, the fact remains that on many health indicators – such as infant mortality and life expectancy – the U.S. ranks less than average when compared to other industrialized countries.

While root causes of health care disparities lie within the larger social, political and economic forces, and exceed the scope of any individual health care organization, we – Children’s included – do not exist in social isolation.  In fact, as a major force toward health of all children in our community, our obligation is two-fold: we must ensure that the care we provide is equitable; and we must partner with others to address broader disparities affecting children’s health and health care.

To these ends, I look forward to a lively exchange of ideas on this blog! Leave a comment below and let me know what you’d like to see me write about in this blog.

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