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By Te’Aja McCoy

How important is a healthy lifestyle? What does it mean to you? Whether it means spending more time with your grandchildren or living to see your thirtieth birthday, a healthy lifestyle is extremely important and often very hard to come by as a minority. As a minority, there are multiple barriers which prevent many from having access to proper health resources which contribute to poor health in minority communities. These barriers include but are not limited to: limited access to transportation, a lack of education, financial insecurities, as well as miscommunications in the doctor-patient relationship. While these key barriers are illustrated in multiple articles, they are also outlined in the 2019 interview by Ina Dixon with Stephen Coles.

Stephen Coles is an African American healthcare worker at Pleasant View where his interview takes place. He reflects on the biggest limitations in health care as finances, transportation, and education. He also notes that he believes that the communication between the patient and care provider can be very limited and lacks proper understanding. This is very insightful as he’s speaking as a care provider and not just a patient. This interview is relevant to our theme, health and wellness in minority communities as it illustrates some of the biggest gaps regarding health and wellness in minority groups.

Public transportation is an important driver of health and equity in the United States. Stephen Coles identifies this as a contribution to poor health in minority communities as he states in his interview, “biggest barrier to health. I’m going to throw that number one, of course, is always transportation” (Cole, 1:03:39.6). Transportation not only allows better access to proper medical care but improvements to public transportation also has various other benefits as illustrated in the article, “Public Transportation in the US: A Driver of Health and Equity” written by Wendy Heaps, Erin Abramsohn, and Elizabeth Skillen. The authors demonstrate that improvement to public transportation supplies various positive options such as “reducing traffic crashes and air pollution, increasing physical activity, and improving access to medical care, healthy food, vital services, employment, and social connection” (Heaps et al., p. 1). Due to a lack of transportation many minorities lack access to proper medical care as well as vital services, employment, and social connections as well as an increased risk of air pollution which may further detriment one’s health.

In addition to a lack of transportation, poor education is also a contributor to poor health in minorities. A poor education can allude to a lack of understanding of one’s health as well as a barrier of attaining a job with proper medical benefits which could allow for access to better healthcare. Additionally, a poor education is often associated with negative stereotypes as Stephen Coles illustrates, “Education, too, like, the understanding of what’s going on, because a lot of people—well, people get treated a certain way when certain persons ain’t around” (Cole, 1:05:15.3). Those who have a poor education are often treated negatively in situations that prompt high education such as the medical field. In the article, “Why Education Matters to Health: Exploring the Causes”, by VCU center on Society and Health, the authors illustrate the health benefits of education. The authors state that in today’s economy “an applicant with more education is more likely to be employed and land a job that provides health-promoting benefits such as health insurance, paid leave, and retirement. Conversely, people with less education are more likely to work in high-risk occupations with few benefits” (VCU center, p.1). With a poor education one is less likely to receive these benefits which can lead to improper medical care or a limited access to healthcare. Additionally, it can be inferred that having a lack of education can contribute to financial burdens of accessing proper care as one is more likely to attain a job that lacks health benefits. Furthermore, having a poor education and a job lacking proper health benefits may also mean a lower income where one isn’t able to “easily purchase healthy foods, have time to exercise regularly, and pay for health services and transportation” (VCU center, p. 3) and makes one more vulnerable during difficult times.

Finally, the doctor-patient relationship is also a driving contributor to poor health in minorities. In his interview, Stephen Coles describes the lack of understanding that the doctor-patient relationship consists of in minority communities as he states, “I feel like sometimes doctors don’t understand that they not talking to another doctor, …And they get taught so much like, “Hey, this is what this is,” that they forget that everybody ain’t go to doctor school” (Cole, 01:06:18.9). The medical field is a trained specialty, it is extremely difficult for a patient to understand proper medical terms and language when they haven’t been taught that same specialty and lack knowledge thereof. Patients often get ‘spoken to rather than talked with’ as illustrated in the article, “How Poor Communication Exacerbates Health Inequities- and What to do About it” by Stuart Butler and Nehath Sheriff. The article also goes on to illustrate the “distrust and poor communication related to racial and cultural differences pervade the health system and frustrate many efforts to reach the goal of good and equitable care for all in America” (Butler & Sheriff, p.2). Miscommunications in the doctor-patient relationship often led to a less effective medical care and consist of less empathy and concern for the patient ultimately resulting an environment of distrust, leading to poor health in minority communities.

In closing, there are various contributions to poor health in minority communities such as limited transportation, a lack of education, financial insecurities, and miscommunications in the doctor-patient relationship. While there are many barriers to proper health in minority communities, there are improvements that can be made to tackle these barriers such as more minority representation in the medical field, improvements to public transportation, and better access to education. The Stories to Save Lives interview conducted by Ina Dixon with Stephen Coles is very insightful as it demonstrates his own expertise as a healthcare worker rather than as a patient.


Butler, Stuart M, and Nehath Sheriff. “How Poor Communication Exacerbates Health Inequities – and What to Do about It.” Brookings, Brookings, 9 Mar. 2022,

Dixon, Ina. Interview with Stephen Cole. 1 April 2019 (Y-0086) Southern Oral History Program Collection (#4007), Southern History Collection, Wilson Library, University of North Carolina at Chapel Hill.

Skillen, Wendy Heaps Erin Abramsohn Elizabeth. “Public Transportation in the US: A Driver of Health and Equity: Health Affairs Brief.” Health Affairs, 29 July 2021,

“Why Education Matters to Health: Exploring the Causes.” Center on Society and Health,


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