Language Coordinator’s Dedicated Care Makes Patients Feel Safer and Translates Into Better Health Outcomes

Updated on Jul 14, 2022 | Diversity and Inclusion, Stories of Excellence

Sylvia Dabalsa, Language Coordinator.

Sylvia Dabalsa began her career at the New York Eye and Ear Infirmary of Mount Sinai (NYEE) in 2014 as a Spanish medical Interpreter, and a few months later took on additional administrative duties, which eventually led to her current position as language coordinator. In this role, she says, “it is a privilege to serve our diverse patient population.”

Sylvia makes sure that patients with limited English proficiency or who are deaf or hard of hearing have easy access to interpretation services via telephone, video, and face-to-face interpreters. In addition, she plays a key role in implementing and expanding policies and procedures that meet the language requirements of the New York State Department of Health and Joint Commission. These include annual language needs assessments; increasing the number and utilization of video remote interpreters; expanding the number of staff who are assessed and added to the language bank; and overseeing regular in-service sessions to ensure that staff are familiar with the resources available to communicate effectively with all patients. She also oversees the translation of key documents and consents that are used throughout NYEE.

Miguel Arenas, MS, CPXP, Senior Director Patient Relations, Mount Sinai Downtown and Mount Sinai Brooklyn, says that Sylvia is tireless in her efforts and advocacy for all patients, but especially those with limited English proficiency and those who are deaf or hard of hearing. These patients feel safer, comforted, and reassured when Sylvia is in the house. “Her dedication to this work comes from her clear understanding that a simple error when interpreting can put patients’ lives in danger or limit their ability to understand their diagnosis or plan of care,” he says. “Sylvia has a keen ability to work with a wide range of providers and managers across all departments. She is agile, caring, smart, resourceful, and embraces any challenge that comes her way.”

Sylvia is committed to providing patients with the best possible experience through high quality, compassionate, and unbiased care. “I love my work,” she says, “as it allows me to facilitate communications between limited English proficient or sensory disabled patients, their family and friends, and our staff. Improved communication translates into better diagnoses, better patient understanding of the plan of care, and better health outcomes.”

Read more Stories of Excellence

Non-Hispanic Blacks Found Twice as Likely to Have Atherosclerosis as Hispanics in Study of Young Adults in Harlem

Updated on Jul 15, 2022 | Cardiology, Diversity and Inclusion, Featured, Research

A unique Mount Sinai study focused on a multiethnic, underserved community in Harlem found that young non-Hispanic Black adult participants were twice as likely to have atherosclerosis as young Hispanic adults.

The research, published in the Journal of the American College of Cardiology in July 2022, is part of the FAMILIA Project at Mount Sinai Heart, a pioneering trial created by Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital.

The new study is one of the first to evaluate atherosclerosis—the plaque build-up in the arteries that can lead to a heart attack or stroke—in asymptomatic young populations. Its findings emphasize the importance of early screening and lifestyle interventions in high-risk minority groups to improve their cardiovascular (CV) health.

Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital.

“What’s interesting about this study is that Black individuals appear to be more vulnerable to atherosclerosis early in life than people of Hispanic origin, even when adjusting for known cardiovascular and lifestyle risk factors such as smoking, unhealthy diet, lack of exercise, high blood pressure, and cholesterol,” Dr. Fuster says. “This can then put them at increased risk of cardiovascular disease, suggesting the existence of emerging or undiscovered cardiovascular risk factors in this population.”

The study is part of a multinational effort to intervene early in the lives of children, their caretakers, and teachers so they can form a lifetime of heart-healthy habits. These new results come after highly successful interventions involving more than 500 preschoolers, caretakers, and educators at 15 Head Start schools in the Harlem section of Manhattan, an urban area that is socioeconomically disadvantaged—a situation commonly linked to higher rates of obesity, heart disease, and other health issues.

The FAMILIA team focused on 436 adults, including preschoolers’ family members, caretakers, teachers, and school staff. Of that group, 147 participants were non-Hispanic Black and 289 were Hispanic, with an average age of 38; 80 percent were women. Non-Hispanic white, Asian, and Native American groups each formed a small proportion of participants (2.3 percent, 2.3 percent, and 0.3 percent respectively) and people in those groups were excluded from the analysis.

Each participant answered a comprehensive questionnaire at the start of the study, addressing their nutrition, physical activity, tobacco use, and alcohol consumption, and whether they had conditions such as heart disease, hypertension, diabetes, or a family history of health problems. They also had their weight recorded, and blood pressure and cholesterol checked.

Overall cardiovascular risk factors were prevalent for both ethnic groups at baseline. Thirty percent of non-Hispanic Black participants had hypertension, almost triple the rate of the Hispanic group, 11 percent. Conversely, non-Hispanic Black participants had lower rates of dyslipidemia—unhealthy levels of lipids/fat in the blood (18 percent) compared to the Hispanic group at 27 percent, and better eating habits, consuming more fruits and vegetables. Researchers used these data to calculate a predicted cardiovascular risk score for each group. They found the overall risk of having a cardiovascular event in 10 years was low for both Blacks and Hispanics—around four percent for both groups.

Participants also had 3D vascular ultrasounds to determine if they had atherosclerosis in their carotid (neck) and femoral (leg) arteries. These vascular ultrasounds pointed to a significant discrepancy between the groups. Overall, nine percent of participants had subclinical atherosclerosis (nearly one in ten participants showed at least one artery with plaque). Also, the rate of plaque build-up in the arteries was two times higher among non-Hispanic Blacks than Hispanics. The results were consistent even after adjusting for classic cardiovascular risk factors including age, sex, body mass index, hypertension, diabetes, and cholesterol; lifestyle factors including diet, physical activity, and tobacco use; and socioeconomic factors such as employment status.

The study noted some limitations and areas for further investigation. “The population included in the study was from a specific area, Harlem, with known intrinsic health disparities compared with other areas in New York City,” the study said. “This could, to some extent, limit our results’ generalizability.” In addition, “Given the heterogeneity among racial and ethnic groups, assessing associations between self-reported racial or ethnic identity and disease is complex and is vulnerable to confounding due to the effects of socioeconomic inequality, environmental disparity, unequal access to care, and other possible emerging or unknown CV risk factors.”

However, the study is one of the first to assess the presence of subclinical atherosclerosis by 3D vascular ultrasounds in an underrepresented younger population, the research team says, and it contributes to the understanding of higher rates of CV disease observed at an early age in disadvantaged communities.

“These findings may in part help to explain the observed differences in cardiovascular disease prevalence between racial and ethnic groups,” Dr. Fuster says. “Until underlying biological factors and other undiscovered cardiovascular risk factors are better understood and can be addressed by precision medicine, affordable noninvasive imaging techniques such as the portable 3D vascular ultrasounds used in this study, which are easily used and affordable, can be an important form of early detection in underserved communities, and provide valuable information about population disparities and increase the precision of health promotion and prevention programs.”

Dr. Fuster and his team will expand the FAMILIA program to schools across the five boroughs of New York City starting in September 2022. This project will also evaluate how family socioeconomic status and teachers’ characteristics may affect the implementation and efficacy of school-based health promotion programs.

The FAMILIA project was funded by a grant from the American Heart Association.

 

Learn more about Mount Sinai Heart

Clearing Misconceptions About Gender-Affirming Care for Transgender and Gender-Diverse People

Updated on Jun 25, 2024 | Diversity and Inclusion, Featured, LGBT Health, Your Health

Gender-affirming care for transgender and gender-diverse people has advanced over the past decade, but connecting patients to this care efficiently remains a challenge, hindered by a lack of awareness.

“Patients worry about what they need to know even before being able to speak to a doctor for gender-affirming care,” said Joshua Safer, MD, Executive Director of the Center for Transgender Medicine and Surgery at Mount Sinai.

Even health providers can be unsure of what gender-affirming care entails. Many once believed that they would have to run a series of tests before even being able to refer their transgender patients for specialized care, Dr. Safer said. “It’s a misconception that they have to do anything,” he noted. “There are some tests that they could run that would make their patients’ lives easier, but it is fine to send patients along even without those tests.”

In a conversation with his doctor, Miroslav Djordjevic, MD, Clinical Professor of Urology, patient Kyshane Rowe talks about how life has changed since he began the transition process 10 years ago, and how Mount Sinai’s Center for Transgender Medicine and Surgery helped him along the way. Click here to watch the video.

As part of efforts to raise awareness about transgender care, Dr. Safer weighs in on common misconceptions about gender-affirming care and shares tips for patients and providers on how to make the experience seamless.

For patients

For providers

For patients

Seeking gender-affirming care can be overwhelming for transgender and gender-diverse patients, Dr. Safer said. With care that can stretch across multiple specialties, including endocrinology, gynecology, urology, and various surgical subspecialties, patients sometimes think they need to do a bunch of research before even speaking with a provider.

However, speaking with your primary care doctor could be part of that care journey, Dr. Safer said: “Providers can help guide patients with what they need to align their bodies with their gender identities.”  

  • It might be helpful for transgender patients to consider their fertility goals when seeking gender-affirming care. That would help outline what medical or surgical options make sense.
  • Letters of support from mental health and primary care providers are required to be eligible for gender-affirming surgery. Obtaining those letters isn’t necessarily complicated, and our Center provides templates for them.
  • Out-of-state patients seeking surgical care in New York City need to be housed within a 90-minute travel distance of the surgery office for at least two weeks. Additionally, the accommodation cannot be a walkup apartment, and a caretaker must be present to assist with cleaning and daily activities.

The Center for Transgender Medicine and Surgery at Mount Sinai has set up a hotline to help patients with appointments, or even direct them to “champion providers” within the Health System—providers trained in gender-affirming care, Dr. Safer said.

For patients, click here to learn more about accessing transgender care

For providers

Gender-affirming care in a primary care setting doesn’t need to be complicated, Dr. Safer said. It is fine to refer transgender patients after initial assessments without needing a bunch of tests.

However, should the provider choose to order baseline testing for patients, it would make the patients’ care experience more convenient. Here are some typical tests a provider can consider:

There is also a misconception that because insurance companies categorize gender-affirming surgery as a treatment for gender dysphoria, patients need to be seen by a mental health provider, Dr. Safer said.

“If there are underlying mental health concerns, do refer those patients for treatment,” he noted. “But there are many transgender patients who have no mental health concerns and are merely seeking gender-affirming care.”

Providers within the Mount Sinai Health System would already be connected within the Epic system for referrals to any needed specialist, expediting the process, Dr. Safer said. For providers outside the Health System, a dedicated hotline team from the Center for Transgender Medicine and Surgery is there to assist, he added.

For providers, click here to learn more about connecting transgender patients to care

What Pride Means to Mount Sinai

Updated on Jun 30, 2022 | Community, Diversity and Inclusion, Featured

The 52nd NYC Pride March kicked off in full force on Sunday, June 26, returning in person after a two-year hiatus. Mount Sinai displayed its pride down Fifth Avenue and the full spectrum of the Mount Sinai family—providers, researchers, support staff, students, and more—showed up to impress the importance of LGBTQ+ visibility and inclusivity in science, technology, engineering, mathematics, and medicine fields.

Mount Sinai Health System is committed to meeting the needs of LGBTQ+ patients, be it through the Mount Sinai Doctors or hospital networks, the Institute for Advanced Medicine, or the Center for Transgender Medicine and Surgery. In addition, the Health System’s dedication to LGBTQ+ representation in employment and training helped it earn a top score of 100 and the designation of “LGBTQ+ Healthcare Equality Leader” in the Human Rights Campaign Foundation’s Healthcare Equality Index earlier this year.

Check out the Mount Sinai contingent at this year’s Pride March:

Read more about LGBTQ+ health and how Mount Sinai champions this cause:

How to Find an LGBTQ+ Experienced Medical Provider and Why That’s Important

LGBTQ+ Health with Zoe Rodriguez, MD

Mount Sinai Creates LGBTQ+ Medical Fellowship That Will Serve as a National Model of Care

Rising Above the Health Toll of Racism

Updated on Jun 30, 2022 | Diversity and Inclusion, Featured, Your Health


Racism—both on a personal level and in overall society—negatively affects the mental and physical health of millions of people, according to the Centers for Disease Control and Prevention. These health issues, and some ways to rise above them, are addressed in this Q&A with Lynne D. Richardson, MD, Co-Director of the Institute for Health Equity Research at Mount Sinai, and Professor of Emergency Medicine, and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai.

“Racism is a public health crisis that is damaging to all of us, regardless of race or ethnicity,” Dr. Richardson says. “We need to use all of the tools at our disposal to fight it, and to improve our own individual and our collective emotional and physical well-being.”

Lynne D. Richardson, MD

How does racism affect mental health?

That is a big question. The impacts of racism happen at various levels because, of course, racism happens at various levels. There is the experience of being personally discriminated against, whether that’s racial slurs or hate crimes or the experience of being followed in a store because you’re under suspicion that you’re going to steal because of the way you look. All of those sorts of macro and microaggressions really undermine your sense of self-confidence, your sense of self-esteem, and your sense of safety. It’s like having repeated traumas on your mental and emotional well-being.

There is a lot of evidence that racism of various kinds has a destructive impact on mental health, and there is a growing awareness of the importance of structural racism in that picture—this includes limited access to societal resources, like housing, food, job security, and health care. The persistent inequities in the way that those resources are distributed across our society have an impact on our mental health and well-being. It’s those persistent negative messages that you are not valued, that you are not protected. This is why we see huge disparities in conditions like depression. African Americans are much more likely to have more severe symptoms. They have a longer course of illness, and they experience greater levels of disability from depression compared to white patients. This is also why rates of youth suicide are exploding in the black community, with something like a 73 percent increase over the last decade of suicide attempts among young people of color. In terms of suicide death rates, the fastest growing segment are black children between the ages of five and 12. We are seeing the impact of racism and the harmful effects that it has on mental health reflected in this epidemic of suicide among black youth.

How does racism affect physical health?

Racism affects physical health in direct ways. Due to structural racism, you may be more likely to live in housing that is substandard, housing that has environmental toxins or irritants that directly impact your health. You are more likely to live in a neighborhood where there are higher levels of air pollution, where there are higher levels of violent crime. You are more likely to not get the health care that you need, and so you may have a higher burden of disease and more avoidable complications of illnesses like hypertension, diabetes, heart failure, or asthma. These effects are cumulative, and they directly impact the physical health of communities that are experiencing the effects of structural racism.

There is also a connection between mental health and physical health. We know that the assault on your mental health also affects your body. It affects your immune system and makes you more susceptible to disease. It affects your hormonal system and results in problems with your adrenal regulation. So the more we understand about how complex health disparities are and about all the things that create these differences in health between blacks and other groups, the more we understand how racism is often a root cause of many of these effects.

What are some ways to feel better?

I think it is important to not only talk about the negative ways in which racism impacts black people, but also to remember all of the strengths that have helped us to get to where we are today. I think that we have to pay attention, to take care of ourselves and take care of each other, especially given the recent impact of the COVID-19 pandemic. I think it is even more important that we lean on our strong social supports of families and friends. For many people, spirituality is a source of strength and comfort.

In addition, I think we have to try to directly address the inequities that are leading to these negative impacts on our mental and physical health. I have a colleague who talks about spreading hope, as a strategy to deal with what we are facing as we combat the effects of racism—and I love that image.

What are some ways to help?

I think all of us have an obligation to advocate for anti-racist policies, and that happens at every level. There are societal issues. There are policies and processes in every institution that we belong to. There are things that we can do, in every place we are, to try to understand how the structural inequities are embedded in our society, and to start to dismantle them. We need to do that where we work, where we go to school, where we worship. In every context, we all need to be doing this anti-racism work if we really want to make a difference and we really want to end these long-lasting, persistent effects of racism on communities of color.

What else should people know about racism and health?

There is a lot of discussion now about implicit bias. One of the things that is not widely understood about implicit bias, or unconscious bias, is that while it may happen at a subconscious level on the part of the person who has the bias, it has a very explicit impact on the person who is the recipient of the bias. There is often a sense that because this kind of bias is not intentional it’s not harmful, but it is very harmful, and it results in micro aggressions that do create repeated micro-traumas that erode our physical and mental health.

Therefore, I think everybody has individual work to do on themselves to understand the extent to which they have internalized the biases that are pervasive in our society. At the same time, we should work at a higher level collectively on our organizations and institutions and try to eliminate the structural racism that is persistent and pervasive throughout our institutions.

Learn more about the Mount Sinai's Institute for Health Equity Research

Security Staff Honored for Their Vital Role in Keeping Mount Sinai Safe

May 26, 2022 | Community, Diversity and Inclusion

Seated: Wayne Powell, training supervisor, and Margie Rodriguez, parking and transportation manager. Standing: Telvet Zimmerman, operations manager; Herschel Nurse, security coordinator; and Zorina Costello, director of community engagement.

The Center for Stress, Resilience, and Personal Growth recently hosted a luncheon for the Mount Sinai Hospital security staff, honoring them for their vital role in keeping staff, visitors, and patients within The Mount Sinai Health System safe. More than 50 staff members and supervisors attended the event on Friday, April 29, at the Leon and Norma Hess Center for Science and Medicine on The Mount Sinai Hospital campus.

“This work became even more important and challenging throughout the COVID-19 pandemic; and every day, they do the hard and emotionally challenging work of managing very tense and upsetting situations,” says the Rev. Zorina Costello, DMin, MS, Director of Community Engagement for the Center for Stress, Resilience, and Personal Growth and the Center for Spirituality and Health.

The luncheon is part of a broader effort by the Center to support the emotional well-being and resilience of security staff, says Deborah B. Marin, MD, Director of the Center for Stress, Resilience, and Personal Growth.

Pin It on Pinterest