At the Margins of Healthcare

Blog post by Colin Hung.

I recently had the privilege of attending the annual Cinderblocks event in Grantsville MD. Organized by the incredible Regina Holliday, this event is a blend of art school, community town-hall, healthcare update, and patient rally. It is definitely not your typical healthcare conference. This was my third year attending and every year I get more out of the event.

The only thing I can compare Cinderblocks to is summer camp. Remember going to camp in the middle of nowhere – seeing old friends and meeting new ones while doing things you don’t normally do? That’s kind of what Cinderblocks is like. It’s the only event on my calendar where I will hear a plea from an HIV-positive patient about the need for better access, followed by an update from a local community leader about the latest in affordable housing, followed by a walking tour with a park ranger.

Although there is never planned theme to Cinderblocks events, one always emerges. For me, the theme of this year’s event was marginalized populations and their access (or lack of access) to healthcare.

  • Amy Edgar APRN, CRNP, FNP-C @ProfAmyE spoke about her work pioneering mental health work at Children’s Integrated Center for Success @CICSuccess and the challenge of access to mental health services
  • Heather Hanline, Executive Director of the Dove Center @dovecenter_gc – which provides safety, advocacy and counseling to victims of domestic violence and sexual assault.
  • Robb Fulks @TheInedibleF, who has numerous comorbidities including HIV and who struggels daily with a healthcare system that wants nothing to do with him.
  • Ashley Elliott a recovering addict (sober since 2012) who talked about how she battles the stigma in her small town and how there is a lack of recovery programs in rural communities
  • Michael Mittelman @mike_mitt who highlighted how poorly living organ donors are treated by the healthcare system after their live-saving gift is given
  • Jade Kenney and Kendra Brill who spoke about their struggle to build a safe haven (Rainbow Bridge Home – for the LGBTQIA community in a rural setting and how they were/are both marginalized by “polite society”

It’s is horrible that so many people who need healthcare services are unable to access them – either because of distance, because of stigma or because of economics. It shouldn’t be this way and these heroic individuals at Cinderblocks are fighting the good fight despite the odds being stacked against them.

In recognition of Cinderblocks, I thought it would be interesting to explore the lack of access to healthcare. Please join me on Tuesday May 22nd at 8:30pm ET (for your local time click here) for the weekly #hcldr tweetchat where we will be discussing:

  • T1 Is there a marginalized population that you feel is not getting the healthcare they need?
  • T2 What do you believe is at the root of this marginalization? Economics? Lack of understanding? Stigma?
  • T3 What could be done at the macro level (across all of healthcare/society) to help these marginalized populations?
  • T4 As healthcare leaders, what can we realistically do as individuals to help address the chasm in healthcare these marginalized populations have fallen into?


“Low-Income HIV Patients Suffer with Healthcare Access”, Paul Logothetis, McGill University Health Centre, 19 April 2018,, accessed 21 May 2018

“How to Honor Patients’ Lived Experience: Learning from Community-Based Organizations”, Warren Wong, Institute for Healthcare Improvement, 18 July 2017,, accessed 21 May 2018

“The role of street nurses in increasing access to health care for marginalized populations”, Meaghan Thumath, Association of Registered Nurses of British Columbia, 9 June 2016,, accessed 21 May 2018

“Marginalization in health care”, Gary Xu, University of British Columbia, 18 December 2016,, accessed 21 May 2018

“Stigma of addiction and mental illness in healthcare: The case of patients’ experiences in dental settings”, Mario Brondani et al, PLOS One, 22 May 2017,, accessed 21 May 2018

“People with drug dependence need better access to health care”, World Health Organization, 26 June 2012,, accessed 21 May 2018

“Vulnerable Populations: Who Are They?”, AJMC, 1 November 2006,, accessed 21 May 2018

“Stigma Reduction Training Improves Healthcare Provider Attitudes Toward, and Experiences of, Young Marginalized People in Bangladesh”, Geibel et al, Journals of Adolescent Health, February 2017,, accessed 21 May 2018

Image Credit

Colin Hung at Cinderblocks 5

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