Health Ineqaulities

The term “white privilege” is one that has gained popularity over the years. However, what exactly is “white privilege.” It is the inherent and unearned benefits Caucasian people receive in today’s society. While this privilege cannot be avoided, proof of its existence is everywhere. For example, a study from the CDC showed that white men in the highest income bracket were the healthiest people. One of the most significant advantages of this privilege is not being discriminated against. Discrimination happens in many sectors of society, and it also appears in our health care systems. Discrimination in health care settings is a significant concern because it is a roadblock in preventative care. 

One thing that is important to mention is that “white privilege” is solely for upper-class caucasian people. Privilege is a foreign word to lower-income white people; also, people of all races when they come from a lower socioeconomic status. 

Results from a study regarding the percieved discrimination in health care saw that patients who felt discriminated against were more likely to go without medical care. The study also revealed that as a result of the percieved prejudice, patients would have substandard relationships with their medical providers. This shaky relationship may cause patients to lack trust in providers and make them less likely to follow what they say. 

Discrimination in health care is discouraging, mainly because the people who report it tend to be ones who need medical supervision the most. It has become common knowledge that minority groups tend to have unfavorable health outcomes compared to their white counterparts. Quality health care should not be a privilege; It should be available and consistent throughout all ages and all social groups. 

In an article, a doctor told a story about one of her patient’s previous experiences. The patient was an African-American woman who went to the emergency room with complaints of acute pain. She reported that the emergency room staff were dismissive and treated her as an addict seeking another dose of pain medication. There was nothing in the middle-aged lady’s life that pointed to her having substance abuse problems. The doctor, who was also the author of the article, believes that most medical providers are not blatantly racist, but it is that they work for an “inherently racist system.” This racist system is what she believes is the cause of health inequities such as access to quality education, healthy food, affordable housing, and more. 

The best course of action to address privilege in health care is to understand that “white privilege” and “wealth privilege” does exist. To minority groups, it is evident. Nevertheless, It would make it more productive if the people who have those entitlements become aware of them. Discrimination in health care has undoubtedly affected the relationships between providers and patients. From a provider’s perspective, it is essential to consider the race of an individual when it comes to health conditions. Providers must educate their patients about what the health demographic they belong to, but at the same, not grouping them, but treating each one of them as the unique people they are. For patients, while discrimination will never end, many doctors are genuinely in practice to treat people regardless of race or socioeconomic status. Patients should not lose faith in doctors, and doctors should not discredit or downplay their patients. Health care can be a beautiful thing; it just requires effort and change from all sides.

Recently, the outbreak of the COVID-19 Pandemic has been making its way across the United States. What was once a foreign problem is now the United States’ most significant health care challenge seen in this generation. People who were not already aware of America’s flawed health care system are now coming to realization. With hospitals, doctors, nurses, and other medical staff lacking protective equipment, ventilators, and more, many now see that our health care system before the Pandemic was in a precarious position. 

While the Coronavirus is not particularly discriminatory, people of low economic status still face health inequalities. The NY Times article “As the Corona Virus Deepens Inequality, Inequality Worsens Its Spread,” discusses how the Pandemic is expanding the social and economic divisions. Research has suggested that people from low economic classes are more likely to contract the Virus and more likely to die from it. A public health expert from the article brought up a point that following a disaster of this magnitude, pre-existing social vulnerabilities only get worse.

As discussed in previous blogs, low-income people are more likely than any other group to have underlying health conditions. Conditions like cardiovascular disease, diabetes, asthma, and obesity are all disorders that are popular among today’s society and also are the underlying conditions that put people at higher risk of mortality if they contract the Virus. In a stunning statement, the article brings up that health organizations say people above the age of 70 are at a much higher risk of dying of COVID-19. However, based on research, people of low socioeconomic status are around the same risk at just the age of 55. 

Another factor to consider is that people of low economic status mostly work blue-collar jobs. Blue-collar jobs are not built for the work at home option. With the current mandates in place shutting down non-essential businesses, many people are at home without income. People from disadvantaged households still working may have to use mass transportation which only increases their risk of contracting the Virus. Health inequalities such as access to health care make getting sick a substantial financial burden. Some people of low socioeconomic status are ignoring symptoms and avoiding medical care because of the intimidating cost of uninsured medical treatment. Experts say that people who fear seeking medical care is a big problem because if there is no detection of the Virus, transmission rates will continue to soar. 

A story that has made headlines regarding a Los Angeles Teen is discomforting. A teen who had no underlying conditions tested positive for COVID-19 and died of septic shock. Potentially fatal septic shock usually results when the body has an overwhelming response to an infection. In the case of this teen, it was fatal. The teen went to an urgent care facility with respiratory complaints but was denied because he did not have health insurance. The facility advised the teen to seek help at a public hospital instead. The young man went into cardiac arrest on his way to a hospital, he was revived, but it did not last long. This story is unfortunate, but we must not let it slip through the cracks, there is no reason why someone should be turned away with acute symptoms, especially in times like these.

Now, testing for the Coronavirus is entirely free. However, if someone tests positive and their condition requires hospital treatment, there may be a significant financial sum awaiting them if they get out. Stay Healthy!!

Compared to other races, African American people are known to have more unfavorable health outcomes. An interesting question is whether genetics or the environment holds a greater influence on one’s health outcomes. Is it nature or nurture?

The article from The Harvard Gazette named “ ZIP code or Genetic code?” was based on a study at Harvard University. In the study, researchers used a massive database to determine the effects of genes and environment in 560 medical conditions. Results from the study show that many diseases that occur are not solely reliant on genetics or environment, instead a complex blend between the two.

225 out of 560 of the diseases contained a genetic aspect, 138 out of 560 were based on socioeconomic factors. Cognitive and reproductive disorders were more likely to result from a genetic component. Diseases having to do with “connective tissues,” meaning related to the physical functioning of the body had a much smaller genetic influence. Diseases pertaining to eyes and the respiratory system had more to do with environmental factors. From the study, it was determined that the condition with the strongest association with socioeconomic status was morbid obesity.

In an alarming study, the Center for Disease Control reported that African Americans between ages 18-49 are twice as likely to die from heart disease than Whites. In addition, African Americans around that same age range are more likely to have higher blood pressure levels. Heart disease and hypertension are directly correlated with obesity. 

The social factors that affect African American people are plenty. Unemployment and the number of people living below the poverty line contribute to the health disparities. Economic barriers are sizeable because they are the root of all health barriers. When people lack economic stability, they often fear seeking medical attention. Without seeking medical attention, many diseases go on to prevail as a result of no professional surveillance. A regular preventative care routine, entailing primary care visits, and appropriate resources is useful in promoting awareness and preventing diseases. 

There’s a lot that needs to be done to change the adverse health outcomes of all people. We can’t change someone’s genetic composition, but we can put things in place to lessen their disorders’ effect on their lives. There’s something we can change regarding lifestyle and environmental diseases because they are acquired; therefore they are preventable. There needs to be a collaborative effort by health providers, public health officials, legislators, and other groups to identify groups at risk, provide awareness, and provide the holistic care everyone deserves.

While external groups and organizations have a part to play, people of color and minority groups also have a role. If we want better health outcomes, we must put ourselves in the best position to attain them. As an African-American male myself, I have taken the initiative to be in control of my health outcomes as much as I can. In my family, many generations have struggled with cardiovascular disease. While there may be a minor genetic predisposition, I know that a healthy diet, active lifestyle combined with a vigilant mindset will put me in a favorable position to avoid negative health outcomes. 

“ACE’s are the single greatest unaddressed public health threat” these are the words from Dr. Nadine Burke Harris, the current Surgeon General of California. Dr. Burke Harris was quoted during a TED talk titled “How childhood trauma affects health across a lifetime.”

Well, what are ACEs?

ACE’s is an acronym for the term adverse childhood experiences. The term arrived following the ACE study done in 1998. The study was performed by Kaiser Permanente and the Center for Disease Control. The research was done to analyze the connection between chronic stress as a result of adverse experiences and their effect on long-term health. Participants in the study were given a questionnaire based on their childhood experiences. For every one of the adverse experiences they encountered during their childhood, they received one point. Examples of the adverse experiences measured are abuse & neglect, domestic violence, mentally ill parents’, and substance abuse. 

From the study, there were two observable findings. One of them was that ACE’s were more common than expected. 67% of the participants recorded at least one adverse childhood experience. 13% of participants recorded to have experienced four or more adverse childhood experiences. The total tally of someone’s ACEs would determine their score. The hypothesis was that the higher the ACE score, the worst long term health complications would be. The results of the study showed a graded dose-response. The premise was valid; the higher the number of ACEs someone encountered resulted in them being at higher risk for chronic health complications in the future.  

There was a time I had the chance to speak with a respiratory therapist. Having been an employee in health care for many years, he explained to me a scenario I would never forget. The situation he told was if you’re driving a car on the road and it has a flat tire, you can fix it. Say now, you drive on that same road, and the tires become flat once more. You can continue to fix the tires, but eventually, one should begin to wonder what is on that road that is causing the tires to go flat. That scenario he explained was an example of the current state of our healthcare system. The United States health care system sometimes provides temporary fixes to problems without looking at the underlying causes of those issues. This makeshift approach may be setting people up for reoccurring and chronic diseases. 

A way the United States could help address ACEs and shift from temporary fixes is through primary prevention. According to the Child Welfare Information Gateway, primary prevention are attempts to avoid adverse health outcomes before they occur. For primary prevention to work, there needs to be a common ground between the general public, service providers, and policymakers. Primary prevention would include identifying which groups are most likely to be affected by ACEs. The groups at higher risk are the ones that are low-income and people from minority groups. After identifying the people at high risk, we must place the right resources around them to prevent the health outcomes that eventually may await them.