A Reflection on the Course

This course has been eye-opening for me. The most interesting idea I have learned is the correlation between socioeconomic status and health outcomes. The Whitehall studies in England produced a result I did not expect. Prior to the course I would have expected wealth to correlate with health but I would not have expected race, education or stress to correlate with health as well.

Another topic I found very interesting was the need for the medical profession to focus on care and the quality of patient life as well as curing the affliction. This idea is one that I have seen in the past when dealing with family members in the hospital. However, I was not aware that the quality of life is not always the primary concern of doctors. This realization had a large impact on me.

A final topic was shown to me in the analytical postings, but I wish it was discussed more in class. Mental health infrastructure is a serious problem that has been around for far too long. A large percentage of the population experiences some form of mental health issue, and there is very little infrastructure to support these patients. Moreover, the majority of homeless people and a large portion of the prison population suffer from a mental illness. I feel that, in the context of a course that is teaching students to address societal medical issues, this would have been a great topic to study in depth.

Final Process Reflection

Sociology of Healthcare has opened my eyes to the many multifaceted  problems within the healthcare system, especially in the United States. As a developed country, one would expect the best quality care and equality for all its citizens. This is clearly not the case. Our current system has been  and is continually hesitant to change.

Traditional medicine and practices are not always the answer to good care. Some major takeaways from this class are equity and access to care and the importance of a universal healthcare system. There are large disparities in health among racial and ethnic minorities. These disparities create major spikes in healthcare costs and promote a continual decline in health that impacts the overall health of the United States. There are more problems to consider such as doctors and feeling, and how it affects the patient and health outcomes. The lack of feeling and emotion in healthcare overlooks patient needs. This leads to a poor experience and in some cases poorer health outcomes. If doctors would take the time to get to know their patients, they would be better able to address their problems (some that may not be easily identified in a healthcare setting).

In the end, it is crucial for the individual to be the focus in healthcare. At the end of the day, we are caring for people not human bodies. Access to quality care is a must to promote healthy lives at all stages of life.

Minority Patients in ER Less Likely to Get Painkillers for Abdominal Pain

Earlier this morning, an article was posted by Robert Preidt about how minority patients are more likely to experience racial stereotyping in the emergency room when compared to those that are white. Preidt starts the article by stating minorities are much less likely than whites to get painkillers for abdominal pain. He goes onto also stating that minorities are more likely to wait longer before being seen in the ER and less likely to be admitted to the ER when compared to white patients. Continue reading “Minority Patients in ER Less Likely to Get Painkillers for Abdominal Pain”

Investor Ownership of Nursing Homes

In a study of whether or not investor ownership of nursing homes affect quality of care, it was found that investor ownership of nursing homes does affect quality of care and, more importantly, for the worse. After reading this study, I was not surprised by what was found. The thing I was surprised about was how much worse investor owned nursing homes were in comparison to non-profit and public homes. Although this study did not prove that public and non-profit nursing homes were good to begin with, the results were extremely significant. My questions are why have restraints not been put on these “money making firms” by the government? Is it difficult to regulate how nursing homes are managed because they are considered a part of the free market system of healthcare? Are the issues with nursing homes the same in other countries? If not, are the problems avoided in other countries because they don’t pay for healthcare to begin with?

Quantifing Quality of Life and Overcoming Social Death

In the article, “social Death as Self-Fulfiling Phophecy”, Timmermans makes a plethora of pertinent points to the effect of proving that there is “no equalizing potential of rationalization of resuscitation techniques and legal protections.” I find the last discussion about quality of life to be most personally resonant. The anecdote about the nightmare scenario is something that does present the personally worst case scenario for a medical procedure. It does bring into question the quality of life that is acceptable for ‘success’. Is it a common feeling that mentally disabled lives resulting from a medical procedure are “not worth living?” In what ways can the quality of life be quantitatively measured in order to weigh the risks of a procedure? How can the resuscitative efforts have a better outcome than the original expectations?

Social Death as a Self-Fulfilling Prophecy

In Timmermans’ Social Death as a Self-Fulfilling Prophecy many points were brought up that overlap what we talk about a lot in discussion and lecture. In this piece, Timmermans described how a patient’s social status/value pre-determines the effort given by those trying to revive them. Specifically, Timmermans said that, “during reviving efforts, age still remains the most outstanding characteristic of a patient’s social viability “; meaning that more effort will be put into reviving someone who is 25 compared to someone who is 95. Continue reading “Social Death as a Self-Fulfilling Prophecy”

Social Viability in Resuscitation

In Timmerman’s “ Social Death As Self-Fulfilling Prophecy”, Timmerman describes the impact of social value on the fervor and vigor in which resuscitating techniques are applied to a patient. Certain positive characteristics contribute to the patients presumed social viability such as age, social importance, and identification with the patient. Negative characteristics include seriously ill or older patients and addicts, who have less effort put into their resuscitation. In terms of seriously ill patients, less effort is put into resuscitation because the medical staff sometimes believes that sudden death is not the worst possible end of life and these patients may be in significantly more pain living. However, Timmerman does not mention the impact physical manifestations of defects would have on an individual’s social viability. Are those with genetic disorders or birth defects who exhibit these disorders/defects also viewed as less socially viable even though they are not seriously ill? For example, would someone with Down syndrome have less of an effort put into resuscitating him or her even though they may be perfectly healthy and happy in life otherwise? Additionally, would someone exhibiting a physical birth defect but otherwise healthy have less vigor put into his or her resuscitation? What is the impact of disorders and defects on resuscitative efforts?

Social Value Versus Equivalent Care for All

In Timmermans’ text about Social Death, he cites many sources including past researchers, physicians and nurses in order to piece together the idea of social value as a determinate of received care. Throughout his segment, sources are cited claiming that a person’s social worth has and should determine the care they receive which in turn leads the outcome of their situation. For example, there seems to be a trend that old people are determined as less important and less urgent to deal with as opposed to younger people or people of high social status.

Is this idea of social status as a limiting factor in determination of care a real component of our medical system today? If so, is this fair it certain patients receive a lower degree of care due to their social situation even if they have to pay the same amount of money?

Process Reflection 2

As we progress into the second midterm, I think back to the first section and can conclude that the second half was definitely more interesting and insightful than the first. In the first section, the professor went over a lot of fundamental debates and keypoints of healthcare and gave an sociological overview of healthcare in the United States. We discussed many problems with it compared to other countries in the world, and came up with potential solutions that we as health care providers and sociologists can do in the future. In the second half of the course, we were really able to delve into details about what medical professionals face on a day to day basis and see the forces that come into play when doctors see their patients. Continue reading “Process Reflection 2”

See Something? Say Something: Health Inequalities in Boston By T-Stops {Process Reflection 2}

The discussions revolving around the impact of social factors on health and illness have expanded my perspective tremendously. There is certainly stark health inequality between countries, like the US and Sierra Leone, but what about between cities in the US? In fact, if we zoomed in all the way down to a single city, like Boston, would we begin to see a clearer picture of health inequality at a relatively microscopic level?

Dr. Sandro Galea, Dean and Professor of the Boston University School of Public Health, did just that. In his Dean’s Note, Dr. Galea paints a picture of Boston’s health and its determinants geographically using the map of the T (see below).

T

Dr. Galea asks us, “Suppose we are riding the T and stopping at various stops: What does health look like at these stops, and what do the drivers of health look like?” The results are dramatic. First, Dr. Galea starts by mapping the core health indicator: premature death rates per 1,000. We can see that the death rate around the Arlington stop on the green line is the lowest, with 2.6 per 1,000, and the highest death rate is at the Dudley Square station on the silver line, with 5.7 per 1,000.

Premature death rates

He then goes on to map the homicide rates that are linked to violence; again, we can see that the Arlington and Maverick stations have the lowest homicide rates, while Dudley Square and Mattapan (with a whopping 32.2) have the highest homicide rates.

Homicide rates.PNGHealth differences are then mapped onto the T by low birth weights, percent of adults with diabetes, SES, and levels of physical activity. The health inequality between various geographic areas of Boston are large and strong. Yet, what surprised me the most was that, despite how geographically close the T stations were with one another (geographic differences of approximately four miles), and despite how each station had nearby access to healthcare facilities (Boston Medical Center, Tufts Medical, Mattapan Community Health Center), I was shocked that areas so close to one another and with top-notch healthcare facilities still have large health inequalities that exist due to varied health indicators. This case-study opened my eyes to realize that we don’t have to look globally to witness health inequality. It exists right around the corner, in every city, and Boston is certainly no exception.