Discussion question: The Silent Curriculum

In lecture and discussion, we spoke about how socioeconomic status does, in fact, greatly influence health. We analyzed scenarios and watched videos on how the poorer populations in America were more susceptible to a decline in health just by where they lived or the quality of food they ate. Socioeconomic status, and furthermore diseases themselves, are sometimes, but never always, indicative of race, yet we never study why these differences occur. My question is how, as future medical professionals, can we understand and break down the differences in health among races? Will we ever know why certain races have worse health than others? If so, can we ever change that?

Advertisements

The Breast Cancer Racial Gap

In the New York Times article “A Grim Breast Cancer Milestone for Black Women” Tara Parker discusses the “dubious milestone” African American women have recently reached. According to the American Cancer Society the incidence of breast cancer among black women is now equal to that of their white counterparts. This is troublesome for the women of the African American community because statistically they are more likely to die from breast cancer. Now that the incidence rate in African American women has gone up it is expected to broaden the mortality gap between black and white women.

What changes have occurred in recent years that have led to more black women being diagnosed with breast cancer? Could it just be that early diagnosis is allowing doctors to recognize more cases?

While, early diagnosis is discussed as a contributing factor it is not enough to explain this great of a raise in the trends. It is rather obesity and a change in reproductive patterns that is increasing the risk of breast cancer in black women. So this explains why black women are being diagnosed, but does not explain the higher mortality rate. Parker attributes this to several factors including the lack of availability of that black women have to quality health care compared to white women. In addition to the fact that black women are more likely to be diagnosed with triple negative breast cancer, a form of the disease which has a worse prognosis than estrogen-receptor positive disease, the most treatable form of breast cancer; more commonly found in white women.

This disturbing statistic that projects that African American women are 70 percent more likely to die from breast cancer than white women speaks to on going inequalities in our health care system. Why is it than in 2015 race still plays a role in the quality of care that a person receives? I believe that these disparities date back to policies and the lack there of in previous decades and gives us reason to modify our health care system so that it benefits everyone equally. Because the perpetuation of the current United States health care system will continue to indirectly kill black women.

Just because black women lack the insurance coverage and access that their white counterparts have to seek and pay for quality treatment does not mean that they should continue to suffer more. This also speaks to the lack of standardization of care in the United States. The only way to fix the system so that race does not continue to be a determining factor in the quality of treatment is equalization of our hospitals, medical schools, insurance policies, pharmaceutical research studies and medical facilities across the board.

The inequalities in our health care system stem from social and economic policies that have failed to equalize the social and economic statuses of communities, neighborhoods, and cities across the nation. To start enacting change we need to start on a small scale and then work our way up from there. At the community level African American women need to be more informed about breast cancer, how it could potentially affect them and ways to seek preventative care. At state and possibly federal levels universal coverage plans need to be enacted so that lack of insurance is not a death sentence. People who lack insurance turn life saving treatments and even preventative care down everyday and this should not be the case. Until the health care system is equalized, the mortality gap between black in white women will continue to widen; because the system we have now is not operating in favor of black women, but against them.

http://well.blogs.nytimes.com/2015/10/29/a-grim-breast-cancer-milestone-for-black-women/?_r=0

The contrast in health and health insurance for different races and genders

In the article “Understanding Gender and Health”, the author compares the health of men and women. Women on average live longer than men, but they also have different social roles and community actions than men. Rieker looks at the differing social factors between men and women to try and explain the difference in health, without just considering biological reasons. In lecture we have been discussing health differences for people of different races and ethnicities. There is a shocking difference in life expectancy, infant mortality rate, and disease between genders and races. We learned in our last unit that health insurance plans are different for men and women for both cost and coverage. However, health insurance is not tailored to a certain race like it is to a certain gender. Looking at the statistical differences between African Americans and Caucasians for example, African Americans seem to have a higher likelihood of developing a serious disease than Caucasians do because of social factors. How do we create a health care system that is applicable to everyone and not just the statistical averages across all races and genders? Also, I’m curious if private insurance companies (before the ACA prohibited cherrypicking) were able to deny people from purchasing insurance if they were of a certain socioeconomic status or race. Knowing how selective insurance companies have been, it seems as if they might have justified not covering a certain person because of his or her race or socioeconomic status based on the statistical evidence.

Socio-Economic Status and Race

We have been studying how the socio-economic status of a person is a strong predictor of health, as well as what factors contribute to this status. In fact, the socio-economic status of a person is a better predictor of health problems than genetics.  Why is that important to our discussion of race? It’s very important because, on average, in our society, socio-economic status differs by race. On average, African Americans have lower levels of income, lower levels of wealth, and lower levels of education than whites do. And for other minority populations, a similar pattern is evident. Additionally, African Americans have a high mortality and morbidity rate as well.

Continue reading “Socio-Economic Status and Race”

Race Differences in Healthcare

In the past week, we have read several articles and watched several movies about the difference causes of inequality in healthcare.  One of the biggest contributors that was mentioned in everything we’ve read or watched is the difference of race.  In the article by Williams and Sternthal, they say that biologists have found little differences on the genetic level between different races.  That should mean that, biologically speaking, our bodies should not react in different ways to the same disease or health-related situation based solely on race.  Yet, in one of the movies from class, they talk about an African American woman who was of relatively high SES whose daughter was born prematurely with a low birth weight. Yet, white women of the exact same SES, income level, education level, and occupation status as this African American woman consistently carry their babies to term, and their babies are born with a normal/healthy birth weight.  This suggests that racism negatively affects our health, even in today’s society that has supposedly eliminated all racist ideas and supposedly guarantees equality for all.  What, as a nation, can we do to reduce these negative effects of racism on health? Is there any sort of governmental policy that can address this, or would it take a full scale ideological revolution?

COLOR BLIND

In “Understanding Racial-ethnic Disparities in Health : Sociological Contributions”, David Williams and Michelle Sternthal explore racial and ethnic inequalities in health in the United States. Personally, I am a proponent of color-blindness, but I question if it is a possibility in America’s future. The section of this publication titled “Racism and Health” opened my eyes to the concrete data and evidence that shows that our nation is still inherently racist, both intentionally and unintentionally. Williams and Sternthal reveal the very real presence of racial segregation that remains in this nation to this day, and this concerns me greatly.

Is institutional and wide-spread color-blindness a possibility in the future here in the United States? What, if anything, can/must be done to bring this change about? Is segregation and racism an unavoidable and everlasting aspect of our cultural fabric now?

Continue reading “COLOR BLIND”

Does Race Alone Influence Health Outcomes?

In Williams’ and Sternthal’s article, “Understanding Racial-Ethnic Disparities in Health: Sociological Contributions”, they explain that factors such as race, racial discrimination, gender, socioeconomic status, and social structure all have a role in health outcomes in the United States. Although we as a country have come a long way in the fight against racial discrimination, it seems that it is still a pressing issue in today’s society regarding the media, health care, violence, etc. In regards to health care, where doctors take an oath to do no harm and what ever they can to provide care to someone, it is hard for me to agree that health outcomes are because of race alone. Sure, there will be outliers that do discriminate their patients because of race, but generally, I do not think race plays a huge role in health outcomes. I think most health disparities are due to socioeconomic status.  Socioeconomic status and race are intertwined and the go hand-in-hand. Thus, I do not think racial discrimination alone accounts for a lot of health disparities but instead I believe that health disparities are due to socioeconomic status and that those people just happen to be apart of a minority racial group.  This is the reason why people are seeing health disparities when they look at solely at racial groups.

I would love to hear the opinions of others who think similarly or that that racial discrimination in the health care settings play a major factor in health disparities. Does racism alone actually correlate to health outcomes?  Another question I want to ask is that how do these studies access racism and quality of care for someone who can afford to see a doctor among different racial groups.  If the argument against my claim holds true and that racial discrimination alone influences health outcomes, then what are the health outcomes of minorities who can afford doctors and are well off? If racial discrimination is a big influence, shouldn’t their outcomes reflect among the general population among their race or is it different?

Should Race be an Opinion?

In the Williams article, it was stated “Sociologists have also emphasized that science is not value-free and that preconceived opinions, political agendas, and cultural norms, consciously or unconsciously, can shape scientific research by determining which research questions are asked and which projects are funded”. However, I do not believe that race should be an opinion but a fact. Being Caribbean American, there are times where I don’t know whether to put other or “African American” as my racial identification.

Is it possible for us to go about as a society correctly classifying individuals without using preconceived judgement and assumption?

Factors Influencing Health Outcomes

In the article “Understanding Racial-ethnic Disparities in Health: Sociological Contributions,” Williams and Sternthal explain in detail the many factors that influence health outcomes, such as race and racial discrimination, gender, socioeconomic status, social structure, and migration history. Although all these factors are important, I felt like the article was just listing out all the problems that influence health outcomes and wanted to prove that these problems do in fact exist. However, we already know that these factors influence health, so how should sociologists and medical professionals take what they already know and create practical solutions for our communities today? At the end of the article, they say that policy needs to be changed and that there needs to be more awareness in the public. Are there any other effective solutions that can be created and implemented today? (Maybe create/influence government policies that assist underserved communities, provide health benefits for vulnerable groups, make farmer’s markets and groceries stores more readily available in poorer communities, etc?)

Discrimination from Health Care Professionals

The article “Understanding racial-ethnic Disparities in Health: Sociological Contributions,” by Williams and Sternthal stresses four points. It challenges the biological understanding of race, it emphasizes how social structure determines racial differences in disease, it discusses how racism affects health, and finally it discusses how immigrant status can play a role in healthcare quality.

Specifically, in the section on Racism and Health, Williams and Sternthal discuss how segregation has played a role in minorities’ health, especially African Americans. Additionally, this section also discusses discrimination, but only generally, and not in the context of a healthcare setting.

Thus, this article leaves out some of the medical sociology factors, like racism and discrimination by health care professionals. Therefore, I question and wonder about how quality of care after one has access to and can afford the healthcare varies for different minority groups. How does discrimination by doctors and other healthcare professionals affect the health of these groups? What research has been done to challenge this and bring it to light?