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”
In Nicholas Bakalar’s NYTimes article, “Minorities Get Less Pain Treatment in E.R.” he discusses recent study findings from the Centers for Disease Control and Prevention (CDC) regarding treatment in the E.R. for patients of various racial and ethnic backgrounds. This nationwide study was conducted over a four-year period using “a sample of 6,710 visits to 350 emergency rooms by patients 18 and older with acute abdominal pain.” Despite the fact that severe pain frequency was equal across all patients at 59 percent, Black patients and those of other minorities “were 22 percent to 30 percent less likely to receive pain medication” than White patients. In addition, they were “less likely to receive pain medicine if they were over 75 or male, lacked private insurance or were treated at a hospital with numerous minority patients.” The article ends with some remarks from the senior author of the study, Dr. Adil H. Haider of Brigham and Women’s Hospital in Boston. His remarks were as follows: “It may be that different people communicate differently with their providers. If we as providers could improve our ability to better communicate with patients so that we could provide more patient-centered care, we’ll be making several steps toward reducing and hopefully eliminating these disparities.”
Within the article “Understanding Racial Ethnic Disparities in Health:Sociological Conditions” written by David R. Williams and Michelle Sternthal, the racial gap in life expectancy was determined to increase, as education increased. I found this highly puzzling, as generally, we have seen that the rise in education typically correlates with the rise in position/power. Due to this rise in power/position, individuals are in turn able to gain a greater quality of healthcare and benefits, and often suffer less medical ailments. Thus, why is it that minority groups still fall behind in terms of life expectancy, when it was presumed that education provided a means with which to obtain an improved quality of life and care? The article denotes the “diminishing returns” hypothesis as the reason. However, what exactly falls under the category of “health returns?” What allows for these returns to decline for people of color as they move up through the ranks in terms of education and occupation? How have the differences in the quantity and or quality of “returns” for whites and people of colored not been recognized previously? If not education, the tool often deemed the key to equilibrating the classes, what could remedy the difference in health returns?
In “Understanding Racial ethnic Disparities in Health” Williams and Sternthal argue that more policies are needed to improve the health of the minority population. The article blames racial discrimination and low-quality living conditions for declining health in vulnerable social groups. While reading the article I realized that a similar event took place in the 20th century when Blue Cross presented itself as the best alternative to national health insurance. This undercut the middle class concern for health access equality. As stated in Rothman’s article at that time it would require empathy for the middle class to push for national health insurance. Are we experiencing a similar situation here? Is it the majority group, native-born Americans, to blame for not pushing for equality in living conditions, access to education, SES, and most importantly health? Could they be more powerful allies in reforming the system?
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?
This year, thanks to the combined efforts of Nicolle Gonzales, Brittany Simplicio, and the nonprofit “Changing Woman Initiative,” a plan has been put into place to create the first ever Native American birth center. Gonzales and Simplicio are two of only fourteen certified nurse midwives who are Native American. The pair have a firsthand understanding of how frequently Native American women suffer the consequences of being minorities with a low socioeconomic status when it comes to health, and, more specifically, pregnancy, birth, and neonatal care.
On this topic, I have mixed feelings.
On one hand, Native American women will have better access to pregnancy and birth care, but I also wonder, how in the world is this first ever birth center for this already largely underserved group of people? How much has this group had suffer as the result their inability to access a birth center?
There is no greater illustration of how institutional racism and mishandled bureaucracy directly harm health outcomes for Native American people than what we see with Indian Health Services (IHS), particularly at the Santa Fe location where Gonzales used to work. Due to underfunding, native women only have access to prenatal care because the labor and delivery ward was shut down in 2008. When I see that, I immediately wonder and worry: when a native woman does go into labor, how far does she have to travel to safely give birth? Does she have access to a safe, clean place if she gives labor at home? How far is the nearest hospital if something goes wrong? The answer all of these to these questions are provided nowhere other than the disproportionately high rates of infant mortality among Native American people.
To add insult to injury, at the Santa Fe location, women are provided neonatal care through IHS, which is funded by the federal government, but for delivery at a hospital, they must apply for Medicaid. The interaction between IHS and Medicaid—for all medical procedures, not just birth—has created a confusing mess for native American people who don’t realize they’re eligible for both.
Gonzales and Simplicio explain that “poverty, discrimination, geography, and racism” have created cultural disparities that leave Native American people less healthy than they should be. These disparities manifest as “higher rates of gestational diabetes, increased rates of postpartum depression, and higher rates of preterm birth and low birth weights.”
It’s just amazing to me that it could take this long to finally give Native American people access to a service that might have saved an unknown number of lives had it been provided earlier.
In Williams article, he discusses the role that sociologists play in studying the effects of racial discrimination/inequality on a particular group’s health status. In the article, Williams explains numerous factors that affect ones’ health, such as SES or racial discrimination.
Which factor has the greater contribution to the lower health outcomes for certain racial groups? Is it SES, racial discrimination, or other factors? In what ways can these issues be addressed? (other than administering surveys by group and gender as the article suggests).