BioQuakes

AP Biology class blog for discussing current research in Biology

Tag: healthcare

Healthcare Inequality Within the United States

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On March 23, 2021

In Student Post

The healthcare field, that is painted to be a blessing for many Americans, happens to also be a huge source of fear for many Americans as well. Throughout history, our healthcare system has shown to ignore and strike fear into specific groups of people. For this reason, through years of trauma and story telling, the fear of these same healthcare systems tend to be passed down as generations pass by. Many Americans then grow up with the constant fear of the healthcare system and seeking assistance when something alarming may appear.

According to CenterJD:

  • The Harvard Medical Practice Study found, “there were significant differences between hospitals that serve a predominantly minority population and other hospitals. That is, Blacks were more likely to be hospitalized at institutions with more AEs [adverse events] and higher rates of negligence.”
  • The Agency for Healthcare Research and Quality, a division of the U.S. Department of Health and Human Services, found, “Blacks received poorer quality of care than Whites in 43 percent of the core measures” and “disparities in quality and access to care are growing wider in the Hispanic population.”
  • Racial and ethnic minorities are uninsured more often than non-Hispanic Whites, a status that frequently results in less than adequate care.
    • A study by the Robert Wood Johnson Foundation found that compared with the insured, those without health coverage who are hospitalized are more likely to receive fewer services, experience second-rate care, and die in the hospital.

Although this CenterJD post is from 2008, it puts into perspective how medical malpractice is not only a problem of the past during chaotic events such as WWI and WWII and how medical malpractice still very much affects our society today.

As Covid-19 is the modern issue at hand for most people in the United States, we often take into question who and how quickly is Covid-19 affecting people. Pasted below are statistics around Covid-19 in relation to race and ethnicity in America.

Evidently from the statistics given by the CDC, American Indian/Alaska Natives, Black/African Americans and Hispanic/Latino persons are way more likely to die and be hospitalized by Covid-19 than their White counterparts. This may be due to a multitude of reasons stated by the CDC. They claim that “Race and ethnicity are risk markers for other underlying conditions that affect health including socioeconomic status, access to health care, and exposure to the virus related to occupation, e.g., frontline, essential, and critical infrastructure workers.”

One very prominent example of this inequality in the healthcare field is Black women in America’s healthcare system. According to Black Women’s Health Imperative, “Black women are 3-4 times more likely to die from pregnancy-related complications and 3-4 times more likely to suffer from severe disability resulting from childbirth compared to White women.”  Black women are also much more likely to experience birth injuries and deaths due to other factors that are engraved in our societal structure. According to AJMC, When analyzing preterm birth numbers, it is evident that women living in areas of high violent crime and high air pollution that have the highest risk of preterm birth. “Black women are 4 times more likely to live in a neighborhood with high violent crime and high air pollution than White women,” which may partially explain why there is such a difference in the birth characteristics of these two groups.  Heather Burris, a current medical doctor, stated that “both physical and psychological stressors can lead to low birth weight and other health disparities” as well. This is why we must view these issues with historical context in mind. Discrimination and Racism, such as redlining, food deserts and many other forms of control by the American systems were used and ultimately affect the way that many Black Americans and other American groups function to this day.

According to Endofound, Health conditions that disproportionately affect Black women receive less government research funding than other similar diseases. They state that “estimates reveal that nearly a quarter of Black women between the ages of 18 and 30 have [uterine] fibroids — compared with 7 percent of White women. By age 35, that number increases to 60 percent. However, NIH annual funding for the condition is $17 million — compared to $86 million for cystic fibrosis, which impacts far fewer people each year (though the great majority of those impacted are Caucasian).” Cystic Fibrosis is a much rarer disease according to Cystic Fibrosis Foundation as there are around 70,000 currently living people worldwide with this condition. There are more than 200,000 cases of Uterine Fibrosis in the United States alone. Cystic Fibrosis appears to be much deadlier, however, the lack of funding in a department for an illness that is extremely common should be of concern. With more demand, more funding would seem like a plausible reaction, however, the current funding clearly shows otherwise.

 

As shown by the article’s data presented by Nature’s Alice B. Popejoy and Stephanie M. Fullerton, many racial and ethnic minority groups are still not present in genome wide association studies funded by the National Institute of Health. Popejoy and Fullerton state that “together, individuals of African and Latin American ancestry, Hispanic people (individuals descended from Spanish-speaking cultures in central or South America living in the United States) and native or indigenous peoples represent less than 4% of all samples analysed.” These numbers are ridiculous and makes it very hard for many people of color to feel as safe as their White counterparts, since there is significantly less statistical data that provides the same support and comfort in their own safety.

According to an article by Lauren Frayer, the NHS, which is the state funded company that funds health care for all in Britain, polls better than the queen, showing that British citizens are extremely fond of the system that is set in place to help all of its citizens. Richard Murray, a policy director for a health care think tank named the Kings Fund, says that it would be “electoral poison” for any political figure in the UK to advocate for privatizing the NHS. This feeling is mutual among many citizens of other countries with some form of universal health care as well. Many other countries such as Canada, Sweden, Spain and many more have very similar policies set in place to help aid citizens in getting better health care coverage. In a similar fashion the Affordable Care Act (ACA) in the United States made health insurance much more attainable for some citizens but also made more complications for others citizens as well. According to healthline, “more than 16 million Americans obtained health insurance coverage within the first 5 years of the ACA. A more affordable health insurance would help many groups such as the large amounts of people who live in high crime areas and high levels of poverty such as big cities like Chicago, Los Angeles and many other similar areas. Although our country is yet to promote policies that provide realistic health care policies for all, there is always room for change and progress as we try to become more united as a country.

Universal health care coverage can be achieved in a multitude of ways and this graphic by commonwealth fund displays methods of achieving the end goal of universal health care.

 

This is evidently a multi-faceted issue as the health care problems for many groups in America are not only caused by one specific source. Our country must start by fixing the issue of widespread poverty in our country because it directly correlates to so many problems within our country including health care inequality. We must use our resources to help build up and fortify the communities that are not properly funded nor given the opportunities as many of the wealthier communities in the United States due to this lack of funding and lack of emphasis to support these areas. Without proper steps towards building these communities and making health care a more realistic option, a large amount of the United States’ population will continue to suffer and struggle for years to follow.

How the Healthcare Industry Disadvantages Minorities

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On March 10, 2021

In Student Post

Although our country is built on the principle that “all men are created equal,” this notion has yet to be completely true in modern America or our history. The disproportionate death rate from COVID-19 in Black Americans is a telltale sign of the inequities, or injustices, in place in the healthcare industry. While it’s easy to blame these inequities on higher obesity, diabetes, or hypertension rates in Black Americans, there is more to it than that.

These inequities are also very prevalent in prostate cancer mortality, as the numbers are far higher in Black men than white. This results from a multitude of factors, including that they “generally get fewer PSA screenings, are more likely to be diagnosed with later stage cancer, are less likely to have health insurance, have less access to high-quality care,” or perhaps even other factors, according to Daniel Spratt, M.D. These are all indications of structural inequality, a system of unfairness created by institutions, in our country, not just circumstantial or individual biases. 

coronavirus, COVID-19, emergency, face mask, protection, temperature, equipment, medicine, healthcare, health

COVID-19 equipment, including masks, medicine, and thermometer

Black and minority patients are likely to feel more comfortable with minority doctors, but unfortunately this isn’t always possible. For obvious reasons, this reduces implicit bias from the physicians. Aside from a harder time getting proper care, minorities also suffer from an unequal amount of expenses. According to a UMichigan team, “the last six months of life is $7,100 more expensive to the Medicare system for Black people, and $6,100 more expensive for Hispanics, compared with white people,” although more research must be done to determine exactly why this is. One of the root causes for these trends could be lack of nutrition. Even before the pandemic, many minority adults and children didn’t have access to nutritious foods, which plays a major role in health status. This also continues to be perpetuated by institutional racism and the vicious cycle of poverty in America. Unfortunately, many situations only worsened with the emergence of COVID-19. This is a very pressing issue that must be addressed sooner rather than later, in order to ensure the safety of many adults and children.

As we have learned in bio class, the use of masks to prevent the spread of COVID-19 is absolutely essential. Especially in urban or tightly packed communities, where COVID-19 can easily spread from person to person, masks are needed more than ever. Additionally, these communities often have high amounts of minorities, worsening their odds of becoming seriously ill. Fortunately, with the development of safe and effective vaccines, there is finally a light at the end of the tunnel. Minority communities desperately need vaccines in order to prevent any more lives lost, and luckily distribution is gradually picking up. Although this has been a tragic year, I hope America will learn from this situation, becoming more prepared for future unpredictable scenarios and fixing the inequities prevalent in our country.

Is Racial Bias Ruining Science?

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On March 10, 2021

In Student Post

In this video posted by Wonder Collective on Youtube, Dr.Esteban Bruchard gives a general overview of how racial biases have been implemented into medicine and general science. Primarily, Dr.Esteban Bruchard shed light on the exclusion of minorities from clinical research. By doing this the scientific conclusions had to be generalized to other groups who haven’t been included in the research. Specifically, a graphic that was shown in the video, showed that a drastic 81% of the participants of a “Recent genome study” were European.  Other races making up only 19% of the participants. The underrepresentation of other races will cause an inability to properly assess certain situations regarding other races. An example of this, as touched upon in the video, was how a difference in gene frequency in Blacks caused many African-Americans to be misdiagnosed with an enlarged heart.

Black patient getting attended to by a doctor

This isn’t the only instance of racial biases affecting science and medicine. In an article by Mathieu Rees, the topic of racism in healthcare is further discussed. Rees, dives into how certain aspects such as pregnancy, emergency care, pain treatment, etc. One thing that Rees highlights in his summary is that these racial biases can lead to inaccurate diagnoses. Rees also uses some statistics to show the racial disparities in healthcare. A specific statistic that I found alarming was a study that was conducted with white medical students in 2016. In this study, “73% held at least one false belief about the biological differences between races”. Examples of some of their beliefs were “Black people having thicker skin, less sensitive nerve endings, or stronger immune systems.” Not only are these biases alarming because of the obvious racial assumptions, but it is also so problematic because the people with these preconceived notions are those who will potentially be leading the healthcare of the future.

Going forward there are many steps that need to be taken to prevent the prevalence of racial biases in healthcare and sciences. One big step that can be taken is the involvement of more POC in the science world. Not only in hospitals as leading figures like doctors and physicians, but also as participants in things like clinical trials, advanced studies, etc. Also, the acknowledgment of various “social factors that affect health outcomes“. Finally, addressing these biases head on is one of the best ways to avoid them from being prominent in the line of work and in the development of science.

Why are there inequities for people of color in the healthcare system, specifically in the COVID-19 pandemic, and what are the solutions?

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On March 8, 2021

In Student Post

Throughout the past few months, the push for social justice has grown significantly. Throughout the COVID-19 pandemic we have heard about the inequities for people of color. I have taken in interest in this topic through my psychology class as well as my portfolio project. In my psychology class was where I started to really learn what inequities emerging majorities face in the healthcare system, and as someone who is white I think it is so important to learn what some people go through. Though I will never understand what it is like, I want to do my best to understand and create change for those people. I would like to enter the healthcare field, so I want to educate myself on these problems within the healthcare system and strive to create solutions. 

In my portfolio project, where I focused on effectiveness and accessibility to COVID-19 testing, I researched an article that dove into a divide for people of color trying to be tested. These people were not able to go to drive-thru testing centers because they didn’t have a car, and therefore could not be tested. This is one of the problems that minorities have faced throughout the pandemic. 

This article focuses on the problems of emerging majorities during the past few months. According to the article, in New York City, black people and latinos have a mortality rate from COVID-19 that is 1.6 to 2 times higher than white people. In Arizona, 16% of the deaths are Native Americans. Many people who work in the healthcare system, as well as officials and the general public, are working to solve this issue. The article addresses specific reasons why these inequities exist. 

People of certain races, ethnicities, social position, and economic status could be more exposed to the virus because of their jobs, size of their family, child care, public transportation, etc. Some jobs don’t allow people to work from home and their children might be in child care. Some also rely on public transportation or live with many people at home. People who have faced poverty or discrimination often have chronic pychosocial stress that can eventually lead to inflammation. This develops a maladaptation that can cause an impaired response in the immune system to COVID-19. Unfortunately, these people may not have access to a primary care provider. To learn more about psychosocial stress I found an article that explains this in minorities. Oftentimes, minorities face stress because of economic status and not as much access and delivery to healthcare. Stress is associated with cardiovascular disease, hypertension, and inflammation.

Black leaders in the healthcare profession have proposed immediate solutions such as recording data for races and ethnicities, access to current treatments, mobile testing, and communication with leaders that are trusted. The Vanderbilt University Medical Center (VUMC) has worked to address these problems identifying and preventing inequities. They have created resources for COVID-19 to people who speak languages such as Arabic, Nepali, and Spanish. I didn’t realize that there were also inequities for people based on the language they spoke, so this was surprising to learn. I found an article that talks about inequities for Spanish speakers in healthcare. The article discussed how latino children who have limited English proficiency (LEP), are more likely to have compromised healthcare and parents have less communication with the provider which makes more dissatisfaction with the healthcare system. Although there are many inequities for people of color right now, there are so many solutions and people working to fix these problems. This relates to our goal in biology to learn about inequities in the healthcare system, especially during Black History Month.

 

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