Who gets to be Healthy?

 

“Of all forms of inequality, injustice in healthcare is the most shocking and inhumane”

            -Martin Luther King Jr.

One issue facing people of color in America is massive inequities in healthcare. This extends to everything from health insurance, to accessibility, affordability, and appropriateness of care for different groups of color. These problems are felt more harshly by poor people of color, but there are also many health problems that face middle and upper class people of color, particularly in the African-American community. Additionally I will delve more extensively into HIV/AIDS testing, care and information, due to the fact that HIV/AIDS disproportionately affects more African-American and Hispanic people than any other groups in the United States. The goal of this page is to raise awareness of a variety of health problems that are more common among people of color, as well as organizations dedicated to solving these inequities, and resources for accessing accessible, affordable and appropriate healthcare for all people regardless of socio-economic class or race.

A note regarding what “appropriate, accessible and affordable healthcare” actually means:

While many people know about the problems related to the affordability of healthcare it is also important to note that there are other factors that play a role in whether or not health initiatives will be effective or worth undertaking. For instance say a city builds a free clinic to serve a community, however the workers in the clinic do not speak the language of the area’s residents, don’t understand or respect their cultural beliefs and the clinic is only open between 9 and 5, a time when many of the residents, who cannot afford to miss work, are in fact, working.  The fact that there is a clinic, funded staffed and built is only half the battle. Patients do not want to listen to doctors who treat them like they are dumb or do not respect them or their beliefs, patients do not want to have to try and explain medical problems to a doctor who cannot understand what they are saying and on top of all that do not want to have to choose between making money to feed and support their family, and going into the doctors to get their high blood pressure, or blood sugar checked. There needs to be more planning and thought that goes into healthcare than simply stocking it with bandages and vaccines and medical staff. Hospitals, clinics, doctors, nurses and administrators all are caring for people. People who want to feel as though they will be respected and understood, especially in a medical setting when news can be life-changing and regular visits can literally mean life or death. That being said, America needs to do more to end health disparities for people of color than just sticking doctors and nurses in a building.

“Lifestyle Diseases”

The idea of a “life style” disease is a relatively new concept to the health field. It has only come around with the dawn of modern and largely westernized society. The phrase deals with the fact that in America today people are no longer dying from communicable diseases in mass numbers, instead our leading causes of death are heart disease, cancer, and stroke.[1] All three of which can be argued are caused by “lifestyle” choices like a lack of exercise or a poor diet. That being said there are also social determinants which can contribute to these choices like not having the luxury of free time to exercise or the money to afford a gym membership, or maybe the neighborhood you live in doesn’t have a grocery store that carried whole grain bread and fresh vegetables, at a reasonable price. My own feelings on the matter obviously support the idea that society is to blame for these diseases not the individuals, however there are plenty who will argue differently. For more of an idea about what the commotion is about check out the editorial posted at the bottom for a slightly different perspective on the matter of “life style” diseases.[2]

A few snapshots of health inequality…

Racism and prejudice has always been a part of the US healthcare system. The United States has subjected legal citizens to disgusting and inhumane experiments because they were mentally ill, poor, or “not white”. The government has refused to take significant action in preventing and treating a disease because it deemed that those who were suffering from it were unworthy in some way. Yet it appears as though these moments in our history, like the Tuskegee Syphilis Study or the HIV epidemic are left out of student’s history books and attempted to be forgotten. In reality 600 African American men in 1932 were experimented on without their consent, and without full knowledge of what was happening to them. These men were left to wither and die from horrible deaths “in the name of science” This “study” last for forty years, and even though penicillin became the common course of treatment by 1947, the study still continued on. It was not until 1972 that the study was brought to the attention of the public, and consequently stopped by the government. The following summer the NAACP filed a class action suit against the US government and its survivors, widows and children were awarded 10 million dollars in a settlement outside of court ,as part of the settlement the surviving participants, and eventually their wives, widows and children were awarded free lifetime health and medical benefits as part of reparations[3].While there were obviously structural injustices in between the United States once again turned it back it it’s citizens in the early 1980’s. The United States failed to act when what would become known as HIV/AIDS starting ravaging the gay community of San Francisco. The group was stigmatized and many blamed the disease on those who had it, claiming it was their own fault. The disease killed thousands and it was not until it started to affect heterosexual hemophiliacs that the government wanted to step in. They wanted to step in because hemophiliacs were “innocent victims” unlike gay men, prostitutes or intravenous drug users who had “brought it upon themselves”[4]. While the government sat and ignored the problems dozens of non-governmental activist groups and organizations sprung into action in order to support their friends and loved ones in anyway they could, from running food banks for HIV patients to organizing protests against government inaction. Today HIV/AIDS, as well as a variety of other “lifestyle” diseases are stigmatized and downplayed by US officials, when in reality thousands continue to die from inactivity against these health problems.

Get Involved!

There are many organizations dedicated to solving problems related to health inequality. One in particular is Tapestry health. It is an organization based in Western Massachusetts that funds a number of heath programs, including STI and HIV testing centers, a needle exchange program, as well as a variety of supplemental nutrition programs. They work to provide appropriate, affordable and accessible health care. In particular they reach out to members of low-income communities in Western Massachusetts, many of the residents of which are people of color, in order to help the uninsured and underinsured to receive the healthcare and health services they need to live a healthy life.

*I personally love Tapestry Health and I encourage those who don’t live in Western Mass to reach out to similar organizations in their own communities Additionally try and help your community’s health centers![5] Often times the centers are understaffed and underfunded and will always appreciate enthusiastic volunteers! Everyone can help, everyone can contribute.

Working from the inside the system …. There are certainly movements to try and eliminate these numbers, including some run by the government. The Department of Health and Human Services has an office for Minority Health and it also sponsors an organization called “The National Partnership for Action (to end health disparities)”, abbreviated at the NPA. You can click here to visit the HHS and NPA website. The organization does a good job of providing information related to why so many people of color suffer from serious illnesses, like diabetes or heat disease, it discusses social determinants of health and overall does a nice job of providing people with background knowledge of the health disparities that are occurring so prevalently among people of color in the United States. The HHS has also recently released an action plan targeted to eliminate health disparities for people of color [6]. The only downside to the NPA and the HHS is that they are funded largely by government money, and often times when budgets get tight (as they are now) funding gets cut for HHS program, regardless of their necessity. However the organization does an overall good job of providing appropriate information regarding the truth behind health inequities in the United States.

 Health Issues

 HIV/AIDS is one of the biggest health issues facing Hispanic and African-American people in the United States today[7]. HIV is an easily preventable disease, for more information on how to prevent or where to get tested check out the link below[4]

Physical Effects of Racism-Research has shown that racism has real and lasting physical effects, especially for African-Americans. The effects cover everything from hypertension to a ridiculously high infant mortality rate. There have been dozens of studies, even documentaries (see the links below!) to show the public just what racism can do to people

My Thoughts

Healthcare is a human right. Period. End of Discussion. As a concerned human being and someone who hopes to work in the healthcare field someday I can honestly say that inequality in healthcare is one of the most atrocious forms of not only racism but overall injustice. As I said I believe that healthcare is a human right, everyone deserves to be healthy, just as everyone deserves the right to “life, liberty, and the pursuit of happiness”. When people are healthy everything is easier; working, cooking, driving, cleaning, spending time with your family, it is one less thing to worry about. While it is impossible for us all to be healthy all the time, it is imperative that we all, at the very least, have the same access to quality healthcare. However, that is just simply not a fact in America today. There are massive healthcare inequalities that extend far beyond a divide between the rich and the poor. African-American women who’s lives have been so full of stress from the constant pressure of racism that it literally can cause harm to their unborn children, Childhood obesity skyrocketing in poor neighborhoods of color because healthy food is not available and even if it were it would be too expensive to afford. When people try to throw around the concept of “lifestyle diseases”, its hard to blame somebody for developing adult on-set diabetes when they haven’t lived with miles of a real grocery store for their entire lives and are instead forced to get their dinner from fast-food enterprises or neighborhood bodegas (check out the video below). There is a lot that can be done to improve the quality of healthcare in the United States. To start there are always volunteer positions at clinics, they are often times underfunded and understaffed and always looking for enthusiastic and dedicated volunteers. Additionally there is a great need for socially conscious healthcare professionals who are ready to work to improve the quality of healthcare, to provide care to their patients and clients that not only makes them feel cared for, but also respected. When people need to go to the doctor’s office or to a hospital it’s usually not under the best circumstances and this can either be improved or exacerbated based on what type of care people receive from their providers. At the end of the day no one should be worrying about money when they’re worrying about being well. In my mind healthcare is not, nor will it ever be a commodity. It should not be run like a business, it’s sole purpose should be to take care of its patients and their friends and loved ones, not to make a profit. Appropriate, accessible and affordable healthcare is a human right, not something to be based off of the race(or any other attribute for that matter), of a person.

Documentaries, Articles, etc.

Unnatural Causes- Documentary series about just how health inequalities are affecting the health of all Americans- http://www.unnaturalcauses.org/episode_descriptions.php?page=1

“How racism hurts—literally”- Boston Globe- http://www.boston.com/news/globe/ideas/articles/2007/07/15/how_racism_hurts____literally/

On Institutional Racism- http://academic.udayton.edu/health/07humanrights/WCAR02.htm

A satirical piece on bodegas (I apologize for some of the language in the video, however it makes a great point!)-http://www.youtube.com/watch?v=11nsZ3lEWD0

“The Spirit Catches You and You Fall Down”-Anne Fadiman- A great book about comprehensive healthcare, tells the story of a Hmong family in the United States who have a daughter living with epilepsy the book details the story of the interactions between the girl’s doctors beliefs and her family’s own beliefs about the best way to care for and treat the girl

Citations

[1]http://www.cdc.gov/nchs/fastats/lcod.htm

[2] http://opinionator.blogs.nytimes.com/tag/lifestyle-diseases/ Editorial on Lifestyle diseases

[3]http://www.cdc.gov/tuskegee/timeline.htm

[4] http://www.avert.org/aids-history-america.htm

[5] http://www.nachc.org/about-our-health-centers.cfm  National Association of Community Health Centers

[6] http://minorityhealth.hhs.gov/ -Office of Minority Health website

[7] http://www.kff.org/hivaids/upload/6089_05.pdf– Black Americans and HIV Fact Sheet

Created by Sam Barry

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