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YoungDemCA

(5,714 posts)
Mon Sep 21, 2015, 09:30 PM Sep 2015

How racial inequality in American society contributes to poorer health outcomes for PoC

Some information from Stanford professor Donald Barr here:


"A principal determinant of access to health care in the United States is the availability of health insurance. As is the case with health status, those from lower SES groups in the United States also have worse access to health care, based on this econmic fact of life. However, a growing body of research has shown that, even when people have the same level of health insurance and are treated for the same disease by the same physicians and hospitals, those from minority racial or ethnic groups often get worse care - either not receiving care when appropriate or receiving care that is lower in quality."


Barr, D. A. (2014). Health disparities in the United States: Social class, race, ethnicity, and health. JHU Press. p. xiv-xv

https://books.google.com/books?hl=en&lr=&id=8kZjBAAAQBAJ&oi=fnd&pg=PP1&dq=food+health+america+social+class&ots=-52kOxj5GI&sig=0S-wRKOY8IA6cqlR8BA1w_vI1JE#v=onepage&q&f=false

I should note that in Chapter 4 of this book, Donald Barr introduces the concept of allostatic load, which he defines as "the physiologic response to the stress of being in a position of social disadvantage, which over a period of years can result in physiologic injury and illness" (p.xiv).


Other stuff:

From the CDC website:

- African Americans in 2009 had the largest death rates from heart disease and stroke compared with other racial and ethnic populations; these disparities in deaths were also found across age groups younger than 85 years of age.

- From 2007-2010, the largest prevalence of hypertension was among adults aged 65 years and older, African American adults, US-born adults, adults with less than a college education, adults who received public health insurance (18- 64 years old) and those with diabetes, obesity, or a disability, compared with their counterparts. The percentages of African American and Hispanic adults who had control of high blood pressure were lower than among white adults.


snip:
Infants of African American women in 2008 had the largest death rate, which was more than twice the rate among infants of white women.

African Americans in 2009 had the largest death rates from homicide among all racial and ethnic populations. Rates among African American males were the largest across all age groups.

African American adults in 2010 had the largest HIV infection rate compared with rates among adults of other racial and ethnic populations. Prescribed HIV treatment among African American adults living with HIV was less than among white adults.

In 2010, a larger percentage of Hispanic and African American adults aged 18-64 years were without health insurance compared with white and Asian/Pacific Islander counterparts.


snip:
In 2011, similar to other racial and ethnic minority adults aged 25 years or older, African American adults had a larger percentage who did not complete high school compared with white adults. Also, a larger percentage of African American adults lived below the poverty level and (ages 18-64 years) were unemployed compared with white adults


snip:
Factors contributing to poor health outcomes among African Americans include discrimination; cultural, linguistic and literacy barriers; and lack of access to health care.



http://www.cdc.gov/minorityhealth/populations/REMP/black.html

As always, free to share your thoughts, comments, or even stories.
22 replies = new reply since forum marked as read
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How racial inequality in American society contributes to poorer health outcomes for PoC (Original Post) YoungDemCA Sep 2015 OP
I read something like this years ago. qwlauren35 Sep 2015 #1
i'm kind of surprised by this but maybe i shouldn't have been JI7 Sep 2015 #2
I read where even BLACK DOCTORS treat black patients worse than white ones Number23 Sep 2015 #4
Not to mention the attitude many doctors can have anyway kjones Sep 2015 #5
Absolutely. It's the most noble profession in the world (imho) but it does inspire alot of arrogance Number23 Sep 2015 #7
Not so noble for many who go into the medical field. randys1 Sep 2015 #14
My father is a primary care physician YoungDemCA Sep 2015 #15
Your father is becoming an antique in that too many new physicians are not randys1 Sep 2015 #16
I'd like to think there are lots of noble professions kjones Sep 2015 #17
That Internalized Hate is no Joke lib87 Sep 2015 #11
Yep. And it touches all of us. Even when you KNOW better. Even when you know it's wrong Number23 Sep 2015 #12
Heart disease and stroke due to the disproportionate amount of liquor stores and fast food Number23 Sep 2015 #3
This is a great post JustAnotherGen Sep 2015 #6
Girl, this is why we have no interest and cannot be bothered. We know what they are about Number23 Sep 2015 #8
If they can't see how innocent an infant is? JustAnotherGen Sep 2015 #9
I was thinking of this study when Julian Bond died, at a rather young age, imo. Starry Messenger Sep 2015 #10
A little kick JustAnotherGen Sep 2015 #13
K & R historylovr Sep 2015 #18
This true and not discussed nearly enough rbrnmw Sep 2015 #19
i never CarlaJonesChicago Oct 2015 #20
Welcome to DU, Carla! Number23 Oct 2015 #21
Thanks CarlaJonesChicago Oct 2015 #22

qwlauren35

(6,148 posts)
1. I read something like this years ago.
Tue Sep 22, 2015, 12:34 AM
Sep 2015

From my memory, some of the issues were: initial distrust of doctors - especially because of the Tuskegee Experiment, a tendency to put off getting care, lack of black physicians, poor patient-physician interactions that caused patients not to seek additional help.

There was supposed to be more diversity training at medical schools to address this...

Good news, we now have 4 HBCU medical schools: Drew University, Howard University, Meharry Medical College and Morehouse School of Medicine.

JI7

(89,252 posts)
2. i'm kind of surprised by this but maybe i shouldn't have been
Tue Sep 22, 2015, 12:38 AM
Sep 2015

"even when people have the same level of health insurance and are treated for the same disease by the same physicians and hospitals, those from minority racial or ethnic groups often get worse care "

this is just sad. and shows how widespread problems with institutional inequality go.

Number23

(24,544 posts)
4. I read where even BLACK DOCTORS treat black patients worse than white ones
Tue Sep 22, 2015, 01:49 AM
Sep 2015

I know I say this all of the time and it's because it is beyond true. NEVER underestimate the power of racism. Even black people are not immune to racism against black people.

kjones

(1,053 posts)
5. Not to mention the attitude many doctors can have anyway
Tue Sep 22, 2015, 06:52 PM
Sep 2015

Doctors are awesome, for sure, but they can have the tendency to treat you
as...well, an idiot. Add that sometimes dismissive attitude to a somewhat "paternalistic"
professional ethos and a dash of prejudiced views of black "ignorance" and you can end
up feeling like nothing but a piece of meat. It's a wonder anyone ever gets into the doctor's
office.

Number23

(24,544 posts)
7. Absolutely. It's the most noble profession in the world (imho) but it does inspire alot of arrogance
Tue Sep 22, 2015, 06:59 PM
Sep 2015

in those who go into it. Like you said, it's a paternalistic profession to begin with and then combined with that arrogance -- most people feel turned off by it.

But when that extra dash of racism is tossed in as well, and unfortunately it very often is, it can have deadly consequences. Especially if you're sick as well as a minority and/or poor. So many don't get the care and attention that they need.

randys1

(16,286 posts)
14. Not so noble for many who go into the medical field.
Wed Sep 23, 2015, 04:17 PM
Sep 2015

So many people who go to medical school want to be specialists because it is better money.

That is a big problem and one of the reasons medical costs are too high, not enough primary care physicians.

Which is also the number ONE problem with the VA.

I say if you want to be a doc in USA you WILL do a certain amount of free work, you WILL do a certain amount of donated help to the VA and you WILL take ALL government payments such as medicare.

Make it less attractive to be a specialist, not completely less attractive but just enough to make it so more people are willing to be GP's.

 

YoungDemCA

(5,714 posts)
15. My father is a primary care physician
Wed Sep 23, 2015, 05:42 PM
Sep 2015

He works his ass off and gets burnt out. And yes, his pay is not as high as that of a surgeon or radiologist or what have you.

There are fewer and fewer professionals who get into their careers because of the value to society that they provide. The main motivation these days is to make a lot of money. That's a problem.

randys1

(16,286 posts)
16. Your father is becoming an antique in that too many new physicians are not
Wed Sep 23, 2015, 06:29 PM
Sep 2015

doing it for the right reason.

He is to be thanked for his service.

My GP is a hippie doc, who gives me a hard time about all kinds of stuff, and at the end of the day he is just awesome and really cares.

kjones

(1,053 posts)
17. I'd like to think there are lots of noble professions
Thu Sep 24, 2015, 10:29 AM
Sep 2015

Doctors couldn't operate without the miners who dig out the metal for their surgical instruments, the farmers that grew/raised their breakfast, the janitors who keep the place clean enough to operate in, etc. Not relevant to the topic, sure, but it's a nice thing to consider to brighten your day a bit (and we could all use some of that around here)


But to dire things...
Yes, that day I made that comment, I had actually been talking to a fellow grad student who had recently had some related experiences. He's a large, black man who recently had a stay in the hospital for blood clots. He got the usually (I assume) array of medicines to take to mitigate the problems, but he was telling me about how he had to go out of his way to get advice/instructions on lifestyle/diet/exercise and keeping weight down...etc. He studies attitudes of racism as a cultural anthropologist (I'm an archaeologist...anthropologist as well), so in retrospect, he closely examined the experiences he had over his time in the hospital. He noted that his condition (weight issues and associated health problems) was viewed as somewhat of an inevitability. "Oh, well, black men gain weight and have heart attacks, just happens." So, they stuck to medications while on the "making changes" side of things, they were pretty much silent. Of course, this is a thread many doctors use for all patients...."medicate, medicate, medicate." However, the "large black man heart attack" is such an ingrained medical stereotype that some doctors apparently treat it as a natural, medical inevitability. So, my friend had to go out of his way to get access to preventative advice and information. Luckily, he did, and is changing his lifestyle and such...but those with less resources, less informed, less motivated, with more deference to doctors, or with less confidence to confront the doctor with it may very well have gone home with only their medicinal regimen.

It was a complicated situation with a lot of underlying biases, stereotypes, and factors....but the racial undertones in his experience (vs say...my grandpa's experience) are evident. What's so disheartening about it isn't that it was cruel or overt, but that it was hardly even noticed...not by the doctor, and almost not by the patient. Instead, it was passed over and almost ignored as the "natural order" of things...and so, quite insidious. Thus, people who are certainly not racists by any means can still be a party to a malignant systematic racism. We can all be tools to it.

Edit:
At the same time, I suppose there is an upside to that kind of racism. An overt racist is unlikely to change their views and beliefs regardless. However, someone who unknowingly holds erroneous, stereotyped views can (and usually will) modify their views to closer fit reality if they are gently educated or informed that "Well, no, that's not really true." Awareness, bringing it to their attention, can often fix the problem, at least for the individual. One doctor down....thousands to go
I myself have (and perhaps everyone has) excised many of these erroneous beliefs. When I become aware of such beliefs, it is both tremendously embarrassing and at the same time liberating...cathartic. The views are remodeled in unending fashion to more closely match reality, and I become just a little be better for it.

lib87

(535 posts)
11. That Internalized Hate is no Joke
Tue Sep 22, 2015, 08:37 PM
Sep 2015

I use to think that people of particular career helping fields were immune to this due to ethics but working around them has taught me this is not true.

Number23

(24,544 posts)
12. Yep. And it touches all of us. Even when you KNOW better. Even when you know it's wrong
Tue Sep 22, 2015, 10:51 PM
Sep 2015

Nobody is immune, not even folks sworn to protect and serve or to heal.

Number23

(24,544 posts)
3. Heart disease and stroke due to the disproportionate amount of liquor stores and fast food
Tue Sep 22, 2015, 01:48 AM
Sep 2015

restaurants in AA and/or poor neighborhoods. High homicides because of a lack of opportunity and too many people being taught in every single way to hate themselves, that they have no value.

To quote Chuck D:

Now let's take a look at that word projects. Another word for experiment. On one side of the street is a church. Across the road is a liquor store. Both of them keeping us poor.

Though I don't necessarily share his sentiment that the church keeps black people poor.

The fact that black HIV numbers are so high and so few of us get treated for HIV when they are so extremely close to finding a cure breaks my fucking heart.

JustAnotherGen

(31,828 posts)
6. This is a great post
Tue Sep 22, 2015, 06:58 PM
Sep 2015

And all of those folks that only show up back here when it's to defend The Bernie show what their intent is by not responding or rec'ing it.

I'll remember that.

Lather, rinse, repeat:
Infants of African American women in 2008 had the largest death rate, which was more than twice the rate among infants of white women.

Number23

(24,544 posts)
8. Girl, this is why we have no interest and cannot be bothered. We know what they are about
Tue Sep 22, 2015, 07:00 PM
Sep 2015

and why we won't allow them to waste even a second of our time.

JustAnotherGen

(31,828 posts)
9. If they can't see how innocent an infant is?
Tue Sep 22, 2015, 07:09 PM
Sep 2015

Then I know what they are.

Thank a Republican: http://www.huntershope.org/site/PageServer

Granted Hunter died and it woke them up. But if you ever get a chance to speak with Jill Kelly? Let's put it this way - they knew about those numbers a long time ago. She's a little bit on the Jesusy Tip - but all infants are innocent and deserve the same shot.

Not just those whose parents are deserving.

20. i never
Thu Oct 15, 2015, 02:53 AM
Oct 2015

Wow! I NEVER looked at this from that angle. My goodness! I believe it. I gotta say this. I live in Chicago and on a normal weekday droves of people walk the streets. I don't like going downtown because of so many white faces. Im not racist. I love all but it makes me feel out of place and like I'm not good enough. I rarely go downtown because of this. I know it sounds weird but it's true. So, I know its true about health care and black people. We sometimes don't trust so easy. I believe some black doctors blow off black patients too. I think I had one before.

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