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Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequities, and face worse health outcomes than those who are able to access certain resources. It is not equity to simply provide every individual with the same resources; that would be equality. In order to achieve health equity, resources must be allocated based on an individual need-based principle.
In medicine, rural health or rural medicine is the interdisciplinary study of health and health care delivery in rural environments. The concept of rural health incorporates many fields, including wilderness medicine, geography, midwifery, nursing, sociology, economics, and telehealth or telemedicine.
The doctor–patient relationship is a central part of health care and the practice of medicine. A doctor–patient relationship is formed when a doctor attends to a patient's medical needs and is usually through consent. This relationship is built on trust, respect, communication, and a common understanding of both the doctor and patients' sides. The trust aspect of this relationship goes is mutual: the doctor trusts the patient to reveal any information that may be relevant to the case, and in turn, the patient trusts the doctor to respect their privacy and not disclose this information to outside parties.
Lisa A. Cooper is an American internal medicine and public health physician who is the Bloomberg Distinguished Professor of Equity in Health and Healthcare at Johns Hopkins University, jointly appointed in the Johns Hopkins School of Medicine, Johns Hopkins School of Nursing and in the departments of Health, Behavior and Society, Health Policy and Management; Epidemiology; and International Health in the Johns Hopkins Bloomberg School of Public Health. She is the James F. Fries Professor of Medicine in the Division of General Internal Medicine, Director of the Johns Hopkins Center for Health Equity, and Director of the Johns Hopkins Urban Health Institute. Cooper is also a Gilman Scholar and a core faculty member in the Welch Center for Prevention, Epidemiology, and Clinical Research. She is internationally recognized for her research on the impact of race, ethnicity and gender on the patient-physician relationship and subsequent health disparities. She is a member of the President’s Council of Advisors on Science and Technology (PCAST). In 2007, she received a MacArthur Fellowship.
Research shows many health disparities among different racial and ethnic groups in the United States. Different outcomes in mental and physical health exist between all U.S. Census-recognized racial groups, but these differences stem from different historical and current factors, including genetics, socioeconomic factors, and racism. Research has demonstrated that numerous health care professionals show implicit bias in the way that they treat patients. Certain diseases have a higher prevalence among specific racial groups, and life expectancy also varies across groups.
Gender-biased diagnosing is the idea that medical and psychological diagnosis are influenced by the gender of the patient. Several studies have found evidence of differential diagnosis for patients with similar ailments but of different sexes. Female patients face discrimination through the denial of treatment or miss-classification of diagnosis as a result of not being taken seriously due to stereotypes and gender bias. According to traditional medical studies, most of these medical studies were done on men thus overlooking many issues that were related to women's health. This topic alone sparked controversy and brought about question to the medical standard of our time. Popular media has illuminated the issue of gender bias in recent years. Research that was done on diseases that affected women more were less funded than those diseases that affected men and women equally.
Cultural competence in healthcare refers to the ability for healthcare professionals to demonstrate cultural competence toward patients with diverse values, beliefs, and feelings. This process includes consideration of the individual social, cultural, and psychological needs of patients for effective cross-cultural communication with their health care providers. The goal of cultural competence in health care is to reduce health disparities and to provide optimal care to patients regardless of their race, gender, ethnic background, native languages spoken, and religious or cultural beliefs. Cultural competency training is important in health care fields where human interaction is common, including medicine, nursing, allied health, mental health, social work, pharmacy, oral health, and public health fields.
The medical–industrial complex is a network of interactions between pharmaceutical corporations, health care personnel, and medical conglomerates to supply health care-related products and services for a profit. The term is a product of the military–industrial complex and builds from the basis of that concept.
Undertreatment of pain is the absence of pain management therapy for a person in pain when treatment is indicated.
Artificial intelligence in healthcare is a term used to describe the use of machine-learning algorithms and software, or artificial intelligence (AI), to copy human cognition in the analysis, presentation, and understanding of complex medical and health care data, or to exceed human capabilities by providing new ways to diagnose, treat, or prevent disease. Specifically, AI is the ability of computer algorithms to approximate conclusions based solely on input data.
Gender discrimination in health professions refers to the entire culture of bias against female clinicians, expressed verbally through derogatory and aggressive comments, lower pay and other forms of discriminatory actions from predominantly male peers. These women face difficulties in their work environment as a result of a largely male dominated positions of power within the medical field as well as initial biases presented in the hiring process, but not limited to promotions.
The weathering hypothesis was proposed to account for early health deterioration as a result of cumulative exposure to experiences of social, economic and political adversity. It is well documented that minority groups and marginalized communities suffer from poorer health outcomes. This may be due to a multitude of stressors including prejudice, social alienation, institutional bias, political oppression, economic exclusion and racial discrimination. The weathering hypothesis proposes that the cumulative burden of these stressors as individuals age is "weathering," and the increased weathering experienced by minority groups compared to others can account for differences in health outcomes. In recent years, the biological plausibility of the weathering hypothesis has been investigated in studies evaluating the physiological effects of social, environmental and political stressors among marginalized communities. This has led to more widespread use of the weathering hypothesis as a framework for explaining health disparities on the basis of differential exposure to racially based stressors. Researchers have also identified patterns connecting weathering to biological phenomena associated with stress and aging, such as allostatic load, epigenetics, telomere shortening, and accelerated brain aging.
Uché Blackstock is an American emergency physician and former associate professor of emergency medicine at the New York University School of Medicine. She is the founder and CEO of Advancing Health Equity, which has a primary mission to engage with healthcare and related organizations around bias and racism in healthcare with the goal of mobilizing for health equity and eradicating racialized health inequities. During the COVID-19 pandemic Blackstock used social media to share her experiences and concerns as a physician working on the front lines and on racial health disparities and inequities exposed by the pandemic. She is best known for her work amplifying the message on racial health inequities and her media appearances speaking on the COVID-19 pandemic. She has been featured on Meet the Press, PBS NewsHour, Slate and Forbes among others. Blackstock became a Yahoo! News Medical Contributor in June 2020.
Jasmine R. Marcelin is a Caribbean-American infectious disease physician and an Assistant Professor in the Department of Internal Medicine at the University of Nebraska Medical Center (UNMC). Marcelin is also the Associate Medical Director of the Antimicrobial Stewardship Program and as well as the Co-Director of Digital Innovation and Social Media Strategy at UNMC. Marcelin is dedicated to advancing diversity, inclusion, and equity in her communities and is a founding member of the Infectious Diseases Society of America Inclusion, Diversity, Access & Equity Taskforce. Marcelin uses social media to advance medicine, diversity, and patient advocacy and has published articles on how to effectively use social media for these purposes.
Rachel Renee Hardeman is an American public health academic who is associate professor of Division of Health Policy and Management at the University of Minnesota School of Public Health. She holds the inaugural Blue Cross Endowed Professorship in Health and Racial Equity. Her research considers how racism impacts health outcomes, particularly for the maternal health of African-Americans.
Black maternal mortality in the United States refers to the death of women, specifically those who identify as Black or African American, during or after child delivery. In general, maternal death can be due to a myriad of factors, such as how the nature of the pregnancy or the delivery itself, but is not associated with unintentional or secondary causes. In the United States, around 700 women die from pregnancy-related illnesses or complications per year. This number does not include the approximately 50,000 women who experience life-threatening complications during childbirth, resulting in lifelong disabilities and complications. However, there are stark differences in maternal mortality rates for Black American women versus Indigenous American, Alaska Native, and White American women.
Michelle Evelyn Morse is an American internist. She is an assistant professor at Harvard Medical School/Brigham and Women's Hospital and co-founded EqualHealth and Social Medicine Consortium. In 2021, Morse was named the first Chief Medical Officer of the New York City Department of Health and Mental Hygiene.
Kirsten McCaffery is a British-Australian public health researcher who is Principal Research Fellow and Director of Research at the Sydney School of Public Health. Her research considers the psychosocial aspects of over diagnosis in healthcare. She was elected Fellow of the Australian Academy of Health and Medical Sciences in 2020.
Medical racism in the United States encompasses discriminatory and targeted medical practices and misrepresentations in medical teachings driven by biases based on characteristics of patients' race and ethnicity. In American history, it has impacted various racial and ethnic groups and affected their health outcomes. Vulnerable subgroups within these racial and ethnic groups such as women, children and the poor have been especially endangered over the years. An ongoing phenomenon since at least the 18th century in the United States, medical racism has been evident on a widespread basis through various unethical studies, forced procedures, and differential treatments administered by health care providers, researchers, and even sometimes government entities. Whether medical racism is always caused by explicitly prejudiced beliefs about patients based on race or by unconscious bias is not widely agreed upon.
The gap in socioeconomic status between racial groups in South Africa has been a key contributor to health disparities, with White South Africans, a minority group, having overall better health outcomes than majority Black South Africans. White South Africans, a minority group, have overall better access and health outcomes than other racial groups in South Africa. Black and Colored South Africans, have poorer overall health outcomes and are disproportionately unable to access the private healthcare system in South Africa.
References
- ↑ "The role of experimentally manipulated self-efficacy in determining job search behavior among the unemployed | WorldCat.org". www.worldcat.org. Retrieved 2023-04-10.
- ↑ van Ryn, Michelle (January 2002). "Research on the provider contribution to race/ethnicity disparities in medical care". Medical Care. 40 (1 Suppl): I140–151. doi:10.1097/00005650-200201001-00015. ISSN 0025-7079. PMID 11789627.
- ↑ Researching unconscious bias in health care - Michelle van Ryn, Ph.D. , retrieved 2023-04-10
- ↑ "van Ryn, Michelle Ph.D. » Office of Health Disparities Research". healthdisparitiesresearchblog.mayo.edu/. Retrieved 2023-04-10.
- 1 2 "Implicit Bias Training Is Catching On, And Local Experts Say Oregon Has Work To Do | The Lund Report". www.thelundreport.org. Retrieved 2023-04-10.
- 1 2 van Ryn, Michelle; Burke, Jane (2000-03-01). "The effect of patient race and socio-economic status on physicians' perceptions of patients". Social Science & Medicine. 50 (6): 813–828. doi:10.1016/S0277-9536(99)00338-X. ISSN 0277-9536. PMID 10695979.
- ↑ Bendix, Jeff (2020-07-07). "Overcoming racial biases in patient care". Medical Economics July 2020 Edition. 97.
{{cite journal}}: Cite journal requires|journal=(help) - ↑ Hathaway, Bill (2019-08-05). "Doctors' attitudes toward lesbians and gays shaped early in medical school". YaleNews. Retrieved 2023-04-10.
- ↑ "Our Team". Diversity Science. Retrieved 2023-04-10.
- ↑ Cooper, Lisa A.; Saha, Somnath; van Ryn, Michelle (2022-08-11). "Mandated Implicit Bias Training for Health Professionals—A Step Toward Equity in Health Care". JAMA Health Forum. 3 (8): e223250. doi: 10.1001/jamahealthforum.2022.3250 . ISSN 2689-0186. PMID 36218984.
- ↑ "With Implicit Bias Hurting Patients, Some States Train Doctors". pew.org. 21 April 2022. Retrieved 2023-04-10.
- ↑ "As Maternal Mortality Rates Continue To Cause A Public Health Crisis In New York, Gillibrand Stands With Christy Turlington Burns, Nyc Mothers, Advocates, And Medical Professionals To Announce Her Push On Legislation To Reduce Maternal Deaths, Give Hospitals Funding To Implement Best Practices To Prevent Women From Dying Before, During, And After Childbirth". Kirsten Gillibrand | U.S. Senator for New York. 2019-01-13. Retrieved 2023-04-10.
- ↑ "Challenging Providers To Look Within Themselves: A New Tool To Reduce Bias In Maternity Care". 2021-07-06. doi:10.1377/forefront.20210630.980773.
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