Tag: discrimination

Discrimination and Health Part II: People of Color

Last week, I talked about how discrimination faced in healthcare settings can impact LGBTQ+ individuals’ attitudes towards healthcare, and how facing discrimination in everyday life can negatively impact their health outcomes. People of color (PoC) in the U.S., including immigrants, refugees, and Indigenous Peoples, face this double-barreled oppression as well.

Of course, one way racism affects health is through the broad structures that have placed many PoC groups at disadvantaged positions, intersecting with poverty – one study found that almost 100,000 black people die prematurely each year who would not die were there no racial disparities in health.

But discrimination itself, even on an individual level, can impact the health and healthcare experiences of PoC. Microaggressions, or everyday interactions rooted in racism, are a daily stressor for PoC, and these stressors can lead to premature illness and mortality.

Of course, this discrimination doesn’t just happen in daily interactions, but also in medical settings, which rightfully leads to mistrust and under-use of healthcare for PoC. Language and cultural barriers faced by immigrants can have similar effects.

Because race, socioeconomic status, and health are so intertwined, it may never be possible to know what levels of discrimination have the greatest ultimate effects on health outcomes. But we know they all have at least some, which should be enough to demand action.

Sources: https://www.ncbi.nlm.nih.gov/pubmed/12042611

https://www.hindawi.com/journals/tswj/2013/512313/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821669/#!po=2.38095

https://health.usnews.com/health-news/patient-advice/articles/2016-02-11/racial-bias-in-medicine-leads-to-worse-care-for-minorities

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2696665/

https://www.ncbi.nlm.nih.gov/pubmed/17001262

Discrimination and Health Part I: LGBTQ+ Americans

Past research has suggested that discrimination can impact health outcomes – perhaps through vehicles such as stress of daily interactions and negative experiences with the healthcare system. One group whose experiences with discrimination can be linked to negative health outcomes is LGBTQ+ Americans. A study found that over half of LGBTQ people have experience slurs and offensive comments, and over half have been sexually harassed or experienced violence, or had an LGBTQ friend or family member experience such trauma.

We can make the connection between discrimination and trauma through various factors. One is through microaggressions –  seemingly harmless daily interactions with others who express, in this case, homophobic or transphobic views. These have been found to negatively impact health. Another is through discrimination within the healthcare system that lead LGBTQ Americans to seek healthcare less frequently. 18% of this population has avoided necessary medical care. Various forms of discrimination they face at the hands of medical professionals, police, and community members are much worse for those of color and those who are transgender.

Unfortunately, we can already see the health outcomes of discrimination to this population – they have higher rates of psychiatric disorders, substance dependence (including higher tobacco use), and suicide; lesbian women are less likely to get preventative services for cancer, and gay men are at higher risk for certain STIs.

How can we work to eliminate these gaps, even when interpersonal discrimination may take longer to tackle as our culture continues to evolve? HealthyPeople2020 provides several recommendations. First, healthcare providers should discuss sexual orientation and gender identity (SOGI) respectfully with patients, and collect data on it. Medical students should be trained in LGBTQ culturally-responsive care. In addition, we must be spokespeople against legal discrimination of this population in social services such as employment, housing, and health insurance.

Sources:

https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health

https://www.npr.org/documents/2017/nov/npr-discrimination-lgbtq-final.pdf

https://www.centerforhealthjournalism.org/2017/11/08/how-racism-and-microaggressions-lead-worse-health

https://www.psychologytoday.com/us/blog/microaggressions-in-everyday-life/201011/microaggressions-more-just-race

http://www.apa.org/topics/health-disparities/fact-sheet-stress.aspx

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2747726/pdf/nihms134591.pdf

Hate Crime as a Public Health Concern

Unless you have been living under a rock the past few months you are well aware of the social tension amongst citizens of the United States. Don’t get me wrong, it has never been ideal, but since the election of President Trump, we have been a country far from united.

In the first month following the 2016 election, there were over 1,000 race-related incidents. While the monthly rates have decreased, the overall occurrence of these incidents continues daily. I’m not here to take sides or point fingers, but instead, look at hate crimes from an often overlooked perspective.

The psychological and physiological damage accumulated by those who face routine discrimination is now considered by many as a public health concern in and of itself. Data from the American Psychological Association shows the impact of discrimination and racism can increase rates of chronic stress, depression, and anxiety; while a meta-analysis compiled by Cambridge University has shown it increases rates of the common cold, hypertension, cardiovascular disease and breast cancer.

While data continues to develop, it is now obvious how snide remarks and hateful actions do much more than simply hurt feelings. In times like these, it’s important to take an introspective look and ask what we are doing in response to this climate of hate.

Dr. Martin Luther King Jr. said it best, “Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that.”

Six Steps to Success!

[dropcap]A[/dropcap]s I prepare for my Master’s Paper presentation this week, I would like to take a minute and share some important information I would like you to reflect on.  My Master’s Paper is an analysis of a questionnaire I created about stigma, discrimination and self-stigma as it relates to T1D.  After reading many amazing comments by participants who took the time to answer the survey, I found some interesting points I would like to make.

  1. You are NOT alone! Others are experiencing similar situations.  Social media can be your friend to connect with others with T1D.
  2. There are laws to protect people with T1D. Title I and Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973 protect people with disabilities in public settings, workplaces and schools.
  3. Be your own advocate! Stand up for what you need, how you treat your T1D and the choices you make as it relates to your T1D.
  4. Everything is finite! There are good times and there are bad times, but there is always a light at the end of the tunnel.  You will take charge of this and be stronger because of it.
  5. Be supportive and tolerate of others. We each have our own struggles.
  6. You write your own story and choose your own path! You can say no or walk away if a situation is not right for you.  Stick to what you believe in.

As many of you may know, I am a huge Broadway musical fan. Kinky Boots the Musical contains what they call “Price and Simon’s Six Steps to Success” that have similar theme:

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[quote]

  1. Pursue the truth.
  2. Learn something new.
  3. Accept yourself and you will accept others, too.
  4. Let love shine.
  5. Let pride be your guide.
  6. You change the world when you change your mind.

-“Raise Up/Just Be” song in Kinky Boots

Whether you follow my observations or those expressed in Kinky Boots, you will succeed and be amazing at whatever you do!

UK’s Time To Change campaign shows drop in levels of discrimination

A new study published in the British Journal of Psychiatry evaluated the first phase of Time to Change, a campaign seeking to end stigma and discrimination against  those suffering from mental illnesses. Started in 2007 by two British charities, the nationwide campaign used social marketing and advertising campaigns, targeting the general population as well as those in the medical profession and employers. Time to Change also made use of special events where those in the target audience could interact with people with mental health issues.

The evaluation found an 11.5 percent drop in levels of discrimination from 2007 to 2011, with many of the shifts occurring within interpersonal relationships. For example, they say a significant reduction in discrimination from friends (14% reduction) and family (9%). There was also a significant increase in the target audience’s willingness to live with someone with a mental health problem in the future.

The researchers concluded that, “People who had seen the Time to Change campaign were more likely to have better knowledge, attitudes and behavior towards people with mental health problems than those who had not.”

However, the study found that significant barriers remain to ending stigma and discrimination against those with mental health problems. In particular, more needs to be done to end sigma and discrimination by health professions (including mental health professionals).

Does anyone know of a similar campaign (and evaluation) targeting US audiences?