I need a peer review on my rough draft for my future research paper. If someone can take a look and give me areas of weakness that can be improved.
Minorities are people too. People with feelings, worries, and the same concerns for healthcare as everyone else does in America. Although anyone can be at risk of getting a misdiagnosis that could potentially lead to a medical malpractice, but the odds are that the victims experienced some level of discrimination by not getting adequate care therefore, leading to a malpractice suit. Racial disparities can birth so many problems and concerns, but it is caused by one thing only, discrimination. There is always a divide between patients when there is undertreatment or mistreatment that is recognized and are restricted to a couple of factors like race and ethnicity. Medical decisions or diagnosis's that are made based on race and ethnicity instead of medical need are still considered as 'medical mistakes.' In the past, the history of racialization has been present even in the midst of pandemics, specifically the most recent one being Covid-19, all by creating a correlation between race and the virus itself. Veering off into the mental health topic space, strong racial biases have also been pretty persistent when diagnosing or classifying any kind of mental health disorder which evidently seem to only affect the racial groups that already experience discrimination. Despite of the fact of there being a Civil Rights Act created to prevent this sort of thing from happening, these instances within the biome of health end up leading to the belief that race and ethnicity are linked to medical negligence and misdiagnosis with little to no disciplinary actions or repercussions.
First, in the United States, pain is something that is considered 'undertreated' even though the wide range of ability to treat pain has never been as great as it is right now. Due to some of the undertreatment that has gone on, it's been recognized that burdens some people more than others and the differences that separates some of these people are factors like race and ethnicity. Specifically, for black Americans, the inequalities in treatment for diseases like lung cancer, show that their treatment options and mortality rates are affected due to the person's race. "Scholars have concluded that persistent racial disparities in access to health care and treatment result from unequal health care that is the legacy of a racially divided health system" (Bonham). Multiple studies have been done where minority groups with cancer in nursing homes were most likely not to receive any kind of pain relief treatments and a 63% increased chance for black Americans to having their pain go untreated when compared to white Americans. All studies that were taken place were done in establishments that are Medicare and Medicaid funded which means that they fall into the federal assistance mentioned in the Title VI of Civil Rights Act which prohibits discrimination within the health care system. This displays a perfect example of the Title VI failing to be affective in ending discrimination in the health care system. The very least that the doctor or physician can do is put forth some effort examining themselves within their own practice to ensure the proper measures that are not based on race and ethnicity are being taken. For example, a. survey being done showing that African Americans were more likely to disclose that their doctors aren't showing any sense of urgency when prescribing medicine or discussing the seriousness of the illness. Its one thing subconsciously treating someone differently based off where they are from or how they speak in comparison to ourselves but its another thing when that level of ignorance is done in the health care and potentially cause life threatening result.
So, besides there being more attention drawn to the racial disparities in the healthcare system, a study was done from January 2002 to December 2007 showing that there has been no decrease in the errors made. In this case, the studies done focused more on the medical malpractice suits that stemmed from these medical errors being made. The evidence that was acquired during a separate study using the demographic variables like race, age, gender, marital status actually have an impact on treatment decisions and overall healthcare. The research that was done was focused on men specifically and it was found that when meeting with doctors, they are more at risk of poor medical outcomes strictly due to their lack of communication of symptoms. Among the different arguments as to why that is, one stands out the most and what was constantly brought up was the toxic masculinity surrounding men needing to be the 'macho' all the time so therefore, they don't seek medical help. Along with the 'macho man' stereotype findings, others have been found persistent; the effects marital status can have on health. "Men's health benefits from marriage more than women, primarily because wives provide some social control over their husband's healthcare" (Harris and Peeples). The studies done for these findings are incredibly intriguing because of how much weight is behind the fact that most misdiagnosis's and malpractice cases tend to happen more to the minority groups whereas, in this study, the men are labeled as more at risk when men are considered the majority and not the minority. In the end, the argument that was made, made a lot sense which ultimately made the entire research process interesting. What came as a surprise was the possible resolution to the problem which was to address the medical errors made as a whole instead of holding the necessary people responsible which ultimately seems like would cause an even bigger headache when getting to the source of the problem.
As you can see, the healthcare system is made up of all different health services including mental health which the topic itself seems to find itself in many heated debates for as long the healthcare system had been around. Debates about whether mental health should be something that government ran healthcare facilities should get involved with or not. While any kind of mental health disorder diagnosis can be a life changing moment is anyone's life, carrying a label like that comes with baggage that has the power to determine whether you will have access to certain doors in life. To add insult to injury, the conditions get worse for those who are diagnosed with a mental health disorder, due to the long-standing issue of racial biases, the people most affected by it are the ones that are already currently experiencing discrimination. "While protections exist in the law to prevent many of these abuses, many other areas of the legal system lack a unified front and refined view of mental illness" (Luth). The history of it all, specifically in the 19th century, mental health disorders were what disqualified people that were considered physical property, mainly women, making the 'confirmation' that women lacked the ability of decision-making. The fact that these protections were put in place to protect the people that already possess their full rights just how that the system itself was never meant to help any minority group, whether it be the healthcare system or being able to make decisions for oneself. This is form of abuse that has lingered in the past stemming from placing minorities in a box labeling them as 'abnormal' inevitably causing differences in the quality and rate of care they are given. Before attempting a resolution, first and foremost starting with understanding the correlation between race and mental health diagnosis rates because without it, there is a lack of compassion which will then result in a level of injustice. As mentioned before, the mental health discussion has always had a certain weight to it especially when deliberating who should step in to help and when but ultimately, the treatment of minority groups doesn't seem to change when they are hit with adversity, instead, a bigger target is put on their backs while the majority are pampered in comparison.
Furthermore, as the push goes on for justifying that race should not matter when one is pursuing medical help, federal health programs like that Medicaid and Medicare continue to show that race does matter. So far, the only thing that has progressed in the healthcare world is the access that has increased for minorities in America yet there has been zero change in the quality of care given to minorities. Race is never the only role demographic that's being considered in these situations, its class and money that also plays a role, but all still classify as medical mistakes at the end of the day. Although it's been frequently shown that race and ethnicity are being associated with poor health access and decisions of treatment, it doesn't change the fact that minorities have much higher chances of being diagnosed with cancer, stroke, heart disease, etc. It's a sad reality for those who are in the worst conditions of health compared to white Americans but yet receive much less of everything that the healthcare system has to offer. When speaking of specifics, "Insured Blacks and Hispanics are less likely than whites to have private physicians and are more likely than whites to rely on hospital emergency rooms and outpatient clinics for primary care. As a result, Black, Hispanic and Native Americans are hospitalized more often than whites" (Watson). The part that may be surprising for some but definitely not for others is that when minorities are hospitalized, they receive fewer diagnostic tests and overall medical services then white Americans regardless of if their source of payment is the same. Obviously, this kind of treatment raises some concerns and maybe it doesn't for others simply because this kind of discrimination has been around for ages but its been proven that even the level of insurance, age, clinical condition does not fill the gap of equal and quality healthcare treatment. On the flip side though, minority patients don't trust the medical care system and some could say that its because of the treatment they are used to receiving or lack thereof but in reality, it's the embedded racism this country still possesses. There is still a chance that some people might have just lived in pure ignorance their whole lives and or lack of communication but nonetheless, it all stems back from America's history of slavery and segregation. A side fact to help with the bigger picture of it all, historically, there used to be "whites only" hospitals with segregated "colored" floors where most white doctors refused to treat black people. So when addressing ways to fix this problem, especially with modern day health care access, racial and ethnic data is not being collected despite the responsibility of Title VI of the Civil Rights Act. As stated previously, the journey to reducing racial disparities in the healthcare system is no easy task due to the many suggestions of where to start but truth be told, it will require mostly experimentation and a little bit of creativity and of course the necessary repercussions put in place as well.
In continuation, lets talk about something that doesn't have any personal vendetta but has taken its toll on all Americans, Covid 19. Some may argued that pandemics also have a history of racialization but we'll take a closer look at what that actually means. The world isn't a stranger when it comes to pandemics ranging from the Black Death pandemic to the Covid-19 pandemic. What spearheads these claims of racialization are the names being assigned to these pandemics that usually stem from where the virus originated from, but who is making these names? For example, the names "China virus" and the "Wuhan virus" being especially linked to the Covid =-19 virus because of the claim that it was leaked from a Chinese laboratory. So while that is the first instance of racialization within pandemics, the next one surrounds the process of vaccine development. There have been calls for diversifying the clinical trials for testing of the vaccines because of the 'allegation' that the vaccine might work differently for black people, Hispanics, etc. I believe the assumption that the vaccine can affect other differently but not for the literal color of their skin but simply because of the potential health burdens they could currently being dealing or the history of health concerns within their bloodline. But as expected, a white person with cancer will be prioritized and automatically given better odds for recovery then a minority with the same cancer and possibly better numbers. Although a lot of light had been shed on the topic of the correlation between race and Covid-19, "this necessarily diverts attention from the historical and on-going structural factors driving racial inequities in health, and has profound implications both for biomedical understandings of race and for socio-political approaches to addressing issues of racial justice in health" (Kahn). As hard as people try to link genetics to the racial disparities but the chances of that are very slim which would be considered obvious to anyone familiar to the history of this country. Instead of the genetic correlation, it's the kind of exposures to certain environments and the experiences we had that have the most impact on the way our bodies individually handle sicknesses. Structural racism in employment, housing, and healthcare caused racial disparities in exposure, sensitivity, and in treatment. Once again, no easy solutions exist, there will always be suggestions made and it might seem like problems always spawn out of nowhere but that doesn't mean the bare minimum is enough to not proceed further.
Lastly, an in person interview I believed would suffice for my research but I figured a better decision of speaking on my own personal experiences navigating the healthcare system these past 3 years. Some backstory to start, I was diagnosed with thyroid cancer in 2017 when I was 19 years old. I lived an incredibly active lifestyle and at the time I was only a sophomore in college, playing basketball as well being a full-time student. The cancer was caught relatively early despite the severe symptoms I was already experiencing; waking up tired and lethargic after sleeping for 12+ hours a day, lightheadedness during showers that eventually led to passing out and massive weight loss. Incredibly hard to ignore those symptoms but after a ton of tests and a month later, they couldn't find anything. They asked if there was a history of anything like cancer or specifically anything to do with the thyroid and that the missing piece because my mom was 'borderline' to having thyroid issues but any concerns that were had, eventually evened out. She did have a cousin that had thyroid cancer and that information was used for the next round of testing. Eventually that was the diagnosis. I was given 2 options for treatment, surgery to immediately remove my thyroid or go through radiation iodine therapy. Considering where I was in my basketball career, I chose the radiation option with hope I recover in time to continue on to my 3rd college season. Doctors told me that with that decision, it would take about 6 months to 1 year to fully recover but at the time, I only had about 3 months until I needed to be back the court. Long story short, I recovered and finished out the rest of my college career and even went pro to play overseas. Fast forward to today, although I did make a full recovery and returned to basketball, it wasn't until I got older and into my mid-twenties when I realized that any kind of radiation therapy comes with long term side effects. I started dealing with symptoms of multiple autoimmune diseases that were mainly attacking the soft tissue in between my joints which inevitably ended my basketball career due to needed multiple knee surgeries. At this point in my life, I am seeing doctor after doctor, specialist after specialist because it got to a point where the constant hopping around different doctors was due to the doctors not taking my pain levels or test results seriously. I'm showing signs and symptoms that is not normally seen in people my age but in people that are elderly. For example, blood tests were consistently showing that one of my kidneys was falling below 50% of function as a 25-year-old who is in the gym daily, eats incredibly clean and healthy. Kidney specialist would tell me, "These numbers aren't great considering your age but you're fine, you're not" and then I'm practically out the door. There were just a number of things that just weren't making sense for someone my age and almost every doctor would brush me aside and discriminate on the fact that I was young. In reality, certain autoimmune diseases can go unnoticed in young people, as far as symptoms go. In other words, from the outside, I live a healthy lifestyle, I stay away from certain foods that can cause health issues as you get older but yet according to tests that are done, I have a failing kidney, 80 year old knees and showing signs for 4 different autoimmune diseases including lupus. So, in my experience I was able to see first-hand how nonchalant and careless a lot of doctors can be despite the obvious attention that is needed on my test results. In retrospect, I have seen an orthopedic surgeon, an endocrinologist, an allergist, a nephrologist, a rheumatologist, and a respiratory therapist, all of whom were involved in my journey for a diagnosis. To this date, I have not gotten a set in stone diagnosis, but I have a found a doctor that has taken a certain interest in the obscurity of my medical conditions and is willing to exhaust all resources to put pieces together. In the meantime, I continue keeping myself healthy, keep stress levels low and take the medication prescribed and go from there. Could this be something that turns into a medical malpractice case for delayed diagnosis? Only time will tell.
Works Cited