Health

Sexual orientation and health disparities have always been linked. Studies show that sexual minorities (e.g., gay, lesbian, bisexual) experience larger extents of discrimination, shame, and tension causing a higher risk of poor health outcomes and behaviors when compared to their heterosexual counterparts. Most of all, these individuals are found to have a lower prevalence of access to health insurance as well as healthcare.

All people who are in need to medical care should be able to go to the hospital without the worry of being mistreated, harassed, or out rightly denied of service. However, discrimination in health care environments endangers the lives of LGBTQ people through denials of necessary care. One example of this discrimination was after one patient with HIV disclosed to have interactions with other men, the hospital staff spurned to supply his HIV medication. In another case, a transgender teenager in the hospital for self-inflicted injuries due to suicide attempts was repeatedly disrespected and misgendered. Moreover, he was discharged from the hospital early causing him to later commit suicide. 

Despite current protections of LGBTQ people, they continue to face health care discrimination from harassment to humiliation by providers. According to a survey conducted by the CAP, it shows the several types of discrimination this community has had to face when seeking health care. Among LGBQ patients, 8% said that a doctor or other provider refused to see them because of their perceived sexual orientation, 6% said that a doctor or provider refused to give them health care related to their perceived sexual orientation, 9% said that a doctor or other provider used harsh or abusive language when being treated, and 7% said that they experienced unwanted physical contact from a doctor or other provider. Among transgender patients, 12% said a doctor or other provider refused to give them health care related to the gender transition, 23% said a doctor or other provider intentionally misgendered them, 21% said a doctor or other provider used harsh and abusive language when being treated, and 29% said that they experienced unwanted physical contact from a doctor or other provider.

It is important to create a safer environment for LGBTQ people discrimination ultimately discourages LGBTQ people from seeking health care. According to a survey conducted by the CAP, 14% of those who experienced this discrimination avoided or postponed needed medical care because of the disrespect and inequity from the health care staff. Avoiding medical care may result in late detection of disease, reduced survival, and potentially preventable human suffering.

Everyone deserves an equal opportunity to lead themselves to a healthy life. Multiple constitutional amendments state the equal rights of everyone regardless of race or ethnicity, however healthcare is not issued in these amendments. Compared with all other racial and ethnic groups in the United States, African Americans are disproportionately affected by lung cancer, both in terms of incidence and survival. People of color are often forced to live in undesirable areas in which carcinogens are prevalent. Carcinogens are cancer-causing chemicals that are typically found in tobacco products and the burning of fossil fuels. In addition to the fact that they are unable to live in cleaner environments, these groups also receive less healthcare opportunities. People of color who are diagnosed with lung cancer face worse outcomes compared to white Americans because they are less likely to be diagnosed early, less likely to receive surgical treatment, and more likely to not receive any treatment. More than 29 million uninsured Americans are people of color, and research is clear that having health coverage impacts people’s medical care and ultimately their health outcomes. 

According to the American Lung Association, “ Black Americans were 18% less likely to be diagnosed early, 23% less likely to receive surgical treatment, 9% more likely to not receive any treatment, and 21% less likely to survive five years compared to white Americans”(State). Based on this data collected by the American Lung Association, we see that African Americans are less likely to proper healthcare prominently due to their economic status. This is similar in other racial groups including Latinos, Native Americans, etc. where instances of inadequate healthcare are present. Since people of color’s ability to healthcare is affected, there are many deaths which are resulted from lung cancer within people of color. The American Lung Association states that “Black men and women have the highest death tolls from lung cancer. Around 9,000 black men and 6,800 black women die from lung cancer, 12% less than Whites(Lung). Looking at this, one can infer that the death rate is higher for African Americans than whites due to the disparity in healthcare as Whites receive more healthcare opportunities than Blacks. Due to the prevalence in healthcare for Whites compared to racial and ethnic groups, Whites tend to have a higher health equity than these groups, which is unfair.

A major reason why this disparity in healthcare exists between people of color and Whites is because systematic racism is an issue in healthcare these days as do socioeconomics, environment, and culture. People of color tend to be poorer than Whites, thus causing them to not be able to afford proper healthcare. According to the Peter G Peterson foundation people of color made significantly less household income than whites, African Americans making about $30,000 less than Whites. Their salary is being used for taking care of their families such as providing shelter and food, and many of these families can’t afford healthcare. Since such racial groups make less income, healthcare is not as accessible to them. In addition to this, racial and ethnic groups often live in undesired communities which are filled with more harmful particles than White communities. According to the National Academy of Sciences which stated that “Scientists calculate that Hispanics on average breathe in 63 percent more of the pollution that leads to heart and breathing deaths than they make. For African-Americans, the figure is 56 percent”(Borenstein). We see that racial groups facing more severe health conditions are too poor to afford proper healthcare, thus leading to more health-related problems such as lung cancer. Overall, these racial groups are experiencing more problems in lung cancer due to their poor living conditions and healthcare.

As clearly shown throughout this blog, racial disparities in healthcare are a major issue which is affecting the survival rates for people in color. Addressing racial disparities in health care coverage is critical to addressing racial disparities in lung cancer care. Currently, states are working their way to pass laws stating free healthcare access for all. We can work further into solving this issue by giving to these communities and helping them so they can receive proper healthcare.

Work Cited

Borenstein, Seth. “Blacks, Hispanics Breathe More Pollution than They Make.” AP NEWS, Associated Press, 11 Mar. 2019, https://apnews.com/article/health-ap-top-news-air-pollution-hispanics-pollution-f6bf2f47c81c4958811dc4e99d526197.

“Lung Cancer’s Impact on Black Men and Women.” Lung Cancer’s Impact on Black Men and Women, American Lung Association, https://www.lung.org/getmedia/87a67675-a8ff-450f-bc82-f9a4631c84cd/infographics-lung-cancer-and-black-men-final.pdf.

“State of Lung Cancer: Racial and Ethnic Disparities.” State of Lung Cancer | Racial and Ethnic Disparities | American Lung Association, American Lung Association, 26 Nov. 2021, https://www.lung.org/research/state-of-lung-cancer/racial-and-ethnic-disparities. 

Health equity is an economic issue as well as a social issue. Several disparities are determined by ethnic groups, socioeconomic classes, and the location of the region. The causes of these inequalities are shown through an increase in infant mortality rates, and a decrease in life expectancy and rates of preventable disease. The main factors of these inequalities are the smoking rates, access to care, nutrition, and physical activity. Health and healthcare inequities result in the inferiority of healthcare, worse health outcomes for minority populations and those of low status, decreased productivity, and varying use of corporate healthcare profits. These health disparities are a reflection of the persistent inequities that exist in American society. 

One way to improve health equity is for employers to ensure that their resources are received by diverse populations in the highest quality possible. This can be done by choosing health plans that offer cultural proficiency. This is a crucial step to reduce racial stereotyping and ensures equal services to all populations.

Healthcare organizations can also employ a more diverse workforce of healthcare providers. This is important because ethnic minorities are underrepresented in the healthcare industry. This is also a crucial addition as minorities are often more comfortable seeing a provider of a similar ethnic background which allows for better communication and patient-provider relationship. This causes biased care, judgments, and assumptions to occur less. In addition, this allows for healthcare and public health organizations to collect and use data on these groups to improve the quality of care for their diverse populations as well as point out specific health needs and help plan targeted involvement. 

Health plans and insurance companies can reduce health disparities by using innovative and wide-ranging strategies. One example of this was when the National Health Plan Collaborative brought together 11 leading health plans, including Aetna, Kaiser Permanente, Humana, and UnitedHealth Group among others, to create a toolkit that combined case studies, sample tools, policies, and other resources to help reduce health disparities within their memberships. One way this was done was by using geographic information system mapping to identify the most optimal areas for targeted intercessions. This tool can make it possible to closely examine social and health factors at the neighborhood level, which can help with analyzing the health plan market area for specific health conditions, such as people with skin conditions who have not received recommended care in a particular region.

Health begins in the environments in which we are born, live, and work. Engaging with the social and economic conditions of health is a critical component of any inclusive health equity strategy to improve the health of people throughout the nation and decrease healthcare costs. Improving community environments by supporting programs and policies that address these health inequalities ensures that the root causes are addressed.

Tobacco is a plant grown for its leaves, which is dried and fermented before being placed in tobacco products. It contains a chemical called nicotine, an ingredient that leads to addiction, so it is hard to quit smoking. In 2019, an estimated 14% of adults in the US were current cigarette smokers (Current). Additionally, about 5% of American teens smoked in 2020 (Youth). Although the rate of tobacco use is decreasing, it is still affecting health equity severely, and is impacting marginalized communities as a whole. By burning tobacco, it releases toxins including tar and carbon monoxide. These toxins pollute the environment and cause second-hand smoke, known as Environmental Tobacco Smoke (ETS). ETS is what marginalized groups suffer from, as they breathe in the second-hand smoke caused by Americans. They are receiving social injustice since they are receiving the effects of pollution caused by tobacco but are barely contributing to it. 

According to the National Academy of Sciences which stated that “Scientists calculate that Hispanics on average breathe in 63 percent more of the pollution that leads to heart and breathing deaths than they make. For African-Americans, the figure is 56 percent”(Borenstein). This shows how marginalized groups breathe in more pollution caused by tobacco than they are causing due to the environment they are forced to live in as well as other factors. This percentage of marginalized groups breathing in toxins is significantly greater than whites as the National Academy of Sciences state that “non-Hispanic whites on average are exposed to 17 percent less air pollution than they make” (Borenstein). Again, this emphasizes the relationship between tobacco and health equity as marginalized groups aren’t the one’s contributing as much to our pollution but are the ones who have to suffer from it. Their health equity is reduced significantly as they don’t have the same chance to achieve their best health as non-marginalized groups.

The main reason for this occurrence of why marginalized groups are breathing in more toxins produced by tobacco and other factors is because they are forced to live in less ideal conditions. Often, marginalized groups have to live in dirty environments which are densely polluted. These groups also don’t always have access to hygiene tools so their health equity is lowered as a result. This has always been the cause where African Americans and Latinos were severely affected by the laws put out for them. They had segregation laws in which marginalized groups could only live in red-lined areas; areas in which were worthless and heavily polluted. Now, they are forced to work jobs such as in factories or mining.  According to the Center of American Progress, “Native Hawaiians and Other Pacific Islanders (68.5 percent), people of Two or More Races (66.6 percent), and Hispanics (66.3 percent) had the highest labor force participation rates”(Composition). This explains how marginalized groups have the highest labor force participation such as working in factories. These jobs demand workers to function in  polluted areas which like toxins produced by tobacco are affecting their health. 

To conclude, tobacco has a direct relationship to health equity as marginalized groups don’t contribute as much to the toxins/pollutants in the air caused by elements such as tobacco but are the ones who have to experience it the most. They breathe in the harmful pollutants and live in unideal environments where they have to suffer and don’t have the opportunity to reach their best health. These cause marginalized groups to experience health problems such as lung cancer and chronic diseases. It may seem as if pollution is slowly affecting our world through global warming, but people don’t realize it is affecting part of the society constantly.

Work Cited

Borenstein, Seth. “Blacks, Hispanics Breathe More Pollution than They Make.” AP NEWS, Associated Press, 11 Mar. 2019, https://apnews.com/article/health-ap-top-news-air-pollution-hispanics-pollution-f6bf2f47c81c4958811dc4e99d526197.

“Composition of the Labor Force.” U.S. Bureau of Labor Statistics, U.S. Bureau of Labor Statistics, 1 Oct. 2019, https://www.bls.gov/opub/reports/race-and-ethnicity/2018/home.htm.

“Current Cigarette Smoking among Adults in the United States.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 10 Dec. 2020, https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm.

“Youth and Tobacco Use.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 Dec. 2020, https://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm. 

COVID-19, the pandemic that has devastated the world and taken more that 618,000 lives in the USA alone, is a mirror of our healthcare system. A disproportionate amount of racial and ethnic minorities have died due to COVID-19. A statistic by the CDC states that the death toll of Black or African American, Non-Hispanic persons is 2.0 times more than White, Non-Hispanic persons; 2.4 times more for American Indian or Alaska Native, Non-Hispanic persons; and 2.3 times more for Hispanic or Latino persons. This disparity directly translates to the lack of health equity. 

There are many reasons why racial and ethnic minorities are more susceptible to COVID-19, three being occupation, environment, and education. People from racial and ethnic minorities make up a large proportion of essential workers such as retail, public transportation, and factory personnel. These jobs increase the chance of exposure to COVID-19 because of close contact with other people and in-person work. Crowded living spaces and unstable housing thwart COVID prevention efforts like quarantining and self-isolation. The close proximity to other family members/housemates mitigates the use of social distancing and proper hygiene. Unstable housing situations can lead to homelessness or inadequate living situations which contributes to a COVID positive environment. Many racial and ethnic minorities simply just have not gotten educated on COVID prevention measures. Because they do not know what symptoms to look out for and what to do when they might have the virus, they are unable to catch the illness in its early stages and receive proper treatment.

Racial and ethnic minorities do not have the same chances for equitable health, so what is it being done to bridge the gap during this pandemic? The CDC is taking steps in the right direction which they outlined in their “COVID-19 Response Health Equity Strategy”.  There are four parts: “expanding the evidence base”, increasing the number of programs for “testing, contact tracing, isolation, healthcare, and recovery from the impact of unintended negative consequences of mitigation strategies”, “expanding program and practice activities to support essential and frontline workers to prevent transmission of COVID-19.”, and “expanding an inclusive workforce equipped to assess and address the needs of an increasingly diverse U.S. population”. 

As the CDC does their part to increase the probability of equitable health for racial and ethnic minorities, we should also do our part to ensure that these policies reach all vulnerable groups in our communities. 

Resources:

https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/cdc-strategy.html

https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/increased-risk-exposure.html

https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html