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School

CUNY Queens College *

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555

Subject

Medicine

Date

Feb 20, 2024

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docx

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Uploaded by shuaifeng1989113

1. How does racial discrimination and bias contribute to disparities in health care? How did Linda Villarosa's thinking about racial disparities in health care shift over time? How did her opinions on systemic bias change while witnessing her father’s treatment for colon cancer and dementia? R acial discrimination and bias could contribute to issues in health care in several ways. First, black patients are less likely to receive appropriate diagnoses, treatment, and pain relief compared to white patients, even when income and insurance coverage are equal. Second, there is a lack of diversity among health care providers, with few black doctors and nurses. This can lead to cultural misunderstandings and lack of trust from black patients. In addition, the health care system does not adequately address social factors like poverty, lack of education, and environmental risks that disproportionately affect black communities. Linda Villarosa's thinking shifted from blaming problems on lack of education and self-care among poor Black communities, to recognizing racism's role. Originally, she thought health disparities resulted from poverty and lack of education among poor black communities. She advocated self-help and education as solutions. Later, seeing her college- educated father mistreated made her realize middle-class black people also face discrimination in health care. It wasn't just about poverty. Over time, especially when reporting on maternal/infant mortality, she came to understand how systemic racism and bias lead to unequal treatment and drive health disparities. Witnessing her father's poor treatment showed discrimination firsthand. It contradicted her earlier views and opened her eyes to bias even against educated, middle-class black patients. This was a turning point in recognizing systemic issues. 2. How does the history of medicine in the U.S. demonstrate that its roots are in slavery? How is this reflected today in how Black people are treated, how

their pain is managed, and how they receive care? What can be done to reconcile this history within health care? The history of medicine in the U.S. has roots in slavery in several ways. During slavery, racist pseudoscience claimed Black people were physically and mentally inferior to whites. This justified cruel medical experiments on slaves without anesthesia or consent. Slavery-era doctors like Sims performed painful, unethical experiments on enslaved black women to test medical procedures. Beliefs like Black people having higher pain tolerance continued into modern medicine, affecting how Black patients' pain is managed. Studies show Black patients get less pain relief. Mistreatment and coercion of Black patients has continued, like forced sterilization of the Relf sisters in the 1970s. This echoes the lack of consent during slavery. Distrust of medicine among Black Americans stems partly from this historical mistreatment by the medical system. Several ways could be done to reconcile this history within health care. Medical schools must teach about past medical racism and prevent outdated racial beliefs from affecting care. Providers should acknowledge this history and its present impact as they work to build trust with Black patients. Diversity efforts should aim for greater Black representation among health providers and leaders. Providers must listen to Black patients' perspectives and complaints of discrimination. An anti-racist, patient-centered approach focused on closing disparities can work to overcome this legacy. Ongoing reform is needed. 3. How were residents of Walnut Cove in Stokes County, North Carolina harmed by Duke Energy? Why were the county’s poor and Black residents disproportionately harmed? How was Danielle Bailey harmed? How did local activists battle for better living conditions? Why are activists of color, like Danielle and her neighbors, often left out of the environmental movement? Residents of Walnut Cove were harmed in several ways by Duke Energy. Toxic coal ash with dangerous levels of chemicals was dumped in ponds and landfills, contaminating water and soil. This caused health issues like cancer. In 2014, a coal ash pond spilled over 40,000 tons into a local lake

and river, further spreading toxins. Pollution from the plant contributed to poor air quality and respiratory disease. Poor and Black residents were disproportionately harmed. The plant was located in their community, subjecting them to the worst impacts. This environmental injustice follows historical patterns. Pollution from the coal ash lowered property values, making it hard for residents to move. The lack of political and economic power of this community allowed the plant's damage to go unchecked. Danielle Bailey, a Black resident, developed aggressive brain cancer at age 35. She believes toxins from the plant and coal ash caused her illness. She was forced to move away for her health. Local activists battled for the better living situation in multiple ways. First, they organized groups like Appalachian Voices to pressure Duke Energy to clean up the coal ash. Second, they spread awareness of the health impacts, like Danielle did by speaking up about her cancer treatments. Third, they advocate for impacted residents like Danielle. Activists of color are often excluded because of multiple reasons. First, mainstream environmental groups fail to recognize environmental justice issues in marginalized communities. Second, Lack of resources and influence can limit activism in poor, minority areas. Third, stories of activists like Danielle often go untold in the broader movement. Finally, centering and supporting the leadership of impacted residents like Danielle is key to addressing environmental racism. 4. How is Black mental health care affected by racist stereotypes, assumptions, and stigma? What are some of the vulnerabilities that arise from untreated mental illness? What effect does this have on Black men? Children? Teenagers? Racist stereotypes, assumptions, and stigma negatively impact Black mental health care in several ways. Black patients are less likely to seek treatment due to mistrust of the system and wanting to avoid being seen as "crazy." Providers are more likely to misdiagnose or underestimate symptoms in Black patients based on false beliefs like Black people being "stronger." Black psychiatric patients face greater risk of being involuntarily committed or

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