Because of healthcare’s special status, society has an ethical obligation to ensure that all people have access to adequate level of healthcare including access to new technologies as well as existing ones, without facing excessive burdens in obtaining such care. With everything that we are facing a Pandemic a possible epidemic (Monkey Pox), high inflation, increasing chronic illnesses, housing and employment issues, and an ever-ending issue in the healthcare field of the miss treatment of people of color when it comes to receiving care. The healthcare system still remains, flawed and broken.

Emma Bedell (2019) asserts, “Minority groups in America such as African Americans face “double jeopardy” in the
health care system by experiencing less effective treatment in areas of greater need, while
receiving higher rates of treatment with little value to them. America is considered to be one of
the leaders in healthcare world-wide with top notch medical care. However, this can easily be
overturned due to the growing numbers of racial and ethnic minorities facing challenges in
access to health care in the United States. According to the Robert Wood Johnson Foundation,
African Americans experience thirty to forty percent worse health outcomes than white
Americans (Pearl). This ultimately leads to shortened lives and increased illnesses for African
Americans. Not only do African Americans have trouble finding access to health care, but the
care they receive is often found to be different than the care white Americans receive. This
complex issue involves several factors such as differences in ability to pay and provider
behavior, patient preferences, differential treatment by providers, and geographical variability.”

I personally have been a victim and yes, I say victim to healthcare inadequate treatment of care, which was based on the color of my skin. Going into the ER is one thing I try to avoid, to be honest I totally avoid going to the ER, and here is why. When having a chronic illness and constantly being in pain/lupus flare you just want to get relief from being in pain/lupus flare, I have been told by my physician to never stay in pain go directly to the ER, you see when I go to the ER the first thing that will be noticed is the color of my skin, the type of insurance which will depend on the type of care I will receive. Individuals in underserved communities have always brought this issue out but no one (healthcare system) never listened until now. This is why the mistrust of the healthcare system in underserved communities of color exists.

For those making decisions about resource allocation, ethical pitfalls can be avoided if policy formulation is differentiated from clinical decisions about specific patient’s access to care. The latter can and should be made by each patient’s physician, but to effective, the former must be accomplished in broadly based political processes by both health professionals and others.

Resource

Access to Health Care in America

Emma Bedell (2019) African American Disparities in Healthcare Retrieved from: African American Disparities in Healthcare (gettysburg.edu)

We know that lupus is so very unpredictable, and you never know when and where it will strike. I woke up one morning in excruciating pain, I was fortunate to have an appointment with the rheumatologist. I noticed that my mouth especially my tongue felt enlarged, felt raw and painful, it was so very painful to even brush my teeth. So, I’m dealing with muscle pain which felt as if it was penetrating to my bones, swollen tongue, raw mouth. All I could say is “Lord give me strength.”

Yes, I made it to my appointment barley able to move, barely able to sit down the pain, this type of pain I would not wish on anyone. My physician opens the door of the exam room, I told him to come on in and please help me with this pain. My physician replied, “Susan I can look at you and see that you are in pain and the desperation in your voice when asking for help.” My physician continued on with questions about how long I have been in pain, why I did not go directly to the ER, and never subject myself to dealing with pain without any medication.

I am the type of individual who does not go to the ER just to be going, I prefer to stay away from hospitals totally. When it came to my mouth, I informed the physician to take a look, as he was examining my mouth and tongue his face told the entire story. My physician went on to state “You will be placed on Prednisone 3 tablets daily for 3 days, also you will be on Nystatin 4 times daily until completed, we are going to have labs performed, we need to find out what is causing this to happen to you. Is it Lupus, your weakened immune system or the lymph nodes? We are going to run labs on you to see what is going on, so I sit and wait for the results to come in.

The Mayo Clinic asserts Oral thrush — also called oral candidiasis (kan-dih-DIE-uh-sis) — is a condition in which the fungus Candida albicans accumulates on the lining of your mouth. Candida is a normal organism in your mouth, but sometimes it can overgrow and cause symptoms.

Oral thrush causes creamy white lesions, usually on your tongue or inner cheeks. Sometimes oral thrush may spread to the roof of your mouth, your gums or tonsils, or the back of your throat.

Although oral thrush can affect anyone, it’s more likely to occur in babies and older adults because they have reduced immunity; in other people with suppressed immune systems or certain health conditions; or people who take certain medications. Oral thrush is a minor problem if you’re healthy, but if you have a weakened immune system, symptoms may be more severe and difficult to control.

Weakened immunity. Oral thrush is more likely to occur in infants and older adults due to reduced immunity. Some medical conditions and treatments can suppress your immune system, such as cancer and its treatments, organ transplantation and required drugs that suppress the immune system, and HIV/AIDS.

Individuals with lupus are at high risk for developing Candidiasis, sometimes called thrush or yeast infection and since my SLE (lupus) has been active I am at a higher risk factor, after doing my research I have found that lupus inflammation is linked to fungal infections. We know that I am not a medical doctor, but I have been on several courses of Prednisone which may have weakened my immune system even more. So, I continue to fight with my own body which is constantly attacking itself whenever it wants to without notice or forewarning.

Resource

Mayo Clinic

The risk for food insecurity increases when money to buy food is limited or not available. 2, 8, 9, 10, 11, 12 In 2016, 31.6% of low-income households were food insecure, compared to the national average of 12.3%. 13 Unemployment can also negatively affect a household’s food security status. 11 High unemployment rates among low-income populations make it more difficult to meet basic household food needs. 11 In addition, children with unemployed parents have higher rates of food insecurity than children with employed parents. 14 Racial and ethnic disparities exist related to food insecurity.

In the city of Highland Park exists many disparities, beside proper health care the second greatest disparity is food insecurity. Highland Park, MI is home to a population of 10.9k people, from which 99.6% are citizens. As of 2019, 0.561% of Highland Park, MI residents were born outside of the country (61 people).

Median household income in Highland Park, MI is $18,474. Highland Park, Michigan can be considered a “Food Desert” an urban area in which it is difficult to buy affordable or good-quality fresh food: “many poor people live in food deserts—where they have plenty of food but none of it healthy”.

The CEMPH Foundation reached out to the Kroger Foundation for the Third Annual Giving Back to The Community of Highland Park, MI held in June. Kroger answered our call to assist those in need. Kroger granted the CEMPH Foundation funds to provide over 22 families in Highland Park, and Detroit, Michigan food gift bags. We were also able to feed over 80 homeless individuals a hot nutritious meal.

We at the Charlie E & Minnie P Hendrix Foundation would like to thank Kroger for supporting the community of Highland Park, Michigan.

#kroger #community #combatinghunger #givingback #underserved #highlandprkmi

In this day and time there exists hundreds or thousands of individuals of color that is still lost in the healthcare system. We see and hear the stories of the bias and unfair treatment that individuals of color experience when going to the ER, or physician’s office. It is understandable that medical professionals are taught the business side of health care, but not the empathy side for the patients.  Empathy is fundamental to effective communication. For doctors and nurses, this means placing the patient at the Centre of care, regardless of socioeconomic background, race or ethnicity.

It is heart breaking to hear the stories from individuals who have experienced insufficient care from his/her physician. I personally receive 4 calls each week without fail from individuals who feel worse leaving his/her physician’s office than going in here is an example of a call that I received. ” Hello Susan, this is Mr. Roberts, I have questions and I need for you to help me understand why I was given this pill to take. Now just think, here is a patient who has been to his physician’s office questioning me regarding some medication that was prescribed to him. I replied to Mr. Roberts did you ask the doctor why he prescribed this medication for you? Mr. Roberts replied yes, I asked and all he stated that I needed to take it for my cough, Susan he acts like he never has time for my questions, or that I am bothering him.”

Empathy was totally lacking by the physician of Mr. Roberts, it’s all about the art of effective communication and placing the patient first regardless of his socioeconomic background or the patient’s race. But we know that healthcare has become a business, and the bottom line is what is important to most. The underserved urban population is still lost in healthcare. It makes me wonder why the color of one’s skin dictate on how care will be given.

The urban population is still untrusting when it comes to the medical community, and I believe that it is based on how he/she is treated at the time of care. The myths still exist within the medical community regarding individuals of color, and just maybe this is another reason why there exists no empathy among patients of color?

To achieve health equity and create the Healthiest Nation in One Generation, we must address injustices caused by racism. We must support actions at all levels to ensure equal opportunity for all.

Resource

American Public Health Association (June 10, 2022) Retrieved from: https://www.apha.org/

Studies that used Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations with creatinine (alone or with cystatin C) and included a coefficient for race (Black or non-Black) to account for higher mean serum creatinine concentrations in Black vs non-Black individuals documented racial differences in the association of a low estimated glomerular filtration rate (eGFR) with risk of kidney failure with replacement therapy (KFRT) and mortality. However, the use of race in GFR estimation and other clinical algorithms has been challenged because race is a social and not a biologic construct and does not fully capture the diversity within vs between racial groups.

A creatinine-based eGFR equation that does not incorporate race was developed by CKD-EPI in 2021 and recommended for implementation in clinical laboratories by the National Kidney Foundation–American Society of Nephrology (NKF-ASN) Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease.

 This equation had small biases compared with directly measured GFR in Black and non-Black individuals, with a median of up to 4 mL/min/1.73 m lower and higher values than measured GFR, respectively. As a result of eliminating race from eGFR, Black individuals are estimated to have a 2.0% higher prevalence of chronic kidney disease (CKD), and non-Black individuals a 1.5% lower prevalence, compared with older equations that included race. Whether these changes alter the association of decreased eGFR values with higher rates of KFRT and mortality within and between racial groups is unknown. This is important for assessing efforts to reduce the higher risk of KFRT in Black compared with non-Black individuals and tailoring risk-reduction strategies across the full spectrum of eGFR.

This study examined whether GFR estimating equations based on different filtration markers (creatinine [eGFRcr] vs cystatin C [eGFRcys] vs both [eGFRcr-cys]) and equations that included or excluded race altered risk estimates for KFRT and mortality for Black compared with non-Black participants.

Black individuals have higher rates of incident KFRT and mortality than non-Black individuals. eGFR has been used to detect, stage, and treat CKD and to examine disparities in CKD prevalence and risk for adverse outcomes. Most of the US literature has used eGFRcr equations that include a race coefficient (predominantly the MDRD Study and 2009 CKD-EPI eGFRcr[ASR]). These equations showed a similar or slightly lower prevalence of moderately reduced eGFR in Black compared with non-Black individuals, in contrast to the higher KFRT incidence in Black than in non-Black adults. Possible causes for the discrepancy in racial differences in prevalence of reduced eGFR vs incidence of KFRT have been documented, including faster decline in measured GFR, more severe albuminuria, and other risk factors for CKD progression, underdiagnosis and undertreatment of CKD, as well as adverse social determinants of health, racial discrimination, and structural racism disproportionately experienced by Black compared with White individuals in the US.

Resource

JAMANetwork (June 10, 2022) Association of Estimated GFR Calculated Using Race-Free Equations With Kidney Failure and Mortality by Black vs Non-Black Race. Retrieved from: https://jamanetwok.com/journals/jama/fullarticle/2793290?guestAccessKey