By Anna Birk
Ohio University residents had the opportunity to learn more about unequal medical outcomes for minority communities at a January 25 meeting.
The meeting was co-sponsored by the LGBT Center and the Heritage College of Osteopathic Medicine Office of Rural and Underserved Programs, and presented by Dr. Darren Whitefield, assistant professor of social work and psychology at the University of Pittsburgh. The meeting focused on the health disparities which unequally affect LGBTQ members and people of color.
Dr. Whitefield said that there is a “constellation of social markers” that define how a person’s medical outcome is shaped, these markers being readmission rates, effectiveness of care and mortality. These markers often determine the type of care a patient receives within a medical facility, and can even determine their mortality.
“The disparity we see in health outcomes, mirrors the injustices we see in our society,” Whitefield said. “The influence of oppression experienced by social groups in our society, led to the idea of social determinants of health”
Among these determinants are the health care system, education, and community and social context. Within these markers are subcategories including support systems, stress, language, provider availability and discrimination.
These specific factors can be attributed to systematic racism, homophobia and transphobia. People of color often live in poorer communities because they get pushed out of their homes due to gentrification. This leaves them with limited access to medical facilities and puts them at higher risk for negative stress and environmental factors. For those in the LGBTQ community, doctors are less likely to take their needs seriously and these people may have little to no support system because of homophobia and transphobia. Because of these systematic issues, many researchers and doctors agree that the social determinants of health must be improved at an institutional and societal level in order to improve health quality, according to Whitefield.
“In our society, the root of health inequity … is due to how health markers are directly tied to social identities, which can be traced back to … racism, ableism, ageism, transphobia, homophobia and classism,” Whitefield said.
When these issues are not actively addressed, it leads to unequal health disparities for non-white Americans and LGBTQ people.
According to a CDC study taken between 2013 and 2016, there were roughly 10 times more HIV/AIDS related deaths among Black Americans than white Americans. The incidence rate HIV/AIDS was also much higher among people of color than white people.
Similarly, health disparities for women of color are much greater than white women, according to data from the American College of Obstetrician and Gynecologists, presented by Whitefield.
The data revealed that women of color are more likely to face disparities in health outcomes than white women in America. More specifically, 570 Black women face disparities from gonorrhea, compared to only 24 white women. Relatively, these numbers remain similar throughout the disparities listed. Fetal and maternal death are both more than two times more likely to occur among Black women than white women.
The study went on to say that many of these outcomes are directly related to determinants in the previously mentioned CDC study, such as education, housing and economic stability.
Dr. Whitfield said that the field of medicine has been a key agent of oppression towards minority groups, but offered ideas on how health professionals can better serve their patients who are unequally affected by these disparities.
“You need to put yourself in the place of a gay man, a trans woman or a nonbinary client, a person of color and think about if you were them, how you would perceive this facility,” Whitfield said.
In order to effectively treat patients of all socioeconomic backgrounds, a health care physician needs to put themselves in the shoes of their patients. Due to discrimination such as abelism, racism, homophobia and transphobia, there can be trauma that surrounds a patient when they are confronted with a cisgender heterosexual medical providor, Whitefield said.
Whitefield also suggested that medical providers ask questions about their patients past experience with medical services. Questions regarding a patient’s “scar tissue,” or negative experiences from past medical experiences, can help to better shape that patient’s medical future.
Whitfield closed the presentation by calling on the medical field to mandate social equity. “If the medical profession is truly fighting and cares for the health of all people, that requires us to address the systemic issues that perpetuate health inequities,” Whitefield said. “We cannot treat symptoms of inequities at the individual level, but must treat it at the societal level.”