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Tag: health disparities

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Picture of the Martin Luther King, Jr. Memorial in Washington, D.C.
Photo by Mark Stebnicki

As we reflect on the life, work, and impact that Dr. Martin Luther King, Jr. has had on our nation and the world, we are reminded that Dr. King was passionate about activism on racial discrimination, poverty, and health disparities. A great way to honor Dr. King’s legacy and continue his important work is to learn more about anti-racism, inequities, and disparities in healthcare and use this knowledge to help build a more inclusive healthcare system. Himmelfarb Library has some great resources that can help you learn more about these topics so you can put your knowledge into action!

Himmelfarb Resources: 

Himmelfarb’s Anriracism in Healthcare Guide provides information and resources related to antiracism in healthcare including links to professional healthcare organizations centered around diversity and health justice issues, training resources, and links to GW-specific organizations. Browse the Journal Special Collections tab to find journal issues and health news on antiracism-related issues. Antiracism books and ebooks available at Himmelfarb are also included in this guide including: 

The Antiracism in Healthcare Guide also has links to podcasts, tutorials, and videos including:

In addition to the Antiracism in Healthcare Guide, Himmelfarb has a Diversity and Disparities in Health Care collection of books and e-books with nearly 200 books addressing issues of disparity and representation of minority communities in healthcare. 

Advancing the Dream Event:

On Tuesday, January 16, 2024, at Noon, SMHS and the Anti-Racism Coalition will hold the 8th Annual SMHS Dr. Martin Luther King, Jr. Lecture Series - Advancing the Dream: From Dream to Reality - The Journey Continues. This year’s speaker is Dr. Italo M. Brown, MD, MPH. Dr. Brown is an Assistant Professor of Emergency Medicine and Health Equity and Social Justice Curriculum Thread Lead at Stanford University School of Medicine. Please join us in room 117 of Ross Hall (virtual attendance via Zoom is available) for this great event!

Flyer for the 8th Annual GW SMHS Dr. Martin Luther King, Jr. Lecture Series. Information in image is included in blog post.

Student and Professional Organizations:

If you are interested in becoming more involved, consider reaching out to local student or professional organizations such as White Coats for Black Lives or the Antiracism Nursing Student Alliance. Involvement with these and similar organizations can help you put your knowledge into action and offer opportunities for collaboration in furthering the cause of finding solutions to healthcare disparities and opportunities to educate others on issues of health injustices.

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December is Universal Human Rights Month and this past Sunday (December 10th) was the 75th commemoration of the adoption of the Universal Declaration of Human Rights by the UN. The declaration was formed three years after the ratification of the United Nations charter. In the wake of the horrors of World War II there was a strong impetus to establish both a peacekeeping body and an agreed set of fundamental human rights to be universally protected.

Among the rights in the declaration are:

  • All human beings are born free and equal in dignity and rights.
  • Everyone has the right to life, liberty and security of person.
  • No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.
  • All are equal before the law and are entitled without any discrimination to equal protection of the law. 

There are over 30 articles in the declaration, ensuring freedom of movement, right to asylum, right to education, freedom of peaceful assembly, freedom of opinion and expression, freedom of religion, and right to privacy among others. It recognizes the right to marry and equal rights and dignity in employment. Article 25 specifically addresses the right to medical care:

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. (United Nations, 1948)”

The United States is a signatory to the Declaration. Despite this, our government does not always live up to the ideals of the document. The structure of the health care system in the US does not support the standard of universal care guaranteed in Article 25 and the US has failed to ratify most of the international treaties that include a right to health (Willen, 2019). FDR advocated a Second Bill of Rights to include the right to “adequate medical care and the opportunity to achieve and enjoy good health” in his 1944 State of the Union. President Truman was also an advocate of a national health insurance program tied to Social Security. But in the 1940’s private health insurance became more common in the US, covering about half of the population, and the insurance industry created a barrier to further proposals for a national health program at the federal level (Berkowitz, 2005). 

The Johnson administration established Medicare and Medicaid in 1965 after a many years long fight and negotiation with the insurance industry. It was largely successful because it covered vulnerable populations who typically were too high risk to be privately insured. For decades many Americans fell through the gaps between the coverage of those programs and private insurance. 

While the Affordable Care Act of 2010 brought affordable health care to millions more, the country still fails to provide care to everyone and the current complex system of public and private funding increases inefficiencies and costs. A post pandemic study documented how our “fragmented and inefficient health care system” cost over 200,000 more lives and billions more in expenses during the Covid pandemic than a single payer system would have (Galvani, et al. 2022).  A 2022 survey published by KFF (formerly Kaiser Family Foundation) estimates that 41% of adults currently have some debt as a result of medical or dental treatment and one in 10 has significant medical debt. A quarter say they have debt that is past due or that they are unable to pay. One in four black adults, lower-income adults, and uninsured don't think they will ever pay off their health care debt. 

A January 2023 Gallup poll found that 57% of Americans say the government should guarantee health coverage for everyone, but a 53% majority want to preserve the current private insurance system. The AMA endorses expanding ACA and Medicare while preserving the current system of private insurance while Physicians for a National Health Insurance Program advocates for a non-profit single payer system. The American Academy of Family Physicians takes the middle ground  of laying out multiple options to get to universal care including a single payer model, a public option, and Medicare/Medicaid buy in.

However it is achieved, further progress in health care reform is necessary to provide the universal coverage all Americans deserve and reduce the costs and inefficiencies that are negatively impacting the delivery of healthcare in the US.

Sources

Berkowitz E. (2005). Medicare and Medicaid: the past as prologue. Health care financing review, 27(2), 11–23.

Galvani, A. P., Parpia, A. S., Pandey, A., Sah, P., Colón, K., Friedman, G., Campbell, T., Kahn, J. G., Singer, B. H., & Fitzpatrick, M. C. (2022). Universal healthcare as pandemic preparedness: The lives and costs that could have been saved during the COVID-19 pandemic. Proceedings of the National Academy of Sciences of the United States of America, 119(25), e2200536119. https://doi.org/10.1073/pnas.2200536119

United Nations (1948). Universal Declaration of Human Rights. https://www.un.org/en/about-us/universal-declaration-of-human-rights

Willen S. S. (2019). Invoking Health and Human Rights in the United States: Museums, Classrooms, and Community-Based Participatory Research. Health and Human Rights, 21(1), 157–162.

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October is Breast Cancer Awareness Month, a time when we show support for breast cancer patients and raise awareness of the disease and the importance of early detection. 1 in 8 women will receive a breast cancer diagnosis sometime in their lifetime. Though tremendous progress has been made in early detection and treatment since the 1980s, 43,000 women still die annually of breast cancer and there are significant disparities in who is more likely to survive.

“In the United States, age-adjusted breast-cancer mortality is about 40% higher among Black women than among non-Hispanic White women (27.7 vs. 20.0 deaths per 100,000 women from 2014 through 2018), despite a lower incidence among Black women (125.8 vs. 139.2 cases per 100,000 women)” according to a recently published Perspective article in the New England Journal of Medicine.1 The article asserts that Black women have benefited less from mammography than White women and that social determinants of health play a role. The higher incidence of hormone receptor (HR) negative cancer subtypes, including triple-negative, in Black women is another factor in survival disparity. These tumors are harder to detect by mammography, more aggressive, and not responsive to hormone therapy, making for a poorer prognosis than the more common HR positive subtypes. The NEJM article calls for making prevention and treatment of triple-negative breast cancer a national priority.

Recently there has been a campaign for alternate methods of early cancer detection for women with dense breasts. Dense breasts can make a mammogram more difficult to read. 38 states now require notification of women who have had a mammogram that indicated high tissue density. 16 states and the District of Columbia now also have expanded insurance coverage for these women, usually allowing an annual mammogram and 3D mammography, MRI, or ultrasound screening. However, most organizations in the US that author breast cancer screening guidelines do not recommend supplemental imaging for women with dense breasts. The National Cancer Institute (NCI) has an FAQ on dense breast tissue, breast cancer risk and screening.

Genetic testing for BRCA gene mutations also has the potential to reduce breast cancer incidence and mortality. 55%–72% of women who inherit a harmful BRCA1 variant and 45%–69% of women who inherit a harmful BRCA2 variant will develop breast cancer by 70–80 years of age.2 Testing is not recommended for the general public. Only those with increased risk for a BRCA mutation should pursue genetic counseling and potential testing. The NCI has a guide on BRCA cancer risk and genetic testing, outlining at-risk populations, benefits and harms of testing, and treatment options for those who have the mutations.

  1. Jatoi I, Sung H, Jemal A. The Emergence of the Racial Disparity in U.S. Breast-Cancer Mortality. N Engl J Med. 2022 Jun 23;386(25):2349-2352. doi: 10.1056/NEJMp2200244. Epub 2022 Jun 18. PMID: 35713541.
  1. Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers. JAMA. 2017 Jun 20;317(23):2402-2416. doi: 10.1001/jama.2017.7112. PMID: 28632866.
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