#black healthcare

[ausetkmt]

STAT: In counties with more Black doctors, Black people live longer, 'astonishing' study finds

Black people in counties with more Black primary care physicians live longer, according to a new national analysis that provides the strongest evidence yet that increasing the diversity of the medical workforce may be key to ending deeply entrenched racial health disparities.

The study, published Friday in JAMA Network Open, is the first to link a higher prevalence of Black doctors to longer life expectancy and lower mortality in Black populations. Other studies have shown that when Black patients are treated by Black doctors, they are more satisfied with their health care, more likely to have received the preventive care they needed in the past year, and are more likely to agree to recommended preventive care such as blood tests and flu shots. But none of that research has shown an impact on Black life expectancy.

The new study found that Black residents in counties with more Black physicians — whether or not they actually see those doctors — had lower mortality from all causes, and showed that these counties had lower disparities in mortality rates between Black and white residents. The finding of longer life expectancy persisted even in counties with a single Black physician.

“That a single Black physician in a county can have an impact on an entire population’s mortality, it’s stunningly overwhelming,” said Monica Peek, a primary care physician and health equity researcher at UChicago Medicine who wrote an editorial accompanying the new study. “It validates what people in health equity have been saying about all the ways Black physicians are important, but to see the impact at the population level is astonishing.”

“This is adding to the case for a more diverse physician workforce,” said Michael Dill, the director of workforce studies at the Association of American Medical Colleges and one of the study co-authors. “What else could you ask for?”

Lisa Cooper, a primary care physician who directs the Johns Hopkins Center for Health Equity and has written widely on factors that may explain why Black patients fare better under the care of Black doctors, called the study “groundbreaking” and “particularly timely given the declining life expectancy and increasing health disparities in the U.S. in recent years.”

“These findings should serve as a wake-up call for health care leaders and policymakers,” she told STAT.

The team of researchers, from the Health Resources and Services Administration of the U.S. Department of Health and Human Services and the AAMC, started their work by analyzing the representation of Black primary care physicians within the country’s more than 3,000 counties during 2009, 2014, and 2019. Even this first step resulted in a stark finding: Just over half of the nation’s counties had to be excluded from analysis because they contained not a single Black primary care physician.

“I knew it was a problem,” said Dill, “but ooh, those numbers are not good.”

The team’s analysis of the 1,618 counties that had at least one Black primary care physician in one of the three years found that the more such physicians a county contained, the higher life expectancy was for Black residents. (They’d like to repeat the analysis in the future to see how counties with Black doctors fared during the Covid-19 pandemic, which disproportionately affected people of color.)

The team found life expectancy increased by about one month for every 10% increase in Black primary care physicians. While extending life by a few months may not sound like much given that the life expectancy gap between Black and white Americans nationally is nearly six years, picking up such a signal on a population level is significant, the authors said.

The study found that every 10% increase in Black primary care physicians was associated with a 1.2% lower disparity between Black and white individuals in all-cause mortality. “That gap between Black and white mortality is not changing,” said John Snyder, a physician who directs the division of data governance and strategic analysis at HRSA and who was one of the lead authors. “Arguably we’ve found a path forward for closing those disparities.”

The study did not directly address the reason Black people fare better in counties with more Black physicians, nor does it prove a cause-and-effect relationship. While earlier research suggests “culturally concordant” medical care is of better and higher quality for patients, the new study indicates that one factor may be that Black physicians are more likely to treat low-income and underinsured patients, taking on new Medicaid patients more than any other racial or ethnic group, for example. The study found that improvements in life expectancy were greatest in counties with the highest rates of poverty.

“I wasn’t expecting that,” said Rachel Upton, an HHS statistician and social science analyst who was one of the report’s lead authors. “It shows having Black physicians is not only helpful across the board, but it’s particularly useful with counties with high poverty.”

Many studies have found that communication is improved when patients and physicians are of the same race. Owen Garrick co-authored a 2019 study in Oakland, Calif., finding that cardiovascular disease could be curbed more in Black patients who are seen by Black doctors because they are more likely to engage in preventive health care. He noted during his study that Black patients were not only more likely to talk with Black doctors about subjects like upcoming birthday parties or weddings, they were also more likely to invite them to the events.

But good communication is not the only factor: A 2020 study found that in infant care, where verbal communication from the doctor is not an issue, mortality rates for Black infants were reduced when they were treated by Black physicians; the authors suggested stereotyping and implicit bias may play a role when doctors treat patients outside their racial and ethnic groups.

The current study looked past the patient-doctor relationship and showed that patients may fare better simply by living in counties with Black doctors even if they are not directly treated by those doctors. Living in a county where Black doctors work and thrive “may be a marker for living in a community that better supports Black lives,” Snyder said.

Another factor, said Peek, is that Black physicians may be more likely to do unpaid health-related work outside of the health care system, such as providing expertise to community organizations, being politically involved in health-related matters, and encouraging medical societies to advocate for public health.

That’s the case with Peek, who has spent two decades working with a nonprofit that helps Black women in public housing become health navigators and advocates. She also spends a good deal of time providing a second opinion to her network of friends and family — and their friends and families — who do not personally know any physicians and may have issues of mistrust with the medical system.

“With my non-Black colleagues, it’s like ‘Both my parents were doctors! Everyone’s a doctor!’” she said. “Their social network is not all paranoid when they enter the health care system.”

She said the study also pointed to problems with racism within medicine and bias toward Black patients that has created a “chasm” between non-Black physicians and their Black patients. She’s struck, she said, by the number of Black people who come up to her after she speaks at a local church to give her their detailed medical history and ask her opinion because they don’t trust their own medical team. “I look like them,” Peek said. “They trust I have their best interest at heart.”

The authors of the new paper said they were not advocating segregated care and all doctors should improve their cultural competency. Patients of all races and ethnicities would be helped by increased diversity in the physician workforce, they said.

But increasing the number of Black physicians remains a stubborn problem. Despite decades of attention to the matter, a 2021 study showed the number of Black and Native American medical students, particularly males, has stagnated. The AAMC has reported a recent uptick in admissions of Black medical students, possibly due to a renewed focus on diversity in recent years, but an upcoming Supreme Court decision expected to limit the use of race as a factor in admission could cut into such gains.

The current study did not address how the presence of physicians from other groups underrepresented in medicine, including Hispanic and Indigenous people and Pacific Islanders, affects health outcomes. Upton said she hoped other researchers could focus on such groups in the future and that more researchers would conduct “within group” studies to examine the health of people within a single racial or ethnic group and not just examine how such groups compare to other, usually white, populations.

“Oftentimes we just look at the disparities,” she said. “I would like people to be looking at how people are doing within their own groups and what can help within those groups.”

#Black Doctors #Black Life #Black Healthcare #In counties with more Black doctors #Black people live longer #Black Healthcare with Black Doctors

[imkrisyoung]

#eds zebra #ehlers danlos zebra #zebras of color #people of color #poc #poc health #ehlers danlos #ehlers danlos syndrome #black people #african diaspora #african american #african americans #african american healthcare #health #healthcare #black health #black healthcare

[atotalmessymind]

A lawmaker proposed a bill that would ban DEI in medical schools. Doctors say it could roll back progress toward improving Black maternal health. | CNN

#black healthcare

[inkskinned]

you have to go to work so you can pay for your doctor, who is not taking your insurance right now, and if you say i can't afford the doctor's you are told - get a better job. it is very sad that you are unwell, yes, but maybe you should have thought about that before not having a better job.

(where is the better job? who is giving out these better jobs? you are sick, you are hurting - how the hell are you supposed to be well enough for this better job?)

but you go to the doctor because you had the nerve to be hurt or sick or whatever else. and they tell you that it is because you have anxiety. you try your best. you are a self-advocate. you've done the reading (which sometimes pisses them off worse, honestly). you say it is actually adding to my anxiety, it is effecting my quality of life. so they say that you are fat. they say that all young people have this happen to them, isn't it a medical marvel! they say that you should eat more vegetables. they say that you probably just need to lose a little more weight, and that you are faking it for attention.

(what attention could this doctor possibly give? what validation? that's their fucking job, isn't it?)

there is always a hypochondriac, right. someone always tells you about a hypochondriac. or someone who is unnecessarily aggressive during the worst days of their life. or someone looking "for a quick fix". or some idiot who wasn't educated about how to properly care for themselves who just abandons their treatment. and again, the hypochondriac, the overly-cautious hysteric. these people don't deserve to be treated like humans (right), and since you might be one of these people, you also don't get treated like a human. because those people can really fuck with the system, you now have to pay for it. and besides. you're actually probably faking it.

(more often than not, you find a 2:1 ratio of these stories. for every "hypochondriac", there are 2 people who knew something was wrong, and yet nobody could fucking find it. the story often ends with pointless suffering. the story often ends with and now it's too late, and it's going to kill me.)

you are actually just making excuses. someone else got that procedure or that diagnosis and he's fine, you should be fine too. someone else said they watched a documentary about other inspirational people with your exact same condition, maybe you should be inspirational, too. you're just too morbid. your pain and your experience is probably just not statistically concerning. it is all self-reported anyway, and you're just being a baby.

(once, while sitting down in the middle of making coffee, you had the sudden, horrible thought - i could kill myself to make the pain stop. you had to call your best friend after that. had to pet your dog. had to cry about it in the shower. you won't, but that moment - god, fuck. the pain just goes on and on.)

you know someone who went in for routine surgery and said i still feel everything. they told her to just relax. it took her kicking and screaming before they figured out she wasn't lying - the anesthetic drip hadn't been working. you know someone who went in for severe migraines who was told drink water and lose weight. you know someone who was actively bleeding out and throwing up in the ER and was told you're just having a bad period.

in the ER there are always these little posters saying things like "don't wait! get checked today!" and you think about how often you do wait. how often the days spool out. you once waited a full week before seeing the doctor for what you thought was a sprained wrist. it had actually been broken - they had to rebreak it to set it.

but you go into the doctor. the problem you're having is immediate. the person behind the counter frowns and says we're not taking your insurance. you will be paying for this out-of-pocket.

they send you home with tylenol and a little health packet about weight loss or anxiety or attention deficit. on the front it has your birthday and diagnosis. you think about crying, and the words swim. it might as well say go fuck yourself. it might as well say you're a fucking idiot. it might as well say light your money on fire and lie down in it. and the entire fucking time - the problem persists.

it's okay. it's okay, it's just another thing, you think. it's just another thing i have to learn to live with.

#spilled ink #warm up #can you tell what i'm mad about today specifically #i will say that there are a LOT of things that go into this. like a lot. this is ungendered and unspecific for a reason #it isn't just sexism. it's also racism. and ableism. and honestly classism. #and before a healthcare professional reads this as a personal attack: i understand ur burnt out #we are ALSO burnt out. your situation is also dire. this is not an attack on you. #this is a commentary on the incredible amounts of bigotry that lie at the heart of capitalism #where people have to pay money out of pocket to be told to fuck off. #your job is important. so is our humanity. and if you cannot accept that people are fucking mad as hell #at the industry - you are probably not listening . #anyway at some point im gonna write a piece about sexism specifically in medical shit #but i don't want terfs clowning in it bc they can't understand nuance #> it is true that ppl w/a uterus are more likely to experience medical malpractice & dismissal globally #> it is also true that trans people experience an equally fucked up and bad time in the medical field #> great news! the medical industrial complex is an equal opportunity life ruiner :) #(if you find it necessary to go into a debate about biology while discussing medical malpractice #i want to warn you that you're misunderstanding the issue. because guess what. #cis MEN might experience this. particularly black men. particularly disabled men. #so YES having a uterus can lead to more trouble for you. but this happens a LOT. #instead of fighting those ALSO experiencing your pain.... try working WITH them. #which btw. is like. actual feminism.)

[pinktwingirl]

One of the most common reasons I hear for people being against abortion is because “life is sacred.”

Really? Since when? When has life ever been sacred in this country?

If life is sacred, how come we don’t have universal healthcare?

If life is sacred, how come we don’t pass comprehensive gun laws so first graders don’t get gunned down in their classrooms?

If life is sacred, why don’t we offer paid maternal leave so mothers can actually take care of the babies that you are now forcing them to have?

If life is sacred, how come we don’t bat an eye when the police murder black kids?

If life is sacred, why do we have the highest maternal death rate in the developed world, which is only going to increase now that women are being forced to give birth?

If life is sacred, why is the death penalty even still a thing?

If life is sacred, why are we still encouraging violence against the LGBTQ+ community?

Life has literally never been sacred in this country. Maybe anti-choicers like to pretend that it is because it makes them feel righteous when in reality, they’re just misogynistic pieces of shit, but it’s not. And as long as psychotic, reactionary morons continue to steal power undemocratically and make decisions that the majority of us do not want, it never will be.

#roe v wade #roe v wade saves lives #abortion is healthcare #abortion rights #pro choice #womens rights #fuck the supreme court #fuck scotus #fuck anti choicers #pro abortion #blm #black lives matter #lgbtq #us politics

[left-reminders]

#black lives matter #defund the police #abolish the police #anti capitalism #socialism #universal healthcare #medicare for all

[penwrythe]

What's stopping the possibility of a ceasefire is pretty simple. Hamas is holding 239 Israeli civilians hostage including children and the elderly. What's happening in Palestine is a travesty and horrendous. But Israel can't initiate a ceasefire from the position they're in, so we need to be agitating for Hamas to release the hostages and call for a ceasefire instead.

NO GENOCIDE IS JUSTIFIABLE

HOW DOES THE KILLING OF INNOCENT PEOPLE ON THIS EXTREME LEVEL FORCE HAMAS TO RETURN HOSTAGES??

ISRAEL'S BOMBARDMENT AND INDISCRIMINATE SHOOTING IN GAZA THREATEN EVERYONE THERE INCLUDING DOCTORS JOURNALISTS CHILDREN ENTIRE FAMILIES AND THE HOSTAGES

EVERYONE IS TARGETED

YOU HAVE HOSPITALS BOMBED HOW ANY OF THIS IS JUSTIFIED

@sarroora @fairuzfan @palipunk @wearenotjustnumbers2

You know more about this than I do.

#do you really think this will work on me; like hell I'm gonna stay silent for you #I hoard bookmarks like a dragon so guess what I have been saving from the posts I had reblogged to this blog and my sideblog #firefox bookmarks manager are a blessing oh my gods #how does one block anons #sorry for going full Black here on this post but yeah I'm a little livid #the entirety of Western media heavily propagandized for Israel and the US #how the US media covered this look at how our politicians keep funding Israel with money that could have gone to #our schools healthcare housing etc; my tax payer money is being used to kill innocent people and silence protesters #tw death #tw racial profiling #palestine #update: changed a few tags because I mistakenly compared Al Jazeera's coverage to Western Coverage #Al Jazeera has the best coverage of what is happening in Gaza and unfortunately also lost journalists #They deserve respect for what they are doing #thank you for the corrections wearenotjustnumbers2 (see their response in the notes pls) #genocide

[animatormentata]

🦋 self love hits different 🦋

#black & white #pic of the day #pictures on tumblr #tumblr italia #me #pic post #twin flame #self healing #healthcare #healing #self worth #self love #self improvement #my pics #picture by me #photoart #photography #post on tumblr #tumblr girls #lgbtq+ #lgbt italia #wlw love #wlw post #art on tumblr #aesthetic #black aesthetic #details

[ausetkmt]

New Scientist: Racial and ethnic disparities undermine dementia care in the US

In the US, people of colour receive worse treatment than white people at every stage of dementia care, from diagnosis to end-of-life treatment, according to an analysis of dozens of studies.

Dementia-causing conditions, such as Alzheimer’s disease, are one of the leading causes of death in the US, and older Black people in the US are twice as likely to be impacted as whites. As people in the US live longer, with the risk of dementia roughly doubling every five years they age, more people of colour than ever will be living with dementia and cognitive impairment.

“Access to good-quality care for people living with dementia is essential to achieve equity,” says Ladson Hinton at the University of California, Davis.

Hinton and his colleagues reviewed 71 studies published over the past two decades to gain a clearer picture of how racial and ethnic disparities impact dementia care. The team found key differences in diagnosis, medication use and end-of-life treatment.

Every study that analysed diagnosis showed lagging diagnosis times for Black and Hispanic people with dementia. A recent comprehensive study revealed that the waiting time was 11 per cent longer for Black people and 40 per cent longer for Hispanics compared with white people.

“If there is a delay in diagnosis, that means that there’s going to be a delay in treatment,” says Joyce Balls-Berry at Washington University in St. Louis, Missouri. “That impacts one’s ability to have a good quality of life.”

Studies also found lower prescription rates of anti-dementia medication for Black and Hispanic people. Black people in the US were also less likely to receive care at long-term facilities or hospices specialising in dementia treatment. Perhaps as a result of delayed treatment, many studies reported increased US hospital admission rates and longer stays for Black people with dementia.

“The higher rates of hospital admission and longer length of stay are really not desirable,” says Hinton. The analysis confirms the concerning ethnic and racial inequities in dementia care, but many questions are still unanswered, he adds.

The review found limited data on Asian Americans, Pacific Islanders and Native Americans with dementia, so it remains unclear how these groups are impacted. Hinton says future research in the field must include people of all racial and ethnic backgrounds.

The root cause of these inequities also remains unproven. Balls-Berry believes access to specialists, proximity to high-quality medical centres, lack of insurance, language barriers and cultural differences could all be contributors, but more research is needed to confirm these connections.

Ladson and Balls-Berry both hope this data spurs changes in clinical practice and policy to close the gaps in dementia care. “Some of these systems were not created for patients of colour,” says Balls-Berry.

#Racial and ethnic disparities undermine dementia care in the US #Black Healthcare