How the Covid 19 has exposed racial disparities in health care

 

This is truly a story of racial segregation in homes that has plagued this country for a century. The death rate for black patients diagnosed with COVID-19 would be 10% lower if they received care ....

The death rate for black patients diagnosed with COVID-19 would be 10% lower if they received care in the same hospitals as white patients, according to a new Penn Medicine study adding to growing evidence of racial inequalities in U.S. health care

In the study published last month in JAMA Network Open, researchers examined Medicare data from more than 44,000 patients admitted to nearly 1,200 hospitals last year and found that the significantly higher death rate for black patients was eliminated. as they adjusted to the location of the hospital. .

Because patients often go to hospitals close to their homes, the study highlights the results of structural racism in utter relief: Low-performing hospitals, struggling to find adequate income and resources, are most often found in economically poor communities. disadvantaged.

"This is truly a story of racial segregation in homes that has plagued this country for a century," said Dr. David Asch, lead author of the study and executive director of Penn Medicine's Center for Healthcare Innovation. .

Asch, who is also a professor of health management at Wharton, spoke about the research with Wharton Business Daily on SiriusXM. (Listen to the podcast above). He said the results are not that surprising to medical professionals, because it is well known that the health care system is uneven. But consumers may be surprised to learn how deep the inequality is.

"This is truly a story of racial segregation in homes that has plagued this country for a century." –David Ash

“Of course, a lot of people assume that the doctors, hospitals, and nurses are great, and when you go there, you get unified care. That's the experience that people often have at, say, McDonald's, who have worked very hard to provide a very consistent experience. You can walk into any McDonald's and the fries will be uniformly excellent, "Asch said." That's not really the case with hospital care. "

He even noted that the novelty of the coronavirus exacerbated the variance as hospitals had to move quickly to meet the challenge. Working to improve health care is the "relentless task" of professionals, legislators and insurers, she added. "But as medicine has advanced, that progress has been uneven in hospitals. Some hospitals have a harder time catching up with the best."

An Unequal America

African Americans suffer from COVID-19 in greater numbers due to a wide variety of factors: access to care, lower income levels, occupations with a higher risk of exposure to the virus, and higher rates of hypertension, diabetes, and obesity.

Even those comorbidities "are probably products of long-term discrimination. It's a pretty tangled web, but that tangled web in the middle reveals significant racial differences," Asch said.

Asch noted from previous research that hospitals that serve the majority of the black population have worse outcomes for all of their patients, compared to hospitals that serve the majority of the white population. He said better public policies are needed to close the racial divide in the healthcare system, drawing an analogy to the way public education is funded: Most schools receive property tax revenue, so how much The richer the community, the higher the dollars to fund the schools. finances in that area.

"The same goes for health care," Asch said. "We fund health care in an unusual patchwork, but mostly through insurers and if patients have commercial insurance, which pays better, or Medicaid, which often pays less than cost, or Medicare, which is at some point intermediate. That says a lot about the resources the hospital can develop and deploy for the community. "

"The differential burden of COVID across the country will soon depend less on race and more on vaccination and, in turn, on political ideology." - David Ash

The Next Chapter of COVID

In the progression of the pandemic, one statistic has remained: older patients and men have fared worse than younger patients and women, regardless of race. Vaccines and the best therapies have dramatically reduced the death rate from the disease.

As the pandemic enters its second year and the most dangerous Delta variant emerges as the dominant strain, the greatest threat to the progress already made comes from those who are unwilling to get vaccinated, Asch said. Current vaccines are effective against the Delta variant, according to experts.

Asch said there is no single story about COVID-19 in the US The vulnerability of any community depends on the level of vaccination.

"And that, frankly, has tragically become a political problem rather than a medical or public safety problem," he said. Unvaccinated areas “can become powder magazines for contamination. I bet the differential burden of Covid across the country will soon depend less on racial issues and more on vaccination and, in turn, political ideology. "

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HOW DO RELATIONSHIPS DEAL WITH OUR MENTAL HEALTH?

 

Extensive evidence shows that having good-quality relationships can help us to live longer and happier lives with fewer mental health problems. Having close, positive relationships can give us a purpose and sense of belonging.

Humans are social beings. Mahatma Gandhi wrote: "Where there is love, there is life." Whether you consider yourself a social butterfly, are drawn to personal interactions, or prefer your own business, there is no denying that the quality of your personal relationships can affect your levels of happiness, well-being and physical health. This article highlights how relationships can protect our mental health.

All of our lives we depend on each other to survive. Being self-aware allows us to see this need, prompting us to seek enriching relationships in our efforts to connect with others. Keep in mind that relationships go beyond being romantic and include family, friends, and coworkers. Researchers believe that people spend 80% of their time in front of others, so maintaining positive and healthy relationships is important. According to the Mental Health Foundation, a relationship is "the way two or more people are connected, or the state of connection."

Mental health problems can have a profound impact on a person's close relationships; Expressing emotions and connecting with others can be challenging.212 Experiences of depression can make us want to withdraw and isolate ourselves, and avoid social contact, making it difficult to maintain relationships with our friends and family.213 Social anxiety can make it very difficult for someone to form and maintain relationships due to overwhelming fear and consequent avoidance of social situations.214 Similarly, people with eating disorders, such as anorexia nervosa, have reported problems with close relationships due to difficulties they experience. They can have to express and share how they feel.

Social connections are really good for us and loneliness kills. People who are more socially connected to family, friends, or the community are happier, physically healthier, and live longer than people who are less connected.

• It is not just the number of friends you have, and whether or not you are in a committed relationship, what matters is the quality of your close relationships. Living in conflict or in a toxic relationship is more harmful than being alone.
• Good relationships not only protect our bodies, they also protect our brains. Good quality relationships were associated with sharper memory.

The Mental Health Foundation defines relationships as "the way two or more people are connected, or the state of connection." Research explored in this report shows that social connection and good relationships can make us happier and enhance our sense of well-being9 by giving us a sense of security, support, and meaning in our lives.

Relationships require reflection, time, courage, and grace. Modern life often reduces the space to do this. Many of us are under pressure, whether it's tests, work commitments, or financial pressure. In a message to decision makers and the public, our report reinforces the message that productivity should not come at the expense of our collective ability to connect with one another.

Research has shown that family relationships are critical to children's happiness, highlighting quality as one of the six domains of life, along with health, personal finances, education and skills, that contribute the most to well-being general of children.

Many of these relationships can help us maintain our mental health, but relationships are often complex and any of these relationships can create difficulties and challenges that negatively affect us.

While being in a relationship can have positive health benefits, it is important to recognize that unhappy relationships are more destructive than being single. Research has shown that bad or unhappy relationships have a greater negative impact on physical and mental health than not being in a relationship.

While intimate relationships can have significant positive effects on our mental health and well-being, not all relationships go smoothly, and even those that do can go through difficult times.

Losing relationships through grief has significant potential to isolate and exclude them later in life. People aged 75 and over are the most isolated and lonely, as they are more likely to envy and live alone. Women are at higher risk of isolation because they live longer than men, and older women are more than twice as likely as older men to feel trapped in their own homes. Research shows that there is an increased risk of the elderly going to nursing homes or sheltered housing after the loss of a partner.

Relationships with the people we love are the foundation of our lives. However, the importance of our relationships goes beyond how they affect our emotional well-being. The evidence is clear that the quality of relationships even affects how long we live. Relationships require reflection, time, courage, and grace. Modern life often reduces the space to do this. Many of us are under pressure, whether it's tests, work commitments, or financial pressure. In a message to decision makers and the public, our report reinforces the message that productivity should not come at the expense of our collective ability to connect with each other. Healthy relationships can not only add years to our lives, but also give us a greater sense of purpose in the years that we are. You owe it to yourself and to those around you to take care of your close relationships; you will probably find that it is worth the effort.

 

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