Patients of color more often brace for unfair treatment in health care, survey finds
Patients of color more often brace for unfair treatment in health care, survey finds
Atrip to the doctor’s office comes with a bit of preparation for most, maybe even an internal pep talk to prepare for being told to get more exercise or calm a simmering fear of needles.
But dressing well in hopes of warding off unfair treatment – or even bracing for being insulted?
A newly released poll by KFF, a health policy research group, found many patients of color — including 3 in 5 Black respondents — take such steps at least some of the time when seeing a doctor.
The poll found that 55% of Black respondents said they feel like they must be very careful about their appearance to be treated fairly at medical visits. That’s similar to the rate for Hispanic and Alaska Native patients – and nearly double the rate for white patients.
Nearly 30% of Black respondents prepare to be insulted, also about double the rate for white patients.
“It’s exhausting,” survey respondent Christine Wright, 60, told The Associated Press.
Wright, who is Black, says she’s faced years of discrimination – including once being called a racial slur by a nurse. She was diagnosed with breast cancer in 2017 and recently found a doctor she trusts. But she still makes sure to dress well for any medical appointments, putting on jewelry, a nice coat and making sure her hair is done.
She braces herself for looks and comments from doctors and staff. “They don’t control you," she tells herself. "They don’t. Doesn’t matter what they’re saying about you. Because you’re not that.”
While more than 90% of those polled said they were not treated unfairly or with disrespect in a health care setting because of their race or ethnic background in the past three years, the anticipation of unequal treatment can influence patients’ interactions with their doctors, experts say. That’s a particular concern because of the wide disparities in health outcomes along racial lines in the U.S.
“This survey shows the impact racism and discrimination continues to have on people’s health care experiences,” said KFF President Drew Altman.
Dr. Allison Bryant, an obstetrician at Massachusetts General Hospital who was not involved in the survey, said it provided important – though not necessarily surprising – results.
Bryant, who also serves as her hospital system's associate chief health equity officer, said she has heard similar stories from patients of color and seen it in the system's own patient satisfaction data. And as a Black woman, she lives the experience herself, often double-checking she has her ID or wedding ring visible to ward off assumptions from others.
“I think everybody experiences that to some extent,” Bryant said. “But I understand why it’s more exaggerated in individuals of color, who have a legacy of not being treated well.”
The behavior indicates a deeper problem, Bryant said, one that can influence critical interactions between a doctor and patient.
If you anticipate someone may treat you badly you may be more tense, you may not speak properly, she said. “There are deep harms that are associated with this that go beyond what it might look like at the surface, which is like, ‘I put on some high heels and I put on some lipstick.’”
Jeymie Luna Roldán, 45, also participated in the survey. She thinks her previous lack of health insurance or her imperfect English contributed to her bad experiences at the doctor. She spoke to the AP in Spanish.
“In my case, I’m Latina,” said Roldán, of Lake Worth, Florida. “So when I have an appointment, I have to dress up a little – put on earrings, makeup – so that they don’t see me in my work clothes. There’s a saying that goes, ‘Como te miro, te trato.’”
That translates to: “You’re treated how you look.”
Despite high percentages of people saying they prepare for insults or feel their appearance can influence how they are treated at the doctor, 93% said they have not felt they were treated unfairly or with disrespect in a health care setting because of their race or ethnic background in the past three years.
But there were still wide differences among racial groups. Asians and Hispanics were three times more likely to say they’ve been treated badly in a health care setting because of their race than white respondents and Black respondents were 6 times more likely.
Beyond the doctor’s office, 58% of American Indians and Alaska Natives, 54% of Black respondents, 50% of Hispanics, and 42% of Asians said they experienced at least one type of discrimination in daily life at least a few times in the past year. That includes getting poorer service at stores and restaurants, being threatened, harassed, or treated like they are not smart, or being criticized for speaking a language other than English.
While this shows health care is just one of the settings where discrimination is persistent, Bryant said, being treated with disrespect at a car dealership or profiled at a department store poses a different type of risk. A dismissivecardiologist not ordering the right tests because a patient doesn’t “look the part” is potentially more dangerous.
“The consequences in health care are really striking and very frightening, honestly, to understand what people need to do to be taken seriously, to be seen as a whole person,” she said. “I think these data really speak to that.”
Reference:Story by Devi Shastri: The Independent:
Soybeans 101: Nutrition Facts and Health Effects
Soybeans 101: Nutrition Facts and Health Effects
Soybeans, a potent source of plant-based protein, offer other beneficial plant compounds. They may reduce your risk of cancer and alleviate menopause symptoms, but excessive consumption may cause digestive problems.
Soybeans or soya beans (Glycine max) are a type of legume native to eastern Asia.
They are an important component of Asian diets and have been consumed for thousands of years. Today, they are mainly grown in Asia and South and North America.
In Asia, soybeans are often eaten whole, but heavily processed soy products are much more common in Western countries.
Various soy products are available, including soy flour, soy protein, tofu, soy milk, soy sauce, and soybean oil.
Soybeans contain antioxidants and phytonutrients that are linked to various health benefits. However, concerns have been raised about potential adverse effects.
This article tells you everything you need to know about soybeans.
Cause of painful recurring UTIs discovered by scientists
Cause of painful recurring UTIs discovered by scientists
Scientists from University College London made artificial bladders using human cells and infected the lab organs with six different types of bacteria, including E. coli.
The lab-grown bladders are the most sophisticated in the world, consisting of around eight layers of cells and are the size of a five-pence coin.
Around a quarter of a million people die of UTIs every year globally after contracting a superbug strain of the infection, and one in four UTIs recurs within six months.
Antibiotics work in most cases against UTIs but it was previously not known why some cases do not resolve following medication. The condition disproportionately affects women and is an area that often gets little funding.
Prof Jennifer Rohn, senior author of the study, said the team found a range of ways in which the bacteria avoided being killed by drugs.
“One of the key observations was the importance of persistence,” she added.
“If you want to be a successful pathogen, you have to have strategies that help you to survive treatment and hide from patrolling immune cells, which means you live to fight another day.
“Some species of both ‘good’ and ‘bad’ bugs formed pods within the bladder wall, most likely as a way of surviving in this harsh environment.
“If this happens with a friendly bug, this isn’t a problem, but if the bug is causing an infection, this poses a serious problem for diagnosis and treatment because the bacteria aren’t necessarily going to be detected in a urine sample or be in a position where oral antibiotics can reach them.”
The variety in responses from the bacteria shows that a one-size-fits-all approach is unlikely to be effective in treating UTIs.
The researchers also found that human cells are very good at identifying “friendly” bacteria.
“This study confirms what many women who’ve struggled with persistent UTIs already know, which is that the current methods of diagnosing and treating these infections are inadequate,” Prof Rohn said.
Carolyn Andrew, the director of the Chronic Urinary Tract Infection Campaign, said: “This research has been instrumental in providing unequivocal evidence for our national campaign to improve testing and diagnosis of chronic, persistent UTIs.
“Professor Rohn’s work in this field is a vitally important step forwards and should help tens of thousands of women in the UK to receive effective diagnosis and treatment of a chronic infection in their bladders.”
The findings have been published in the journal Science Advances.
Alzheimer's transmitted from person to person
Alzheimer's transmitted from person to person
Alzheimer’s can be transmitted from person to person, discovered after patients who received human hormones decades ago went on to develop the disease.
Five cases of Alzheimer’s are believed to have been caused by medical treatment given as children.
The new study provides the first examples of Alzheimer’s disease in living people to have been ‘caught’ during a medical procedure.
In these cases, it appears to have been due to doctors administering children with a human growth hormone taken from dead donors.
According to the University College London (UCL) and University College London Hospitals (UCLH) researchers, the findings may have important implications for understanding and treating Alzheimer’s disease.
And although the procedure that led to this transmission was stopped in the 1980s, experts recommend medical procedures should be reviewed to ensure rare cases of Alzheimer’s transmission do not happen in the future.
Alzheimer’s, the most common form of dementia, is caused by the build-up of the proteins in the brain, and usually occurs later in adult life with no specific family link. More rarely, it can be an inherited condition that occurs due to a faulty gene.
The people described in the study had all been treated as children with a type of human growth hormone taken from dead donors (cadaver-derived human growth hormone or c-hGH).
There is no suggestion the protein, amyloid-beta, can be passed on in day-to-day life or during routine medical or social care.
Between 1959 and 1985, c-hGH was used to treat at least 1,848 people in the UK and used for various causes of ‘short stature’ – when a child or a teen is well below the average height of their peers.
What is Alzheimer's and what are the symptoms?
Alzheimer’s disease is the most common cause of dementia in the UK.
Dementia is the name for a group of symptoms associated with an ongoing decline of brain functioning. It can affect memory, thinking skills and other mental abilities.
For example, someone with early Alzheimer’s disease may:
- forget about recent conversations or events
- misplace items
- forget the names of places and objects
- have trouble thinking of the right word
- ask questions repetitively
- show poor judgement or find it harder to make decisions
- become less flexible and more hesitant to try new things
Later stage symptoms include increasing confusion and disorientation, obsessive or repetitive behaviour, or disturbed sleep.
Source: NHS
But the treatment was withdrawn in 1985 after it was found that some c-hGH batches were contaminated with infectious proteins which had caused Creutzfeldt-Jakob disease (CJD) – a rare and fatal condition that affects the brain – in some people.
After that, c-hGH was replaced with a synthetic growth hormone that did not carry the risk of transmitting CJD.
A variant of CJD was responsible for the ‘mad cow disease’ outbreak in the 1990s.
Lead author of the research, Professor John Collinge from UCL, said: ‘There is no suggestion whatsoever that Alzheimer’s disease can be transmitted between individuals during activities of daily life or routine medical care.
‘The patients we have described were given a specific and long-discontinued medical treatment which involved injecting patients with material now known to have been contaminated with disease-related proteins.
‘However, the recognition of transmission of [proteins] in these rare situations should lead us to review measures to prevent accidental transmission via other medical or surgical procedures.
‘Importantly, our findings also suggest that Alzheimer’s and some other neurological conditions share similar disease processes to CJD, and this may have important implications for understanding and treating Alzheimer’s disease.’
The latest study reported on eight people referred to the National Hospital for Neurology and Neurosurgery in London, who had all been treated with c-hGH in childhood, often over several years.
Five of them had symptoms of dementia, and either had already been diagnosed with Alzheimer’s disease or would otherwise meet the diagnostic criteria for this condition.
Another person met criteria for mild cognitive impairment.
The people were between 38 and 55 years old when they started having neurological symptoms.
Further tests supported the diagnoses of Alzheimer’s disease in two patients, and was suggestive of Alzheimer’s in one other person. Post-mortem analysis showed signs of Alzheimer’s in another patient.
Researchers say the unusually young age at which these patients developed symptoms suggests they did not have the usual Alzheimer’s, which is associated with old age.
In the five patients from whom samples were available for genetic testing, the team ruled out inherited Alzheimer’s disease.
Co-author Professor Jonathan Schott, from UCL, added: ‘It is important to stress that the circumstances through which we believe these individuals tragically developed Alzheimer’s are highly unusual, and to reinforce that there is no risk the disease can be spread between individuals or in routine medical care.’
The findings are published in Nature Medicine.Story by Nina Massey: Metro
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