May 2023 Monthly Tips
Facing Health Disparities
▪ Definition: By definition, health disparities are health differences related to social, economic, and/or environmental disadvantages that adversely affect people based on factors such as race, ethnicity, sex, gender identity/sexual orientation, age, socioeconomic status, geographic location, or disability.
▪ Examples of Health Disparities:
-Womenaretwiceaslikelyasmento developlongCOVID(aconditiontypically definedasongoingsymptomsofCOVID-19 thatcontinueformorethan12weeksand arenotexplainedbyanalternative diagnosis).
▪ Examples of some causative factors which can lead to health disparities in chronic disease rates:
▪ Food Desert: neighborhood with no/limited access to healthy foods like fresh fruits and vegetables; foods that are available are often highly processed and high in sugar and fats
▪ Food Swamp: neighborhood with an abundance of fast food, junk-food outlets, and convenience and liquor stores and outnumber healthy food options
-AccordingtoHealthAffairs,“Peoplewith disabilitiesaremorelikelytoreportpoor healthandexperiencehigherratesof chronichealthconditionsthannondisabled people.”
-AccordingtotheRuralHeathInformation Hub(RHIhub),“Ingeneral,ruralpopulations experienceworsehealthstatusthanurban populations.Thisisinpartduetoahigher incidenceofchronicconditionsandhigher engagementinhealthriskbehaviors.”
| 2
Medical Gaslighting
Medical gaslighting - a situation in which a patient’s symptoms and concerns are trivialized, dismissed, or even completely ignored by a healthcare provider – can lead to health disparities. Medical gaslighting:
▪ Can unfold as a misinterpretation or misdiagnosis of symptoms due to a narrowly focused search for an answer that will fit a clinical “profile,” rather than keeping an open mind, actively listening, and being willing to admit to not having all the answers
▪ Can create undue stress, anxiety, and depression, and, in the case of a missed diagnosis, delayed diagnosis, or misdiagnosis, irrevocable harm to one’s health or even death
▪ May also result in an unnecessarily greater cost of care, which impacts out-of-pocket expenses for the patient; for those who are uninsured, underinsured, or have very high deductibles, the risk of financially devastating medical debt is very real.
▪ Some patients may also begin to doubt themselves and/or feel shame or low self-esteem.
| 3
Medical Gaslighting
▪ Medical gaslighting is more common in women, communities of color, patients who are obese, those with mental health conditions or disability, those with conditions like chronic fatigue syndrome and POTS, and the LGBTQIA+ community
▪ Bias, discrimination, sexism, racism, insufficient research (and underfunding of research) in women’s health, lack of diversity in the healthcare workforce (clinicians, researchers, scientists, leadership), lack of diversity in clinical trials, scientific and pharmaceutical data analysis that frequently does not include a consideration of potential gender-based differences, inadequate medical professional training (relative to women’s health, gender-specific conditions, and varying sex-based symptom presentation), and unequal power dynamics in the patientphysician relationship all contribute to the medical gaslighting women may experience.
| 4
Medical Gaslighting
▪ Example: The difference between the symptoms reported by women vs. men when they are having a heart attack. Although chest pain is the most common symptom overall regardless of gender, women may experience different symptoms—including dizziness, nausea and vomiting, heartburn, or unusual and unexplained fatigue—as opposed to the stereotypical jaw pain, “elephant on the chest,” and shortness of breath with which providers are more familiar (and which are seen more frequently in men). Consequently, a woman may show up in the ER experiencing a heart attack and be discharged with a GI diagnosis and no evaluation of a potential problem with her heart.
| 5
Facing Health Disparities
Ways to Help Prevent Health Disparities
▪ Be willing to ask questions and to persist until you get answers and understand them well.
▪ Some questions to ask your healthcare provider depending on the situation:
1. What are ALL my options?
2. What would you recommend if it were you or a family member?
3. Will the medication work well regardless of my sex or race?
▪ Take notes during medical appointments and always read the entirety of a document before you sign it. Ask questions if there are sections or medical lingo you don’t understand.
▪ Educate yourself about any conditions you have and those for which you are at increased risk.
▪ Consider getting a second opinion if you’re not comfortable with the guidance or treatment recommendations you are given.
6
Facing Health Disparities
Resources
▪ Disparities in Health and Health Care: 5 Key Questions and Answers
▪ Advocating for a Sick Parent by Confronting Physician Bias
▪ Cancer Disparities
▪ How To Protect Against Race and Gender Healthcare Bias
▪ Why Heart Disease in Women Is So Often Missed or Dismissed
▪ How Racism Makes Us Sick
▪ CDC Resources for Health Disparities
| 7
This newsletter does NOT constitute medical advice, diagnosis, or treatment nor legal or other professional services. Always seek medical care from your healthcare professional. It is offered with a goal of providing accurate information. However, ensuring all information is entirely accurate and up-to-date at all times is not possible.
Therefore, the author accepts no responsibility for inaccuracies, errors, misstatements, inconsistencies, or omissions and specifically disclaims any liability, loss, or risk, personal, professional or otherwise, which may be incurred as a consequence, directly or indirectly, of the use and/or application of any of the contents of this newsletter.
| 8