Bluford Healthcare Leadership Institute Forums 2020 BHLI Cohort Engagement From Separate to Equal and The 1619 Project

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  • Jihad_Miller
    Participant
    Post count: 2

    A. I think healthcare facilities should be willing to offer employment opportunities to ex-prisoners because I believe in the ideal of everyone deserves second chances. All people are human beings and one of the major flaws of being human is making mistakes. Some mistakes are more costly than others. But I do think that there should be more opportunities for people to redeem themselves. Over the past decade, hospitals and healthcare facilities have been giving more people with criminal offenses second chances. It jump started with John Hopkins Hospital in Baltimore, Maryland and has become more popular over the years. One of the main barriers that prevented ex-offenders from applying for jobs was laws that had restrictions for those with certain offenses such as theft and murder. However, some states such as Pennsylvania are taking steps to help those people. In 2015, the Supreme Court of Pennsylvania eliminated those laws and In 2017, the state of Illinois began allowing people with forcible felony offenses to petition for professional licenses in healthcare. As more states start lifting some of restrictions on ex-offenders, I believe more healthcare facilities will be willing to give these people a chance. However, ultimately its up to the individual to make the best of their second opportunity.
    D. One can conclude that increased co-morbidities of chronic diseases that are present in a patient will lead to increased mortality rates. According to the Center for Disease Control, chronic deaths are responsible for seven out of ten deaths in the U.S. Adding co-morbidities to that will increase the mortality rate. You would more likely see cases of co-morbidities of chronic diseases in minority communities due to the lack of healthcare access in those areas. African American children have the highest rate of asthma in the U.S. Additionally, Hispanics and African Americans are the top two ethnicities with the highest rates of diabetes. Our communities suffer from this because we don’t have the same access to public healthcare as non-minorities do.

    Lauren_Winston
    Participant
    Post count: 6

    A) Since the Bureau of Freedmen, the United States government has implemented more sustainable policies that plan to assist the population with public welfare across race and class. Established in 1865 the Freedmen’s Bureau was the United States’ first federal healthcare program, its benefits that aimed to help the entire population were denied in attempts to target the wellbeing of black people. One century later Medicare and Medicaid were signed into law, after this legislation was passed and it allowed for more policies to be built on improving the United States healthcare system for the elderly and the disadvantaged. The Affordable Care Act of 2010 even builds on the expansion of Medicaid so that it is more inclusive to low-income citizens. I am choosing to focus on policies that are built on well-known 20th-century legislation and how effective their contributions have been to Medicaid, Medicare, and, or, the Affordable Care Act. These policies include the Health Insurance Portability and Accountability Act of 1996, Children’s Health Insurance Program, and the Medicare Prescription Drug, Improvement and Modernization Act of 2003.

    The Health Insurance Portability and Accountability Act (HIPAA) was signed into law in 1996 and has three main goals. It aims to protect health insurance coverage for workers when they are transitioning or have lost their jobs, protect health data, and allows for national regulation of the healthcare system (Greevy). The impacts of HIPAA are recognized through all branches of the healthcare system and play a crucial role in establishing trust between patients and practitioners. From the perspective of healthcare institutions, HIPAA has also allowed for a standardization of data which has been beneficial for coordination of insurance benefits and payments (Bowers). These steps are valued in the modernization of the healthcare system in order to make progress within it more efficient and minimize human errors. However, there has been concern about the interpretation on how to release patient information. It has also accelerated health information management professionals to become more skilled in technology and computer skills (Bowers). Arguments also recognize that HIPAA does not effectively secure employees’ health care when coverage is lost through unemployment due to failure to acknowledge the economic power of private interests (Stephen). Overall misunderstandings between patients and providers demonstrate a need to add amendments to HIPAA in order to make it more effective, but the basic guidelines that were put in place where necessary issues to be addressed.

    In addition to Medicaid’s mission to provide health care coverage to eligible low-income populations the Children’s Health Insurance Program (CHIP) was established in 1997 in order to cover low-income children who were ineligible for Medicaid. As of 2018 9.6 million children are enrolled in CHIP nationwide (“Children’s Health Insurance Program”). Extensive research has shown that Medicaid and CHIP have not only increased coverage among low-income children but that the care that is received is valued and utilized. The median percentage of visits to a primary care provider was 97%. These two programs combined have also provided a safety net during economic recessions and downturns along with reducing racial disparities in children’s coverage due to a significant minority percentage of enrollees (Paradise). Adding CHIP to federal legislation has been beneficial in supporting children during these critical times of critical psychological and physical growth. Other CHIP influenced programs such as Medi-Cal, which plans to be expanded to serve all undocumented children, will become more important in addressing public health issues for some states more than others (McConville et al.). The key issue that CHIP faces is federal funding for Medicaid and CHIP if funding decreases then this could lead to lower benefits or higher out-of-pocket costs (Ubri). This program demonstrates a need as it would leave many children and families vulnerable if there were any abrupt changes.

    The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) addresses an issue that impacted Medicare services. On average by 2004 Medicare beneficiaries were on average spending about $1,000 each year on prescription drugs. In order to adjust to current times, this act opened the option of coverage by price tiers for out-of-pocket expenses (“History of Healthcare Policy in the United States”). Based on the tier level of protection Medicare beneficiaries could then save from $1,700 to $5,900 on drug costs each year (“Fact Sheet”). The act allowed for reductions in premiums of 56%-84% as found by WellChoice, Inc., one of the largest health insurers in the State of New York, at the start of 2004 (Bohren). As the issue of out-of-pocket must have been addressed this act did not address the overall issue of continuously rising drug prices. As it is projected that the cost for prescription drugs will continue to rise and reach a value of about $1,600 in expenditures per capita it will become increasingly more important to open up this problem and address the issue at the source (“Why Are Prescription Drug Prices Rising”).

    In conclusion, federal health policies are bound to have different impacts from a state perspective however there are some consistent patterns that determine the impact federal policies have nationwide. CHIP is the most successful federal policy implemented that adds value to the existing federal program Medicaid. Both the HIPAA and MMA address key issues however in their implementation there are some key issues as they relate to their goals. Due to lack of clarity HIPAA’s main fault is in its impact on employer-based health insurance. Different interpretations of HIPAA’s guidelines can have varying impacts on employees with pre-existing conditions and an impact on job mobility. The MMA as it proves to be effective is only a temporary solution to the overall problem of rising prescription drug costs. Even though it benefits a population that is heavily impacted by the issue it is an approach that will continue to be strained in terms of funding. Therefore, CHIP is seen as the most successful due to its widespread demonstrated need in communities and its long-term impacts. By investing in children’s health care, it helps aid better growth and development while also possibly providing more stability within low-income households. CHIP is successful because it aims to help improve society by investing in it at a young age. More federal policies in healthcare should aim to address problems at the source of the issue similarly to CHIP in order to obtain the most benefit.

    Outside Sources Link: https://docs.google.com/document/d/1vvld6pGRXAdHyV7Vv9k35nYoVYcRQwQGdvcq0vzCUZA/edit?usp=sharing

    Lauren_Winston
    Participant
    Post count: 6

    E) The founding ideologies of America including freedom and individuality are the frameworks of our government along with our economic system. However, it must not be forgotten that these original ideologies were constructed with hopes to benefit only white men. Even with amendments that encourage inclusivity and condemn inequality across race and gender, the founding ideologies of the nation are persistent in advocating these goals for white men first and foremost. Throughout the 1619 Project, the most prominent stories and research that tie back to health-related issues can be connected through the national economy. I believe that factors that influence economic status can play a large role in a community’s health.

    In the 1619 Project America’s capitalistic economy was stated to practice “low-road capitalism” where “inequality reigns and poverty spreads.” Even though time has passed, as stated previously the founding ideologies of the government and economy have been able to become more overtly integrated into these systems. This American economy owes its economic rise to the cruel practices of slavery and the denial of slavery’s impact on black people.

    The American economy embedded the importance of materialism in society by using it to assert one’s status. American history shows that for many years land ownership was associated with political power and social status. As the economy developed other means of ownership, aside from land, became symbols of wealth and political power. Ownership of material goods are most often the other forms of displaying social status. The concept of materialism is amplified in the black community as black people were considered property for so long. Repercussions from this mindset have caused many within the black community to feel a need to prove themselves socially. In order to fulfill this, a culture of conspicuous consumption has been widely practiced in the African American community in order to prove oneself as equals in social status to their white counterparts. Despite having lower overall median incomes black people and Hispanics tend to spend 30% more than white people of comparable incomes on goods that are seen by the public, causing minority families to save less and spend less on all other areas except housing (“Conspicuous Consumption and Race”).

    By focusing on the purchase of material goods, it takes away from prioritizing what can be invested in oneself, from a perspective of wealth accumulation or in one’s health. Investing in materialism allows African Americans to avoid placing trust or seeking help in systems that have historically mistreated black people. The distrust has been gained through the countless unethical experiments conducted such as the Tuskegee syphilis experiment and even in modern day practices of racial bias in the perception of pain-tolerance causing the black maternal death rate to be three times higher than white women experiencing similar conditions (“Black & African American Communities and Mental Health”). Distrust is most prominently found in the stigmas around mental health treatment within the African American community. A combination of stigmas and access to proper health care cause only one out of three African Americans who need mental health care services to receive them (Mental Health Disparities African Americans). The impacts of America’s capitalistic culture that was based on slavery has an effect on the financial decisions that African American communities tend to make. Historical systemic maltreatment of black patients and barriers from healthcare such as exclusionary practices of denying employer-based insurance and misallocation of funds have further discouraged being advised and aided by the American healthcare system, especially in low-income minority neighborhoods. The culture of conspicuous consumption is not the fault of African Americans but is instead a habit that has been ingrained into this community by derivatives of a slave economy. In return, this impacts the finances of many African American communities.

    Along with the stressors of not being able to obtain adequate health care, due to financial reasons, payday cash stores disproportionately have negative impacts on lower-income African American populations. As they provide a way to have quick access to money their costs can outweigh the benefits. These negative impacts are prevalent in restricting financial freedom along with contributing to financial stressors. Six out of seven payday lenders cannot pay their principle on time causing them to pay high-interest rates on it for weeks or even months (Sweet et al.). One third to one-fourth of Americans who do not have credit scores use payday loans, both the population who is impacted by poor credit scores and those who use payday loans are more likely to be low-income people of color in urban areas (Sweet et al.). The concentration of payday lenders is consistently found to be in minority neighborhoods and in those that are considered financially vulnerable, making it easier to exploit these populations (Ilan Guedj). Furthermore, biomarkers of risk factors and poor-self reported health are more likely to be found in payday loan users in a comparative study (Sweet et al.). Even though the correlation between health and use of payday loans could be linked to other covariates the relationship between financial security and health is still prevalent and should not be ignored.

    Overall, the construction of the American economy was not meant for providing financial security for black people. After the economy was built off of commoditizing black people, racial tensions post-slavery attempted to restrict African Americans from gaining any sort of political power. To do so this meant enacting policies along with regulation at all levels of government that jeopardized the financial success and general health and well-being of African Americans. It has been recognized that people with lower incomes have higher rates of heart disease, diabetes, stroke, and other chronic disorders when compared to wealthier Americans (Woolf). Financial matters of wealth, income, land ownership and access to credit play a role in the health of a community. America’s attempts to discourage the upward mobility of black people have been controlled by history. The ties between race, finances, and health play in society have not been adequately addressed in order to build a stronger relationship of trust between the black community and the healthcare system.
    https://docs.google.com/document/d/1vvld6pGRXAdHyV7Vv9k35nYoVYcRQwQGdvcq0vzCUZA/edit?usp=sharing

    Bryant_Dean
    Participant
    Post count: 2

    I do think that hospitals and healthcare facilities should make a concerted effort to employ ex-prisoners that show they really have the desire to help those in need. I think this should happen because it’s a better way for both parties to benefit from the unfortunate circumstances that ex-prisoners are forced to experience due to the discrimination they face upon re-entering the world from prison. So many individuals want to get back into thirst lives and they aren’t allowed to which isn’t my fair. I believe many other industries should do the same thing, including the healthcare industry. Obviously, there would need to be some limitations to the process that could gradually de-escalate as the employees make progress. The main concern would be the pure ability to complete the job, due to the fact that they would need the proper training in order to do so which should be included in the effort as an entirety. There are a number of companies that have and continue to hire ex-prisoners including the Blue Cross & Blue Shield Association a company in the healthcare industry. However, for me, it doesn’t stop at just hiring them but allowing them to flourish in the workplace and supporting them as much as you would any other individual there. Giving ex-prisoners a second chance at life is the care minimum we can do for people who have paid their debt to society.

    The idea that whites wanted to keep African Americans just healthy enough o do their slave work, but not enough physically or mentally to overcome the oppression they were faced with ties to health-related issues for us. Malnutrition was a notorious factor in the dire health of African Americans as well as not having access to medicines and their living conditions affecting them. I think it goes without question that matters of wealth, income, land ownership, and access to credit play a role in healthy/unhealthy communities. It can’t be overlooked that hospitals and healthcare facilities are businesses as well just like those of other industries like retail, automotive, etc. Therefore, there will always be some type of financial barrier between those who can afford care and those who can’t, no matter the magnitude of said barrier. The advantage of payday cash stores is being able to get access to funds you might desperately need in order to move on until you’re next source of income comes in, but a terrible disadvantage is the fact that the consequences behind not being able to pay that money back will last far longer than that loaned money ever will for the person using it.

    Taylor_Hamilton
    Participant
    Post count: 4

    D) One can conclude that more people of color are affected and dying from chronic diseases in America. Even further people from lower socioeconomic are affected at large as well. This can be for a variety of reason and I believe has to do with income and the food and services that they can afford. People of color in lower income communities have less resources to get healthier options of food. Many times, we see people of lower socioeconomic status consuming a lot of processed foods and a less balanced diets. Things such as fruits and veggies and home cooked meals just not be practical for lower income families, fruits and veggies are more expensive than some options of things such as frozen or fast foods. The death rate due to chronic diseases may have to do with the medical care that people of low socioeconomic lack or able to afford. Many times, medical bills are very high, and in areas of poverty it is more difficult to find facilities that are specialized and provide the best care. The prevalence of chronic diseases in low socioeconomic communities of color are due to income and the resources available in their communities.

    Arrington_Ervin
    Participant
    Post count: 2

    d) If one reviews co-morbidities of chronic diseases (hypertension, diabetes, asthma, obesity, etc.) and their associated mortality rates across the 50 United States – to what conclusions can one come? What social-economic determinants are driving those situations?
    After checking the CDC’s “Leading Indicator for Chronic Diseases and Risk Factors” portal, it was present that in the Southeastern region of the United States, as well as Texas and Oklahoma, that co-morbidities of chronic diseases were most prevalent in these areas, with the Western side of the country consistently being lower. With these statistics, I can draw the conclusion that the South has citizens who lack the economic and financial means to make themselves healthier or receive assistance. The Southeastern region has always been a rural area that centers their economy around agriculture and farming; this was evident during the 17th and 18th centuries where the world’s top product, cotton, was being manufactured from this area only. After the emancipation, many slaves and farmers remained in the South to find work near an area their comfortable with rather than having to migrate North. Although, this also led to the isolation of previous slave owners from their past workers and the segregation of colored people from the rest of society, this led to the lowering of the unification of Southern cities. With the lack of density and population, the Southeastern region never became the urban landmark like that of their Western, Mid-Western, and Northeastern counterparts. As a result, the South possesses more people who may not have access to healthcare offices due to the location of their homes, making chronic diseases more prevalent in these areas.

    e) How do the stories and research that supported slavery mentioned in The 1619 Project tie to health related issues for African-Americans today? Do you think matters of wealth, income, land ownership and access to credit play a role in healthy/unhealthy communities? What advantage/disadvantage do payday cash stores play in today’s society?
    With help from the stories explained in The 1619 Project, we can conclude that African Americans were forced to become second class citizens to that of our white counterparts, causing a strain on black lives even to this day. As the United States declared their independence, “our” founding fathers, Thomas Jefferson in particular, envisioned a country where “all men are created” and each person is “endowed by their Creator with certain unalienable Rights” unless you were black. African Americans in the country were seen as inferior to that of the white race, leading to the continued enslavement and discrimination of our people. The economic and political systems that ran the country at the time were primarily focused towards keeping the white people in power and the black people in captivity. Due to the lack of concern over the course of 400 years from the government, African Americans carry burdens that no other race in America does. In today’s world, African Americans are more susceptible to viruses and various other illnesses simply because of their socioeconomic status and proximity to other individuals. According to WebMD, African Americans live in areas that tend to have poor air conditions, causing lung disease and asthma, African Americans respond to blood treatment differently than those of white people, leading to high blood pressure and heart disease, and African Americans are more likely to contract, and die, of diabetes than that of white people. Areas that lack individuals with substantial amounts of wealth and income tend to be areas that suffer from more illnesses, due to the fact that they lack the funds in order to finance treatments; plus, if these low income areas are faced with a virus, like CO-VID 19, it will attack them harder and faster since the people of these areas are, in fact, closer in proximity. Land ownership and credit play an additional part to the problem as well since those who do not possess land or property and have bad credit receive no additional help from insurance companies and the government, allowing for more sick people to roam the city rather than be in their own property isolated from the rest of the community. Individuals might combat their bills using payday cash stores which help tremendously the day of, but over time, I feel as though it will only hurt individuals financially due to high APRs, increasing interest and making it much more difficult to pay off the loan, stated on Self.inc.

    Lauren_Dones
    Participant
    Post count: 3

    b) Can you draw a distinction between equality & equity with regards to healthcare? How do elements of From Separate to Equal and The1619 Project exacerbate the issues? What are the solutions?

    I think it is important to understand that not only do all people deserve access to quality healthcare in an equally distributed way, but it is imperative that leaders in all aspects of healthcare, whether that be from policy making to bedside nursing, should fully represent all members of society on all levels. This is important because in order to ensure that our leaders are advocating for the reform of all issues faced as it pertains to the American healthcare system, we need informed and diverse perspectives. Equity is important in order to level the playing field so that all people can equally benefit from opportunities. From Separate to Equal and The 1619 Project give us examples of how issues of equality and equity are exacerbated by systems put in place that make it extremely hard for black people to not only have a seat at the table, but to also be listened to and considered. For example the film exposed some of the obstacles black doctors had to endure in order to receive the training that they required. Going forward, the solution is to make sure that we not only work to provide wide-spread, equal access to quality healthcare, but that we also remove, through task forks, community liaisons, etc., obstacles previously put in place that make it hard for people to get the most out of their healthcare experience. Lastly, we need to see a national requirement that permanent systems be put in place, which critically evaluate the presence of bias in healthcare.

    e) How do the stories and research that supported slavery mentioned in The 1619 Project tie to health related issues for African-Americans today? Do you think matters of wealth, income, land ownership and access to credit play a role in healthy/unhealthy communities? What advantage/disadvantage do payday cash stores play in today’s society?

    The stories and research from The 1619 Project broadcast the many obstacles African-Americans face, as well as explain the reasons many mistrust the healthcare system. A few of the articles even explicitly highlight the presence of bias and miseducation of those currently working in the field of medicine on the differences between African-Americans and whites, which originates from a deliberate effort to teach that the white race is superior in many ways. Of course individual economic situations play a role in the health of communities. Healthcare is not free, and at the end of the day it comes down to who is going to pay for it. Those who have to pay out of pocket or simply do not have the funds are going to be deterred from being proactive in seeking out treatment. Ultimately, this does cause low-income communities to be among the sickest. The advertised benefit of payday cash stores is that they provide loan options for those that have little or no credit, and in a short amount of time, a borrower can walk out of a store with a cash advance. Unfortunately, payday cash stores are aware that the majority of their borrowers will be unable to repay their loan in full by the next pay day, and they exploit their borrowers by issuing high interest rates in order to make a large profit. The financially stretched then find themselves in a cycle of debt that often greatly exceeds their original loan.

    Miniya_Williams
    Participant
    Post count: 4

    Written response #1:
    (d) If one reviews co-morbidities of chronic diseases (hypertension, diabetes, asthma, obesity, etc.) and their associated mortality rates across the 50 United States – to what conclusions can one come? What social-economic determinants are driving those situations?

    This question was most appealing to me due to my background in research on vigilance and cumulative biological risk through the University of Michigan Institute for Social Research. Vigilance (or vigilance coping skills) is defined as the thought of as the natural response to and marker of the burden of cultural racism. However it is presented as self correcting in white space. Preparing yourself for what you will do or say in the likelihood that you are pulled over. This appears when you fear to be called out for your blackness in white space. This is experienced as the pressure to be perfect at everything and perform with excellence. All of these are real life examples that many of us can attest to. On a biological, psychological, and psychological level these levels of vigilance all have a major effect. What suffers most, is your health. As it relates to co-morbidities of chronic diseases (hypertension, diabetes, asthma, obesity, etc.) and their associated mortality rates across the United States, I would be remiss if I did not mention race. More specifically, the affects and effects of systemic racism. Affect, refers to the actual structure and strategy used to construct and implement [systemic] racism. This includes a social, cultural, political, and economical uphand for white people (specifically white males, middle class, and Christian) by default, because it was created by them. Effect, refers to the disadvantages and outcomes present in Black and Brown communities. For example the COVID-19 pandemic, disportionality affects Black and Brown people (effect). This can be attributed to food desserts, lack of access to healthcare, environmental racism (i.e incinerators, pollution, Cancer valley), vigilance, lower wages inducing stress, and this list goes on (affect). I confidently can state through my research, the research of other scholars, and my personal narrative that [systemic] racism is just as much a threat to our health as cancer. It is also relevant to note the social-economic determinants of these situations as well. As referenced in The 1619 Project, the lack of healthcare attention and coverage is a major factor in the past and current health state of our community. Cost makes healthcare exclusive and unobtainable still for many. Additionally, on top of costs the historical relationship with healthcare professionals and the Black community has been distrusting. Therefore, this provides another understanding as to why our interaction with healthcare professionals is limited.

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    Daniel_Searcy
    Participant
    Post count: 2

    A) Should hospitals and healthcare facilities make a concerted effort to employ ex-prisoners? Why? What might be some of the constraints? Has anyone been successful at such a hiring practice?

    Yes, hospitals and healthcare facilities should make a concerted effort to employ ex-prisoners. This addresses socioeconomic factors that impact their well-being. Ex-prisoners can better take care of themselves when they are employed, especially if they have medical benefits. They won’t be a burden on the state or go back to crime. Some constraints to hospitals hiring ex-prisoners are state and federal regulatory restrictions, fear of liability, a prisoner’s lack of sills and experience, and certain types of convictions, for example, sex offenses, violent felonies, and crimes against children. Some examples of hospitals that have been successful in implementing this method are the Sinai Health System in Chicago, John Hopkins Health System in Baltimore, Henry For Health System in Detroit, and the Metro Health and University Hospitals in Cleveland.

    C) The 1619 Project made reference to the Bureau of Refugees, Freedmen, and Abandoned Lands (Bureau of Freedmen). What other 2-3 federal healthcare related policies have been enacted by the U.S. government since 1865 to 2010? Which of those policies have been most successful?

    Three healthcare related policies that have been enacted between 1865 and 2010 are Medicare in 1945, Medicaid in 1965, and the Affordable Care Act(ACA) in 2010. Medicare and Medicaid have been very successful while the Affordable Care Act has not been as successful because the Republican Party has been passing legislation to reduce its effectiveness. Medicare has been providing insurance coverage for almost 50 million Americans. Medicaid provides insurance to low-income individuals. It covers almost 70 million Americans today. In 2014, it reimbursed hospitals for almost 50 percent of all medical expenses. It has also lowered the nation’s uninsured rate to under 9 percent, which is the highest coverage in U.S. history. The Affordable Care Act requires most U.S. citizens to apply for health insurance coverage with a penalty for those don’t, with an exception for a few protected groups. Companies that employ more than 200 people must provide health insurance coverage. Because the Affordable Care Act was enacted by our Black President, Barack Obama, from the Democratic Party, the Republican Party has been trying at every turn to dismantle it.

    Martin_Searcy
    Participant
    Post count: 2

    B) Equality means providing the same treatment to everyone and the same distribution of resources. Equity means providing the right amount of treatment and resources to each person, to make everyone reach their best health and potential. From the prompts, We are able to know that they exacerbated the issues because even though the two different hospitals may be getting the same amount of resources, they would still be unequal. For example, if all the white people are going to General hospital #1 and are not getting hypertension as much as black people, then when it comes to distributing even resources to general Hospital #2, the African Americans would not have enough resources to treat hypertension because more black people get hypertension than white people. A solution to this problem would be to give each hospital the sufficient resources that they need to be successful and to treat all their patience, depending on how many patients they have and who their demographic is.

    D) As opposed to their white counterparts black people are more likely to have co-morbidities of chronic diseases because of average lower-income earned, lack of access to fresh foods, they have more stress in their life, low access to good quality healthcare,and they tend to live in the worse parts of cities where there are pollutants. The conclusion is that black people are more likely to die at a younger age because of co-morbidities of chronic diseases than white.

    Taylor_Hamilton
    Participant
    Post count: 4

    E) Throughout the “1619 Project” it is widely discussed that during the time of enslaved blacks in America was crucial as it built the American economy at large. Owning property, land, and slaves put white individuals at a higher economic position. As enslaved black people were not considered as human but rather property, because of this black ultimately built a large portion of the early American economy with the free labor on plantations around the country.
    At the end of slavery black individuals were faced inequality of economic opportunity. What now we can consider African Americans were thrown out into society without any resources to strive economically. The African Americans that did not directly enter society as others did started their free lives off as share cropping which ultimately was slavery and in fact put many African Americans into debt. During the period where we saw many African Americans going into share cropping they worked in order to have food and other goods but the longs day of work would not cover their housing, causing them to owe plantation owners an abundance of money.
    I think the transition from a life of slavery to a life of freedom put African Americans at a great economic disadvantage that persist to this day. Because of not having the opportunity to have economic equality many African Americans have been forced into poverty and modern-day slavery through low paying jobs and pushed into the New Jim Crow through mass incarceration. This ultimately has put African communities in more and more debt and poverty. With the health of these communities are negatively impacted as they cannot afford the resources to live healthy lifestyles.
    To conclude all these ideas, the attitudes towards blacks during slavery and the lack of resources during the transition to free life has ultimately as a whole put African Americans at a disadvantage. Because of this putting these communities more and more in dept not allowing them to have they desirable credit that plays a large role in our American lives. Living in poverty does not make having a healthy life be one of your top priorities as most in those communities are honestly trying to survive just by having just the bare minimum things to survive.

    Miniya_Williams
    Participant
    Post count: 4

    Written response #2:

    (e) How do the stories and research that supported slavery mentioned in The 1619 Project tie to health related issues for African-Americans today? Do you think matters of wealth, income, land ownership and access to credit play a role in healthy/unhealthy communities? What advantage/disadvantage do payday cash stores play in today’s society?

    This response parallels my previous response in the sense that both will be examining systemic racism factors of influence that contribute/have a relationship with African-Americans health related issues today. The stories and research that supported slavery as accounted in The 1619 Project, have a direct correlation to health related issues in the Black community today. On a psychological level, the treatment during enslavement is enough for the body to internalize, embody, and genderationaly transfer. This phenomenon is known as epigenetics, or the passing of trauma. This imprint begins when a child is conceived, is modeled through their environment (socialization), and is underscored when they are introduced to society. Hence the neglected mental health issue that is ever so present in our community today. It’s a very interesting concept actually because for Black people in particular epigenetic appears as an imprint reaching back as far as enslavement. Meaning that trauma still lives in us. All the horided and inconceivable heinous acts have been passed down through our DNA. Also, it is important to note that mental and physical health related issues have a strong tie to one another. Meaning depression and diabetes aren’t too far from one another when it comes to their origins. I completely agree that wealth, income, land ownership and access to credit play a role in healthy vs unhealthy communities. Being established and living the ‘American Dream’ is the optimany of success in this country. For those living it matters of finance and health (access and condition) or less likely to be a factor in their everyday lives. For the have nots, the constant reminder of the unachievable “American Dream” can be daunting itself. Let alone the intersectionality of financial responsibility and personal health (both mental and physical) makes life even more difficult. The 1619 Project also premiered the residuals of financial fallacies and disadvantages. Modern day payday cash stores can be found by the church and liquor store down the street. They are strategically placed in our communities to appear as handouts. However, I can not stress enough the capital gain in which the loans provide these businesses. “Making the richer richer and the poor poorer.” Payday cash stores enforce debt due to their extremely high interest rates. For a single parent in today’s society living paycheck to paycheck the large font and inviting colors of the establishment may look inviting however, this is an example of wealthy people preying on the desperate. Back to my point on the structure of systemic racism, it is not by coincidence that you would not find payday cash stores in the suburbs. This is due to their access to knowledge around finance that the African-American community does not receive.

    Carlos_Silva
    Participant
    Post count: 2

    a) Should hospitals and healthcare facilities make a concerted effort to employ ex-prisoners? Why? What might be some of the constraints? Has anyone been successful at such a hiring practice?
    I believe that a potential answer to this question requires a complex and multi-layered response. Multi-layered because there are many aspects that are important to consider when raising this question such as the application process, the competitiveness of the job market, the history of this country’s judicial system’s targeting of minorities, the personality and credentials of all applicants, etc. However, I do believe that our society should strive to offer worthy ex-offenders second chances so as to improve their lives and the overall wellbeing of their communities.

    Firstly, as in any hiring process, the employer must inspect and consider the qualifications and character of each applicant. In a healthcare facility, where many employees are tasked with taking care of patients, selecting the most reliable candidate for an open job position is imperative. This is where the competitive nature of job applications comes in. Realistically, if it came down to choosing between a convicted felon and an applicant with a clean record, the majority of employers would prefer to hire the candidate with the clean record as that choice oftentimes appears to be the more reliable and less risky choice. However, it would be ignorant to not look further than the word felon on an application when considering an applicant.

    In order to be more just, we must consider the makeup and history of this country’s justice system and how it reinforces the construction of systemic racism in these United States. According to a monthly census by the Federal Bureau of Prisons, roughly 46% of current prisoners are serving time due to charges regarding illegal drug usage. Of this 46%, the overwhelming majority consists of Black and Latino inmates. Of course, this is due to the ongoing “War on Drugs” and the systemic oppression of America’s lower income minority population. Now, of this demographic, more likely than not, the majority are not dangerous criminals with tendencies of violence but rather targeted minorities who have been born and raised in a country that has always been in an undercover war against them. Many of them may be decent candidates and deserving of a second chance, however, it is oftentimes difficult for employers to be this optimistic when selecting a job candidate because it is human nature to run with the safer choice.

    Thus, in theory, were I in the position of hiring an individual with a record, aside from inspecting the necessary credentials for the position such as experience, education, and character, I would also consider the nature of their accused crime. If they were incarcerated for something such as possessing a small quantity of marijuana, as an employer I would be much more lenient than if they were charged with a more serious and even violent offense. In conclusion, many of these individuals who are ex-prisoners more than likely have the capability and potential of being great employees, but I believe it would be foolish to completely ignore the severity of an applicant’s criminal history when hiring in a healthcare facility.

    An example of a center that has had a successful experience hiring ex-offenders is the Johns Hopkins hospital in East Baltimore, an at-risk neighborhood. More information on their hiring system can be found at: https://www.diversityincbestpractices.com/medialib/uploads/2016/09/Paulk-Presentation-Hiring-Ex-Offenders-09142016.pdf

    d) If one reviews co-morbidities of chronic diseases (hypertension, diabetes, asthma, obesity, etc.) and their associated mortality rates across the 50 United States – to what conclusions can one come? What social-economic determinants are driving those situations?
    In our society, it is much easier and more affordable to eat processed and unhealthy foods than it is to buy organic ingredients and go through the process of cooking meals and considering aspects such as nutritional value. Quite frankly, a huge percentage of Americans are not able to afford such “luxuries” as eating healthily consistently. For this reason, for the first time in human history, it is the lower class of society that is becoming increasingly more obese rather than the upper class being overweight, as was often the case in ancient societies before the invention of ready-made processed foods.
    In grocery stores across the United States, processed foods are often displayed in larger quantities and at lower costs than their organic counterparts. Sadly, there are even cases in which families are only able to afford fast food meals such as the dollar menu. The consistent consumption of such foods are proven to cause unhealthy weight gain and put the individual at a higher risk for diseases associated with weight and improper nutrition. Obesity and diabetes are two examples of chronic diseases of epidemic proportions that are plaguing many of the people of our nation. Although, obesity and the previously stated diseases are prevalent in all socioeconomic classes in American society, it is no coincidence that low income families and individuals are the most affected and at risk.
    Finding a solution to this issue is very complicated. Firstly, there are multiple culprits that enable this problem to persist and greatly benefit from this such as the corporations that make up a large portion of the food industry. Secondly, many Americans are ill-educated in this field and even if they were better educated, if they are not able to afford healthier alternatives, what then can they do but continue to consume what they can afford? With everything else going on in our nation today, this issue rarely receives the coverage that it needs, but awareness and education is always the first step in combating an issue such as this one.

    Douglas_Burnett
    Participant
    Post count: 3

    d). It is not undenounced to anyone that chronic illnesses plague Black communities at an alarming rate. Much of this can be associated to poor eating habits, but it is important to note that unhealthy eating habits are derived from a form of systematic oppression. The media and, at times the health care industry make an attempt to equate the illness the Black community experiences via chronic illness with a poor diet. It is vitally important to note that Black people’s food is just as unhealthy or even healthy as any other race. Certainly, the food may be different, but the health benefits of them, whether good or bad are synonyms amongst many ethnic groups, but the media and society make a special attempt to note that our ethnic cuisine is nearly the most unhealthy. Many eating habits of Blacks are derived from historical roots of slavery. At most times slaves were essentially given the left overs from the live stock and poultry; therefore they received poor cuts of meat and scraps from the poultry. This particular eating habit lasted for nearly hundreds of years; as long as slavery was prevalent. As we catapult into todays society we still indulge in some of those same eating habits which has led to chronic illnesses like, asthma, diabetes, and obesity. Coupled with the harsh reality of the unprecedented terms of food disparities within Black communities; often times low-income or poverty stricken areas. Many succumb to the horrid circumstances of food desserts; where there are no outlets or nearby resources to obtain healthy food. Much of the aforementioned can be equated to systematic racism; which essentially creates a continuous cycle of oppression and sickness. This harsh reality is quiet astonishing and assures me of my desires to be an advocate for topics like this. A significant amount of lives have been lost because of the health disparities; a result of systematic racism has led to this atrocity.

    Resource Link: https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareFinancingReview/Downloads/00Summerpg75.pdf

    e). AS mentioned in the previous post, systematic racism is the harsh reality of much of the plight of Blacks, especially due to health issues. I am quite certain that class and wealth contribute to equity within the health industry. It is inexpressibly hard to gather the appropriate emotions to explain how heart broken I am to witness us a race be disadvangted in a conutry that we literally built from the ground up. As it regards finances in the Black community; we have an enormous buying power, but only occupy a quite small fraction of the ownership class. Good credit and access to the appropriate resources permits one with keen resources especially related to health care. The cash advance facilities located in low-income areas that are particular occupied by Blacks only set us back and place us in unprecedented amounts of debt which leads to poor credit.

    Lauren_Winston
    Participant
    Post count: 6

    Hi Mariah and thank you for helping me clarify this point I appreciate it! Yes I agree that racism is intentional, I was referring to the illogical reasoning that is commonly found in the attempts to justify racist actions and beliefs.

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