[Lauren_Winston]

in reply to: From Separate to Equal and The 1619 Project #795

Hi Whitney this is a comment to your Question 1 response. I believe something else could come out of this initiative since as you said it involves taking care of a vulnerable portion of society. In doing so, it could also restore a sense of humanity to ex-convicts that feel as though their humanity was taken away from them in the prison system.

[Lauren_Winston]

in reply to: From Separate to Equal and The 1619 Project #794

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.

[Lauren_Winston]

in reply to: From Separate to Equal and The 1619 Project #781

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

[Lauren_Winston]

in reply to: From Separate to Equal and The 1619 Project #780

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]

in reply to: From Separate to Equal and The 1619 Project #747

The 1619 Project Response
After reading The 1619 Project I felt as though many times throughout the reading I was troubled or disgusted by the vivid stories that were told about the cruel nature of America’s history. The feelings of pain and suffering alongside perseverance and hope within this work were encapsulated within the various stories told about the past and the present. Overall, this project was a story that highlights the push towards agency and claiming the black experience as an African American.

The idea of freedom was one of the most prominent concepts I found throughout the magazine. The most basic ideology that America was supposedly built on has only begun to flourish because of the suffering of black Americans. Whether it is in relation to the building America’s physical, economic, or social constructions they all have their roots in slavery. These are the ties that restrict America’s progression as hegemony continues to covertly perpetuate the basic ideals of oppression into modern times.

There is a continual fight within America’s society to perpetually deny the rights of minorities and black Americans specifically. This is because the founding vision for America was not to live in a society of equals, instead it was to acquire power amongst others. The division of racial groups within America allowed for an easy way to allocate various levels of power to masses of people. For centuries an attitude of blaming a group of people rather than the mindset of superiority within America has had grave consequences carried throughout modern times. I even found a passage within this magazine that inspired me to post on social media relating to the recent attacks on innocent black men and women regarding how Americans choose to “ignore the victimization of black people tagged as criminal.”

As this project states that “American capitalism was founded on the lowest road there is” and points out how America has the highest rate of incarceration worldwide, in order to extend dehumanizing practices, reflects how covert methods of systematic racism can be found in any American institution. In regard to the healthcare system, the claiming and protection of the black mind and body has yet to be achieved in the health policy and practices. Since the healthcare system consists of not only providers and patients, but also purchasers, payers, and policymakers it allows for the practice of covert racism through implicit bias or exclusionary thinking. These are critical to recognize in order to improve the care of black and minority populations. I believe that these multiple contributors to healthcare practices also allow for openings of opportunity. As representation in each of these branches increases and social awareness is gained about American society, there can be opportunities for reform and adequate care of minority and black populations within the healthcare system.

[Lauren_Winston]

in reply to: From Separate to Equal and The 1619 Project #746

From Separate to Equal Response
After watching the video, I was surprised to learn more about the black experience past the effects of housing discrimination or the development of 18th and Vine. Through the preservation of racial discrimination within the history of healthcare in Kansas City are stories of perseverance and community that triumph through greed, hate, and illogical thinking. The story of the Truman Medical Center tells a series of pivotal moments within the Kansas City area while contributing to the ongoing discussion about the impact of politics on healthcare.

Along with the many components of healthcare, a patient’s confidence within their system is a significant determinant of how effective services can be in providing for a community. The black community’s experience with a healthcare system controlled by white people put black people in a vulnerable position as a patient. Trusting a white system with one’s black body has been a risk due to the history of devaluing the worth of a black person’s life. However, the production of black health practitioners by Howard and Meharry Medical College brought hope to black communities and opportunities for black scholars.

While segregated hospitals developed in Kansas City the stories shared from General Hospital #2 reminded me of the stability needed in order to continue promoting change. The strong sense of community that existed among the staff was evident in the ways that they referred to their black colleagues as older brothers or mothers. Segregation within the healthcare system allowed for a strong and caring black community to emerge. It allowed patients to feel comfortable, safe, and inspired within this environment. Even though the staff of General Hospital #2 had to work with minimum resources, however, they were determined to provide their patients with the highest level of quality care that they could.

A few of the stories that irked me were the initial barring of black staff at General Hospital #2 and the presence of jail cells being established in General Hospital #2. The decision to prevent black staff from working at General Hospital #2 was argued as a point of racial inferiority due to intellectual incapability of serving as a nurse or doctor. In reality, it was not out of concern of the quality of care the minority person would receive, instead, it was out of fear of black people proving that they could rise to a similar position of intellectual power as a white man. Secondly, the presence of jail cells within the General Hospital #2, further promotes the criminalization of minority groups even in a space of healing. It elevates the superiority and benevolence of white people while expressing a political message that the lives of minority groups and people who have committed a crime are worth less than that of a white citizen.

All in all, I feel as though the health system within Kansas City demonstrates how healthcare has developed over time. However, it is also an example supporting the need to push for improving the quality of care for minority groups and underserved communities throughout America.

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