There was so much controversy about passing “Obama-care”, officially known as The Affordable Care Act, but after all the dust has settled, there is no improvement in the health disparities between people of color in America and white Americans. Healthcare policies were written by those who were ill-equipped to address the issues that poor un-insured people face. Disparities occur in the quality of care received (Care by Provider) even when income, health insurance and access to care are taken into account. Patients from racial and ethnic minorities often fare far worse than their white counterparts on a range of health indicators: life expectancy, infant mortality, prevalence of chronic diseases and insurance coverage, among others. We also know our health is influenced by more than what happens in a health care setting. Our health is influenced by the conditions in which we live, where we work, where our children play (Care Needed due to Circumstances). Those social determinants of health play a significant role in contributing to health disparities.
A year ago I attend a Pri-Med conference in New York City which is a primary care (internal medicine) conference. There were all of the Northeast medical institutions represented with professors paid to teach the latest and greatest American Medical Association decision about “ standard of care” in the land. There were holographic presentations from prestigious university medical school. The case study was of a 62 year old black American woman with diabetes, obesity, hypertension and early signs of cardiac and renal pathology. The panel's general attitude was that the patient “did not want to change her health status”.
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