Health inequities by Professor Diana Paulin https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld Give one example from Sontag or Feldshuh (include page number) and relate it to one example or one claim from one of the supplementary materials (Washington, Goldberg, Onie, Harris). How does this perspective help us understand how structural/systemic or historic inequities shape their experiences and relationship to health/care, sickness, wellness, and caregiving? en-us 2023-10-19 15:14:03 UTC 2023-10-19 15:49:40 UTC hello@padlet.com Cindy Rodriguez cindyrodriguez10 https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754781198 - An example from Feldshuh that relates to the idea that Onie discussed in the Ted Talk is that those who struggle with poverty share the experience of heightened likelihood of illness and not having access to good healthcare, or healthcare at all. People who struggle with poverty are more likely to struggle with an illness/ not live a healthy lifestyle as the Ted Talk says because they cannot afford a healthy diet, or afford to be treated by doctor. In the play, when Nurse Evers first introduces herself, she talks about how the men will get access to free healthcare by signing up to get their blood drawn, Caleb in shock says, “You say, ‘free’,” and Nurse Evers replies with, “Yes, I did. The doctorin’s free and just as fine as any you can get with any kind of money” (Feldshuh 23). This is because it is something so new to them. The men have never had this luxury. Of course, this is a race and a poverty issue, however, it is also harder for the men to access healthcare because of their race, I don’t think this was as issue as highly talked about in the Ted Talk though. 

- “My grandpa he had insurance and he missed one payment and the Union Life took his insurance away and we couldn’t even get him a decent coffin to be buried good in” (Feldshuh 37). - another example of poverty and how it affects access to healthcare. This is not really healthcare though, this is more so after the fact, but it shows how those who struggle with poverty and struggle to make payments without any support cannot have access to basic resources. 
- “No white folk with money come around when my wife took ill or my baby was born sick” (Feldshuh 52).]]> 2023-10-19 15:17:55 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754781198 Diana Dinu dianad01 https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754781459 “it is perhaps not surprising that the newest transforming element in the modern world, computers, should be borrowing metaphors drawn from our newest transforming illness.” - Sontag, page 158

  • Onie talks about how important it is to prevent, rather than focus on treating a disease.
  • She refers to the deficiencies that caused many illnesses for people: nutritious food, water, a house, things that everyone thinks that are basic human needs, but not everyone has them. 
  • The importance of knowing a person’s background when trying to treat them.
  • The attention that is given to that person’s needs rather than focusing on just what medication to give them. 
]]> 2023-10-19 15:18:04 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754781459 Ryley Disner ryleydisner https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754781591
  • Sontag argues that the use of military or war-related metaphors, such as "AIDS as a battlefield" or "AIDS as an enemy to be conquered," (sontag) can reinforce the idea that those affected by the disease are to blame for their condition or that they are in a battle against society. 
  • Sontag uses language like “moral judgments” and “investigation of disease” that show justification for why people choose to not help people with Aids. Because its a marginalized group they can be left unhelped. 
  • Onie touches on the importance of addressing structural and systemic inequities in healthcare. She argues that health disparities are often rooted in social determinants of health, such as poverty, housing instability, food insecurity, and lack of access to education. People who are disadvantaged in these areas are more likely to face health challenges and inequities in healthcare.
  • Sontag states how metaphors and language can be used to stigmatize and marginalize people living with a particular health condition, in this case, AIDS. The war-related metaphors can perpetuate blame and discrimination.
  • "AIDS is a disease that cannot be understood without understanding that moral judgments, which are always present in our feelings about disease, are irrelevant to the scientific investigation of disease. The metaphorical resonance of the disease has been far more accessible to the public than the scientific facts." (Sontag)
  • Onie's perspective emphasizes that inequities in social determinants of health, such as poverty and housing instability, are key factors that contribute to health disparities. These inequities are systemic and often disproportionately affect marginalized communities, including those based on race, socioeconomic status, and other factors. 
  • “Reclaim that real estate and that time and to use it as a gateway connect patients to the resources they need to be healthy” Onie
  • “How is it that if for decades we had a pretty straight forward tool for keeping patients, especially for low income patients healthy that we didn't use it.. If we know what it takes to have a health care system rather than a sick care system, why don’t we just do it?” (Onie)
  • By combining these perspectives, we can understand that systemic and historic inequities, such as those related to poverty and sexual discrimination, shape individuals' experiences with health and healthcare.
  • These structural factors contribute to disparities in health outcomes, and addressing them is crucial for achieving a healthcare system that keeps people healthy and reduces these inequities. It's important to recognize that the language and metaphors used in healthcare and society can both reflect and reinforce these systemic issues and impact individuals' experiences.
  • It leaves them unable to get or afford healthcare, their situation, being discriminated against, living in poverty, homelessness, in an isolated community leads to a higher need for healthcare and a larger growing hole they are getting dug in. 
    • If we put more effort into health care, not just sick care, those communities will have hope of a better future, one where a trip to the doctor isn't a waste of time or money, one where they will be heard or cared about. They should be just as seen as someone who has more privilege. “Not measured by the diseases cured, but by the disease prevented.” (Onie)

    ]]>     2023-10-19 15:18:10 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754781591     Leon Dell'Era ldellera https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754782655 Preventing issues before they become issues

    “DOUGLAS. Penicillin won’t help them. It’s too late. The damage is done.
    BRODUS. It would stop them from getting worse… We’re giving penicillin to every other syphilitic in the country regardless of how many years they’ve had the disease” (Feldshuh 87).

    “WILLIE. You try to understand me. That penicillin would have made it so I could walk without pain and maybe even Jackspring. And they didn’t give that to me in Birmingham because you pulled me out of that line so I could be a part of Miss Evers’ Boys and Burial Society” (95). 

    In Onie’s TED Talk (“What if our health care system kept us healthy?”), she went over how people go to get help at the crisis point, not when damage could have been prevented. People need safe, consistent homes and nutritious food, but noticeable problems pop up when the problems boil over. 

    • Like with syphilis in Miss Evers’ Boys, public health (and social) issues are better fixed at the root. Not waiting until they’re killing the person. 
    • “EVERS. We used to tell the men that this disease had three parts: you get it, you forget it and then you regret it twenty or thirty years later when it comes back to haunt you” (93). 
      • They had the opportunity to treat the men (albeit with mercury and arsenic) over a decade before they were dangerously symptomatic, but didn’t. 
      • Didn’t help them for own personal gain.
    ]]>     2023-10-19 15:18:50 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754782655     Lianna Morrison lmorriso5 https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754783753
  • Individuals should always be appreciated and treated fairly when being cared for. Respect was disregarded in the movie Miss Evers' Boys because instead of the men being respected for being in the study, they were treated poorly by not even being told they were participating in a study. 
  • Talk about how the white people's money and the government are spending money on the black community, and it was said in a condescending way.  
  • There were so many unethical components that came to the Tuskegee experiment, and one of them was the racism faced during the experiment and the ignorance many people had. When it comes to finding a cure, it cannot be done with limiting resources, specifically money. However, for Douglas, they had “a perfect laboratory here: a fixed population, virtually untreated disease. A study could be created and carried out with minimal expenses.” (Feldshuh 40) For many Caucasians, there has been in-depth research on how diseases affect them, and although Douglas and Evers wanted to do the same thing, the significant difference with this experiment was the resources they had for the experiment.  
  • Quote: “What if it proves that N*gro and Caucasians are equal? That the disease affects both races in exactly the same way?” (Feldshuh 41) --> Overall page 41 talks a lot about the disease and how it applies to both races, and overall, all races, how it is not confined to one race but rather was seen as “god’s disease” 
  • “You’re a government patient.” “I don’t want to be no government patient no more.” (70) 
  • “Especially as to race, this matters a great deal because American histories of public health and medicine are saturated with the pernicious belief that race is an inherent cause of all manner of diseases and susceptibilities.” (Law’s Hands in Race, class, and health inequities 271)

    • ]]>     2023-10-19 15:19:37 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754783753     Genet Tewalt gtewalt1 https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754784789 “AIDS is such an apt goad to familiar, consensus building feathers that have been cultivated for several generations” (151)

    - Sontag’s excerpt focusing on the social impact of AIDS made me think of how detrimental the stigma was for impoverished communities. 

    -Black gay men were among the most shunned and ostracized at the height of the pandemic. I think, for the disease to become a national headlining crisis, these men were exposed and therefore even more vulnerable. 

    -The AIDS crisis was an example of a disease becoming everyone's problem out of fear even though a minority group mainly was affected. I then think of how these black gay men received care during such a violent and isolating time. 

    -It wasn’t until Rebecca Onie’s TedTalk that I thought about how basic shelter, education, and food are essentially treatment. However, for such a marginalized group, I can assume that the infected men’s access to such basic necessities was limited. And it was limited out of the hysteric fear of the general population. 

    -The uneducated care takers treated men with AIDS poorly and the public believed that AIDS was a product of God's disapproval for not living by his rules. And so these men were not received with concern or care, but with fear and resentment. 



    ]]>     2023-10-19 15:20:17 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754784789     Illness: Biological or Social? eschaffe https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754784975 Sontag addresses the fact that illness is not perceived as a strictly scientific reality. Culturally and socially, illness is perceived as more than a physical experience given its ties to morality, morals, and religion. Evident during the AIDS epidemic, the disease was thought to be “God's judgment on a society that does not live by His rule.” (Sontag 149) By associating SIDS with moral mishap, it framed disease as a moral issue and not a medical issue. This led to the stigmatization of the illness and drove the social ignorance of not seeing the disease as a scientific, not moral, matter.  Given that during the AIDS epidemic the illness was politicized as a moral issue, the government was late in responding to it as a public health matter. 

    AIDS was referred to as the “gay plague” due to the association of the diseases with the LGBTQ community. Similarly, syphilis came to be known as a “black disease” due to its association with the African American community. Such characterization of the illnesses stigmatized their related identity groups and took attention away from the fact that both illnesses were biological in nature and not dependent on a person’s race or sexual orientation. Given the discrimination which exists for African Americans and LGBTQ individuals socially and in public and healthcare policies, both epidemics were treated as 2nd class issues and consequently with less urgency.

    Public health matters are best approached earlier rather than later. Rebecca Onie's TedTalk, speaks to how the healthcare system is reactive, but not proactive. Although robust in responding to pressing health matters, the system is not good in preventing them in the first place. In the case of the AIDS epidemic, the public health system reacted to the disease instead after its immense spread and impact on society. Had the public health system been more proactive to its initial outbreak, the epidemic could have been contained. Although there are several factors which impact why the healthcare system is reactive, in the case of AIDS it can be credited to the fact that the illness was not perceived by its full strengths given its moral associations. Epidemics often target underserved and marginalized communities. 

    In her TedTalk, Nadine Harris explains how people who experience ACES have weaker immune systems to their counterparts, thus making them more vulnerable to epidemics. ACES are exacerbated by lack of resources and societal discrimination. The linkage between those with high ACE scores and higher vulnerability in epidemics is a mirror revealing how inequities can impact one's health.




    ]]>     2023-10-19 15:20:24 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754784975     zofiasargent https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754788590 • What does this quote from miss Evers boys mean; I just want to tell the men what’s going on. The straight truth. “There’s no mercury in those back rubs. They won’t stop the bad blood. But you got to stick with it so when new money comes you’ll be right up front first in line (Page 55)
    • In this context, the quote reflects a complex ethical dilemma. The character wants to be honest with the participants about the limitations of the medical study, while also acknowledging the potential future benefits that may come from their participation. It raises questions about the ethics of medical research, informed consent, and the well-being of the participants
    • Will they tell the patients or keep this information from them? What is in the best interest of both of them?
    • Doctors aren’t trained for treatment because childhood trauma isn’t considered a real illness. Although they quite literally change our physical bodies and our physical health. Stats prove lung cancer and heart disease are greater with depression than other physical health causes showing it’s an actual health issue.
    • These experiences are not always considered real health problems. 
    • Things like childhood trauma and depression need to be considered more like real physical health issues because they can seriously effect your physical health sometimes even worse than other physical health issues]]>     2023-10-19 15:22:34 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754788590     Eva Gennrich Arias evagennrich https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754794873 WILLIE: You try to understand me. That penicillin would have made it so I could walk without pain and maybe even Jackspring. And they didn”t give that to me in Birmingham because you pulled me out of that line so I could be a part of your watching while I wake up past midnight not feeling my legs or else feeling pain,  burning pain like a hot iron pressin’ on my skin, ‘til I shout, “Take ethos pain away Lord, please take this pain away.” My body was my freedom. You hear me? MY BODY WAS MY FREEDOM. Page 95

    This made me think of the TedTalk “What if Our Healthcare System kept us healthy?” by Rebecca Onie. She discusses the possibilities of care as health care instead of sick care - in other words caring for people while they are healthy to prevent sickness, rather than treating the sickness. The above quote from Miss Evers’ Boys demonstrates the result of the men being refused medicine so they could be part of a study without their knowledge or consent. Miss Evers may have done this without ill intention as she was told by the doctors that if they did not do this the men they were caring for would not come back when they had money to care for them once again. This quote also reflects the racial element of these black farmers not trusting the white doctors, at least not right away. For Willie, trusting the white man ended up in him losing his freedom as he was denied penicillin that would cure his “bad blood”. 

    ]]>     2023-10-19 15:26:24 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754794873     Miss Evers' boys in relation to Rebecca Onie's ted-talk rchakrab1 https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754798230 An example that I found especially relevant to Rebecca Onie's Ted-Talk's in Miss Evers' boys was how syphilis was considered to be an inherently "negro disease" (Feldshuh et al 41).
    • This ties into a critical aspect of what Onie touches on, which is how certain communities get associated with diseases because of other systemic issues they face such as poverty, systemic discrimination. This allows us to essentially ignore them and the struggles they face. 
    • Onie says that health is also often the "underlining" reason behind marginalized people's poverty; I.e. people having to make a choice between paying their rent and paying for their medication
    • In Miss Evers' Boys, Doctor Douglas tries to this research trial to prove that syphilis affects both black and white people in the same way, and that it wasn't an inherently "negro disease." He tried to argue that it was for the "greater good" for Black Americans. 
    • I also noticed a connection between how Onie talks about the way we need to transform the waiting room to a place where external issues that play a factor in patient's health (i.e. house broke down causing injury etc.) could be worked on with an interdisciplinary team of college-student volunteers, and in Miss Evers' boys when Miss Evers tries to engage with her patients in different ways to give space to other facets or issues in their lives, and in doing so she was able to gain trust and treat her patients
    ]]>     2023-10-19 15:28:34 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754798230     Santina Dresser santinadresser https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754799755 DOUGLAS: "We are part of a national treatment program. We must treat six-thousand contagious patients, not in the study, with penicillin, right here in Marcon County. Some of those patients are suspicious fearful, or new medicine and they all know Willie's a government patient. So if we give willie penicillin and he dies, contagious patients with far less risk, patients who could be helped by penicillin, might refuse to be treated with it. And then the disease lives on and continues to spread... I'm not willing to jeopardize that work. And I don’t think you are either." (Feldshuh 74)

    BRODUS: Its been proven. Many times over. 
    DOUGLAS: No. Not if the data is incomplete. 
    BRODUS: Every time another patient, Negro or whtie, is cured with penacillin, its proven again. The question is now irrelevant, There is no longer a need for this study. 
    DOUGLAS: The need is greater than ever 
    BRODUS: Why? 
    DOUGLAS: Fear. The national will to eradicate any disease depends on continuing fear. Raw, personal fear in the right places... I want to treat them. But not yet." (Feldsush 81) 

    DOUGLAS: "The study must go to tend point.  
    EVERS: And how far is that? 
    DOUGLAS: Autopsy. The facts in the study must be validated by autopsy. 
    EVERS: My Patients shouldn't have to make that sacrifice. 
    DOUGLAS: They already have." (Feldsush 88) 

    These questions, in my mind, are not hard because the answers are complicated, they are hard because they require that we be honest with ourselves...That if we are honest with ourselves and listen quietly, that we all harbor one fiercely held aspiration for our healthcare: that it keep us healthy. (Onie)  

    These are related in the sense that Douglas was following the 'medical procedure' far too rigidly and not accounting for the individual's lives, just about the outcome of the study. He was making a 'sacrifice' for the greater good, while his patients are suffering, not following the aspiration for healthcare that it keep us healthy.
     
     
    ]]>     2023-10-19 15:29:33 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754799755     Arden Ferro ardenferro https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754804983
  • Connection between Sontag and “What if Our Healthcare System Kept Us Healthy” 
  • describes inequities in life between people who don't have access to things like, food, water, or a temperate place to live and how it leads to significantly more illnesses 
  • Onie sees this particularly in children (this is a particular group as race, gender, or financial status is discussed in Sontag)
  • HIV medication and rent in a big city→ stigma around diseases like HIV, if you are homeless and have HIV because no one will help with costs (ex insurance), this leads to there being even more stereotype around people with illness
  • “AIDS epidemic serves as an ideal projection for first world political paranoia” (150) -- Sontag 
  • “Child has an ear infection…The real issue is that the child has no food at home” →Rebecca Onie 
  • both articles have several examples of quotations like this that show the deeper reason behind a certain condition or what caused them, we have to consider/help people before they are already really sick (as Onie said in her talk)
  • people who have less financial resources will naturally be exposed to more disease a lot of the time 

    • ]]>     2023-10-19 15:32:52 UTC https://padlet.com/professordianapaulin/bb2oeyb8u1k3m2ld/wish/2754804983