Racism and Prejudice In the Healthcare System
Unconscious basis has been documented to affect the health outcomes patients. Although most practitioners in healthcare take oaths to treat all patients equally, structural and unconscious racism still finds its way into the healthcare system. The New England Journal Of Medicine published an article titled Structural Racism and supporting Black Lives - The Role of Healthcare Professionals on December 1st, 2016.
This article cited that 50% of white medical students believed in incorrect alleged biological differences between races. Some of these false differences include black people having thicker skin and black peoples blood clots quicker.
These misconceptions just begin to graze the surface of how patients are treated differently purely based off of the color of their skin.
Evidence Supporting Basis in the Healthcare System
Many studies have shown how racial basis affects the plans of care for patients. For example, black patients receive less pain management resources than patients of other races in all areas of speciality. Many medical textbooks have been found to present negative and unfounded racial stereotypes, as medical facts. For example, one textbook used in a nursing program titled “Nursing:A Conceptual-Based Approach to Learning” was cited to have extremely offensive material in a section titled cultural differences in response to pain.
The textbook explains that blacks “report higher pain intensity than other cultures… they believe suffering and pain are inevitable”.
This texted book also explains that Jews “believe pain must be shared and validated by others”.
These are just a few examples how basis has affects racial demographics disportionality.
What is Trauma Informed Care
Trauma Informed Care is a movement started by the Centers for Youth and Wellness. The goal of this movement is to inspire medical doctors across all specialities to adjust there practice in a way that takes into account the patient's history of trauma. This history trauma is not focused a head injury in childhood or previous car accident, the history of trauma discussed in this movement are adverse childhood experiences.
Adverse childhood experiences in childhood include physical, emotional or sexual abuse, witnessing domestic violence or substance abuse in the home, addiction, and incraction of a family member.
Trauma informed care is a survey patients fill out during routine physical examination to provide practitioners information about past traumas that can affect there health.
How Past Trauma Affects Long term Health
CEO and founder of the Centers for Youth and Wellness, Dr. Nadine Harris, was inspired to begin the movement for trauma informed care after reading the Adverse childhood experiences study. The ACE Study or adverse childhood experience study was conducted by Vincent Felitti who was the head of the Department of Preventive Medicine in San Diego and Robert Anda who worked at the Centers for Disease Control and Prevention (CDC).
Felitti and Anda created a survey that 17,000 test subjects would take. In this survey were questions regarding childhood abuse and adversity. For each question the test subject checked yes too, meaning that they had experienced it, they would receive a point.
That test subject in the study was then given an ACE score
Findings of the ACE Study
The prevalence of ACE Scores in the study population is as follows:
Ace score of 0=33%,
Ace score of 1=26%,
Ace score of 2=16%,
Ace score of 3=10%,
Ace score of 4=15%.
People surveyed with an ACE score of 4 or more ( meaning that they experienced many types of adversity including physical, emotional or sexual abuse, witnessing domestic violence or substance abuse in the home, addiction, and incraction of a family member) were found to be
2 times (200%) more likely to develop cancer than ACE of zero
7 times more likely to develop alcoholism,
4 times more likely to develop emphysema
30x (3000%) more likely to attempt suicide.
How Trauma Informed Care Can Help End Basis, Racism and Prejudice in the Healthcare System
Trauma informed Care can give physicians and other medical practitioners crucial medical history that they can focus on when treating patients. This medical history can distract them from unintentional forms of racism and basis that affects patients healthcare outcomes. This tool can reinforce the idea of seeing each and every human as person with a story, and help breakdown historical, structural and cultural barriers that may exist between healthcare staff and patients. Evidence in the ace study shows that adverse childhood experiences are incredibly common and that they affect the long term health of those who experience them.
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