Other Projects

Before I even started to work with film, I used infographics and podcasts to learn and spread information about health-related issues. The following projects were possible due to the American Medical Students Association (AMSA) Academy Scholars Programs.

Infographic on the History of Abortion Rights

Podcast on Racial Disparities in Mental Health

Podcast Transcription

Hi everyone! My name is Veenadhari Kollipara and I am a sophomore at the University of Pennsylvania studying Health & Societies. Currently, I am part of the Health Care For All AMSA Scholars program learning about the health care system in the US. One issue I want to focus on for today’s podcast is the racial disparities which exist within the healthcare system. I am going to be discussing some statistics and studies which reveal the racial biases which occur in our healthcare system. I will also be talking about where these biases can come from, and then potential solutions which physicians can be part of. So currently, we live in a system where depending on what race or ethnicity you are, the resources and quality of healthcare can vary. And usually, the minorities are the ones receiving the short end of the stick.

In the paper Contribution of Major Diseases to Disparities in Mortality by Wong et al., the risks of death across various conditions was collected from an NIH interview survey between 1986 to 1994. This data was collected across a wide range of age groups, gender, and levels of educations. To focus in on the racial disparities, the data was adjusted for age, sex, and level of education. When looking at the average of all causes of death, black people tend to lose more years to those conditions than white people. Specifically, racial disparities exist within hypertension, HIV disease, diabetes, and homicide.(Wong, et al., 2002) There are also major disparities existing within conditions such as cardiovascular disease, infection, and trauma. (Wong, et al., 2002) Just with this amount of data, and previous studies done, none of these racial disparities are genetics-related. They are clear problems within the healthcare system in the US.

And these disparities are not only found within physical or biological diseases. They are also found within mental disorders. In a paper by Breslau et al., it was found that racial minorities, specifically black people and Hispanics, had a lower risk of getting a common internalizing disorders, i.e. anxiety, mood, or impulse control disorders.(Breslau, et al., 2006) But when any individual actually got the disorder, the prevalence of that disorder was greater in the minorities. (Breslau, et al., 2006) There are multiple explanations for this type of data. One of those reasons could be that racial minorities are less likely to be diagnosed mental disorder because they are less likely to go to the hospital for a mental disorder. And then when they are diagnosed with it, they have less access to resources to help them. Treatments, such as medications or behavioral therapy are not as accessible to racial minorities than white people.

Another piece of data that I found really interesting and makes this problem more complex and confusing for me, is that while the quality and source of health care is lower for minorities, when black people do get into the healthcare system, they have approximately the same amount of care as white people, in terms of expenditures or nights of stay, and sometimes it might even be more.

But while the amount of care is the same, there are treatment disparities between black and white people. There’s data that shows that among those enrolled in health care plans, white people receive more breast screenings, eye exams, which can be indicative of diabetes, beta blockers, and follow-up examinations.(Schneider, et al., 2002)

This is not just problem of access into healthcare, but also a problem within the clinical setting. Physicians and medical professionals, themselves, are making racially disparate clinical decisions, a lot of the times, subconsciously.(Schulman, et al., 1999) They are various mechanisms by which this can occur. Sometimes, physicians are less likely to believe the symptoms of a person of color versus a white person. Physicians sometimes believe that minorities are less likely to comply to the advice that they are giving. Sometimes, the patients don’t completely understand what the physician is saying. And this is the part where physicians and medical professional can actually be part of the solution, rather than the problem. One way of increasing quality of healthcare for both white people and racial minorities is by the physician properly communicating with the patient. This means using language which can be understood by an average person. And not surprisingly, the average person does not understand most of medically complex terms. Also, using written materials with visual aids, can help the patient understand what’s happening to them. And what’s really interesting is that when patients understand what’s happening to them, they are more likely to change their personal lifestyle. For example, they are more inclined to eat healthier, exercise, and take up good habits. And when looking at a larger scale, when community-based interventions are used, for example, in a school setting, where adults and children are educated about proper nutrition, they can reduce the likeliness of having lifestyle related diseases, such as cardiovascular disease or diabetes.

And for so long, I personally thought that I would have to wait till I became a physician to do anything about racial disparities within the health care system. However, it is possible for pre-med and medical students to be proactive in their communities and health education and health literacy, especially in those communities with a higher percentage of underrepresented minorities. And by no means is the data that I have presented in this podcast encompassing the complete problem of racial disparities within the US. I used this data to show how complex, and multi-faceted this problem, and how multi-faceted approach is necessary to reduce these disparities. I hope that everyone who was listening was able to learn something about the healthcare system and what they can do as an individual to improve their community’s health, while tackling a large problem. I want to thank the AMSA Scholars Program and also my Medical Sociology course professor from Fall 2019 for giving me so much knowledge about the health care system, and what I can do in it. Thank you for listening and have a great day!

Sources for Podcast

Schulman, et al. (1999) The Effect of Race and Sex on Physicians’ Recommendations for Cardiac Catherization. N Engl J Med,340:618-626.

Schneider, et al. (2002) Racial Disparities in the Quality of Care for Enrollees in Medica Managed Care. JAMA, 287(10):1288-1294.

Breslau, J., Aguilar-Gaxiola, S., Kendler, K.S., Su, M., Williams, D., Kessler, R.C. (2006). Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychological Medicine, 36(1), 57-68.

Wong, et al. (2002) Contribution of Major Diseases to Disparities in Mortality. N Engl J Med, 347:1585-1592.