Pregnancies, deaths, and access to health care: What would women want to do if assisted reproduction didn’t exist in their early years?
Black people also have a higher incidence of underlying conditions, such as heart disease, diabetes, HIV and high blood pressure, which puts them at risk of complications during and after pregnancy. They can have a rare type of heart failure called peripartum cardiomyopathy, which can begin between the last month of pregnancies and five months after delivery. Black people are more likely to bleed during labour and delivery.
The researchers were interested in what that disparity in infant mortality would look like “in a group of women that would be relatively affluent,” said Dr. Sarka Lisonkova, an author of the study and associate professor in the Department of Obstetrics and Gynaecology and the Children’s and Women’s Hospital of British Columbia in Vancouver.
Even in a subgroup of women with more money and education, there are still social inequalities that affect fertility treatments. There could be residual confound by the status of the household. The other thing is that there might be differential access to health services, particular in this case of obstetric and maternity care services, and neonatal health services.”
Treatments for infertility that include eggs and sperm are included in assisted reproductive technology. It can be very expensive to have insturment. Each cycle costs between $12,000 to $17,000 according to the National Conference of State Legislatures.
However, she doesn’t want the study to discourage Black, Hispanic, or Asian and Pacific Islander people from pursuing assisted reproduction. She advises people to have a childbirth plan and to continuously consult and follow up with their doctors.
Lisonkova recommends that health care providers keep an eye on babies after they’re born. She said providers have a responsibility to listen to women and provide more access to neonatal care.
“This study should send shock waves through fertility centers, ob-gyn clinics and high risk ob-gyn clinics everywhere,” Dr. Aimee Eyvazzadeh, a San Francisco-based reproductive endocrinologist who was not involved in the new study, said in an email to CNN.
Going forward, Lisonkova said, she hopes research expands beyond the birth of one baby to examine outcomes among twins, which are a common result of assisted reproduction.
The Atlanta Medical Center, formerly known as Wellstar, is closing: The problem of healthcare in black communities is an issue of race, and the state of the economy in the 21st century
Alford, 65, said that she suffers from asthma, diabetes and high blood pressure, and that there were times when the Atlanta Medical Center’s (AMC) downtown hospital, formerly known as Georgia Baptist Hospital, would keep her overnight for monitoring.
The impact of the AMC closings in downtown Atlanta and East Point won’t be evenly distributed. Black residents and low-income residents will most acutely feel the absence of these key providers of community care.
The closures aren’t unique. They’re part of a much larger pattern of urban hospital closures across the US. (Over the past few decades, rural hospitals also have been disappearing.) The facilities in Chicago, Philadelphia and Washington, DC were closed three years ago. Residents in the surrounding poor, predominantly Black communities were left reeling from the losses.
“Wellstar has operated AMC since 2016, investing more than $350 million in capital improvements and to support sustained operating losses. That includes $107 million in losses in just the last 12 months, amid decreasing revenue and increasing costs for staff and supplies due to soaring inflation. AMC has become worse because of the Pandemic and the other financial difficulties straining healthcare organizations, the nonprofit said in a statement.
The president of the NAACP’s Atlanta chapter, Richard Rose, told CNN that urban hospital closings are an issue of race. He said that state and hospital officials have failed to save the hospitals that serve black and low-income residents.
“Urban hospital closures are more apt to happen in racially segregated communities and especially in African American neighborhoods,” she told US News & World Report.
Georgia Republican Gov. Kemp boosted funding to the Grady Health because he wanted to make sure that it could continue to provide quality care even after AMC closed.
In an October open letter to community members, he said that Grady Health would receive more than $130 million in American Rescue Plan funds to add 185 beds to the hospital by the end of 2023.
Nancy Kane, an adjunct professor of management at the Harvard University The precarious state of access to care in Atlanta is summarized by the TH Chan School of Public Health.
“When a hospital leaves, the whole network starts to collapse,” she told CNN. It’s not just the trauma and maternity services. The whole continuum begins to be affected.
The anarchic nature of healthcare: why you can’t do that with people’s lives, but you can do it in the U.S.
Black patients fare better when their doctors are black. Unfortunately, research shows that about 53% of Black Americans struggle to find a doctor who identifies as Black where they live1.
A number of families in south Fulton County are without a full service hospital less than 7 miles away because of the closing of AMC South.
A 15-minute drive from AMC South to Grady could make a commute worse during peak traffic hours.
Rose explained that Kemp’s pledge to give more beds at Grady was a Band-Aid fix on an open wound because it would jeopardize the health of residents who live near shuttered facilities.
“The most obvious consequence is that if you’re in a low-income neighborhood, the distance to care is going to be greater. She said that if you don’t have a car, that distance can be a big issue.
Kane claimed that in low-income neighborhoods, people can’t find the next hospital that is easy to get to, which makes it riskier to die in an emergency.
In the US, race and poverty are related to health disparities, including access to high-quality doctors and care.
Two months later, Philadelphia’s Hahnemann University Hospital, which was the chief teaching hospital affiliated with the school of medicine, announced that it would be closing its doors.
Alan Sager, a professor of health policy and management at the Boston University School of Public Health who over the course of the past 12 years has documented hospital closures in nearly every major US city, characterized the country’s health-care system as “anarchic.”
You are hurting people. You’re really hurting people. You can’t do that with people’s lives. Phillip Lee, a lifelong DC resident, told WUSA that you really can’t do that.
Source: https://www.cnn.com/2022/11/12/us/hospital-closures-race-deconstructed-newsletter-reaj/index.html
Why are Black people at risk of chronic diseases? Why do black people have no clue about science and why do they want to go there? A CNN article by D.A. Kane
There isn’t an event that comes from Mars. She said that it came from under-investment in the facility. “That’s part of the problem. People do not say, “Let’s not go there anymore.” It’s that they can’t get in or the services they need aren’t there anymore or the building’s old and so they choose to go elsewhere.”
“If you look broadly across the country, there are big chains acquiring hospitals. They might have more than 100 hospitals. The headquarters is in St. Louis. The chains might have hospitals in nine or 10 states. Kane said that the chains don’t have a sense of loyalty to the community. “And so, if you’re a hospital that has lots of Medicaid patients or lots of uninsured patients, or if you’re a hospital that doesn’t get much government support, you end up looking like a poor performer in a portfolio where no one knows what’s underneath.”
It is possible that chains don’t have a commitment to the community because state governments aren’t demanding that they pay attention.
The result: Numerous residents will struggle to secure appointments, because metro Atlanta doesn’t have a robust transit system that can get them to other counties.
“They’re putting profits over people,” he told CNN. “We already know that Black people have a lower life expectancy, and suffer from chronic illnesses (at a higher rate). It’s going to be very difficult for those people to access basic services.”
Science is a science with an inherent bias towards injustice. Scientific insights from marginalized people have been erased, natural- history specimens have been taken without consent and genetics data has been manipulated to support the movement towards swastikas. When it comes to science, there is an ongoing barrier for people from minority ethnic groups, who have little trust in science, to feel welcome in academia.
Why are Black people at greater risk for developing these complications? Racist and bias are contributory factors that can compromise immune function and function that control blood circulation. Furthermore, the extra stress that comes with carrying a child as a Black woman increases the risk of poor outcomes. More research is required to understand the effects of stressors on Black women’s health.
I did my residency and fellowship training in Brooklyn, New York, and Newark, New Jersey. I saw how people from the African diaspora who had poor access to health care and lacked insurance had high rates of conditions such as obesity, diabetes, chronic high blood pressure, diabetes, HIV/AIDS and substance-use disorder.
I then worked in West Palm Beach, an affluent urban area in Florida, where I saw a stark difference in how wealthy white women were treated and cared for compared with women in lower socio-economic groups. There seemed to be greater respect for rich white people; they were listened to and offered help, treatment and labour pain relief as soon as needed. People of colour were labelled negatively due to their social situation. They were stereotyped as lazy, substance-using people and not listened to.
The Impact of Medicaid on Maternal-Health Outcomes and Health Care for Low-Income Black People: Evidence from the United States
A multi-disciplinary team including maternal-fetal medicine specialists, boas, geneticists and cardiologists was established.
The incidence of cardiovascular deaths in people at Lincoln have gone down since the programme started. There have been no cases of cardiomyopathy or cardiovascular decompensation, which are symptoms the heart can’t support.
We should also direct more research towards how using medical support staff — such as those who help people navigate the medical system, doulas and midwives — could improve Black maternal-health outcomes.
It’s also worth looking at parts of the world that have better maternal-health outcomes and learning from them. In contrast to people in other countries, a significant number of people in the United States do not have access to low-cost health care during the postpartum period. Nearly half of US births are covered by Medicaid, which offers free or low-cost health care for low-income people, which only covers mothers’ care for the first 60 days after birth. The first three months of a baby’s life should be ideal for Medicaid to cover financial outlays so they can catch more medical problems at an earlier stage. (In 2021, the US Congress approved a Medicaid extension for 12 months after birth and 27 states have adopted such plans so far.) Many people are in danger because each state has their own health- insurance policies.
It is difficult to change how people think about certain groups. Compensating or disciplining physicians financially for the health outcomes of Black patients could be an excellent way to keep them mindful of how racism and bias lead to poor results.
In general, we need more physicians and researchers who look like us. The Association of American Medical Colleges has data on doctors of color and only 5% are Black or African American.
Source: https://www.nature.com/articles/d41586-022-04409-6
Building Relationship in Multi-Sample Research: An Investigation of the Role of Metaplectic Representation in Bi-Analytical Approaches
And from the research perspective, if you are familiar with a particular set of issues because you are from the same background as the participants, then you can address nuances in your research more readily and build rapport and trust.