Equity Response Paper Final

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Recognizing the Marginalization of Women in Healthcare 1 Recognizing the Marginalization of Women in Healthcare Isabelle Wornson Cultural Competency in Health and Healthcare Dr. Rachel Ziner 16/2/2024
Recognizing the Marginalization of Women in Healthcare 2 Abstract The health disparities in the United States healthcare system have detrimental impacts on marginalized groups. There is an undoubted irregularity regarding the treatment of women by healthcare providers when compared to their male counterparts. This inconsistency jeopardizes the health of women in the US prompting studies on its impacts. The healthcare system has a deeply rooted history of neglecting women's health concerns, regardless of race, sexual orientation, or economic status. This biased approach has profound consequences, impacting the health of women nationwide. Urgent reform in women's healthcare is necessary to address these disparities. A significant contributor to health disparities among women is the lack of access to proper healthcare coverage, as the US healthcare system is a mix of public and private financing. While programs like Medicare and Medicaid exist, limited eligibility criteria hinder access for many, particularly those with low incomes. In addition, the disregard for reproductive rights the United States has shown establishes resentment in women toward the healthcare system. These factors play a role in the lack of desire for women to seek healthcare, thus consequently jeopardizing their health.
Recognizing the Marginalization of Women in Healthcare 3 There is no question that the United States healthcare system lacks consistency when providing care to patients nationwide. Minority groups such as the LGBTQ+ community, Hispanics, African Americans, and people with disabilities experience this discrepancy when receiving healthcare. These groups report that their health issues are rarely taken seriously and that they do not feel their quality of care is up to par with other groups. This inconsistency is detrimental to the health of Americans, and the United States has studied the impacts of this issue. From difficulties with affording healthcare to the fight for reproductive rights, women are at a constant disadvantage, resulting in their experiences of mistreatment. The US healthcare System has a deep-rooted history of not only exhibiting irregularities in treatment among minority groups but also concurrently dismissing and disregarding the health concerns of women. For decades, women of all races, sizes, sexual orientations, and economic status have experienced a marginalized approach to their healthcare. The biased lens healthcare providers have been looking through has cost women's well-being and lives. The pressing call for reform in women’s healthcare is imperative to enhance the welfare of women nationwide in the United States. A driving force that is a major contributor to the health disparities among women is the lack of access to proper health care coverage. The US healthcare system is defined as a mixed system, meaning there is a mix of public and privately financed coverages. The publicly financed healthcare insurance is Medicare and Medicaid. Although these programs are defined as public health insurance, there is limited eligibility to receive this insurance. Medicaid specifically depends on socioeconomic status and those who are under the 138% Federal Poverty Level, which are individuals who are in exceptionally low-income households, meet the qualifications.
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Recognizing the Marginalization of Women in Healthcare 4 In 2022, 31.6% of individuals were insured through Medicare or Medicaid, while 65.6% were insured through private programs (Peter G. Peterson Foundation, 2023) . Despite these options for healthcare coverage, the type of health insurance individuals receive largely depends on employment status. Studies have shown that Latina and African American women are more likely to have low incomes and limited accessibility to job-based coverage (Wyn & Ojeda, 2004). These women report their job-based coverage as unstable, including no dental or vision coverage provided. Under the Affordable Care Act, dental and vision coverage is not considered essential health benefits. Nearly any healthcare offered in the United States is unfathomably costly when uninsured. The cost of an uninsured regular dental checkup, while varying by state, costs anywhere from $400-$900. The United States healthcare system ensnares its citizens in a profit-driven structure that often disregards the well-being of Americans, which inherently negatively impacts women. The modern-day treatment of women is a direct consequence of the longstanding history of mistreatment and discrimination against women, which has deeply permeated societal norms and structures, including the US healthcare system. Women consistently are mistreated when receiving care, experiencing dismissive behavior and undertreatment from healthcare providers. “One in five women say they have felt that a health care provider has ignored or dismissed their symptoms” (Paulsen, 2020). The automatic associations done by clinicians result in overlooking the holistic nature of their patients beyond their perceived demographic traits. This categorization is exceptionally applicable to women, resulting in common misdiagnoses, underdiagnoses, and inappropriate treatment. According to Dr. David Newman-Toker, Professor of Neurology at Johns Hopkins School of Medicine, “Women and racial and ethnic minorities are 20% to 30% more likely than white men to experience a misdiagnosis.” ( Szabo, 2024 ). In
Recognizing the Marginalization of Women in Healthcare 5 addition, women are less likely to receive pain management medications, as oftentimes their pain is underestimated and dismissed. Unconscious bias is the explanation for the disparities in healthcare treatment. The subconscious beliefs and attitudes driven by stereotypes influence the interactions between healthcare providers and patients, manifesting in various ways such as undertreatment, misdiagnosis, and harmful assumptions made by physicians. For decades, women have fiercely waged the battle for reproductive rights, displaying resilience and strength. The fight for reproductive rights is not merely a passing venture but a longstanding and deeply entrenched campaign for justice, autonomy, and equality in matters of reproductive health and choice. In 2022, the Supreme Court overturned Roe v. Wade, the landmark Supreme Court decision in 1973 that established a woman's legal right to abortion. As of 2023, 21 US States have some form of abortion ban, including fourteen with full bans. This overturning has robbed women of their right to the choice of motherhood. Unintended pregnancies are a public health issue in the United States, where studies show that “the unintended pregnancy rate is significantly higher in the United States than in many other developed countries” (Guttmacher Institute, 2022). The United States' high rates of unintended pregnancy are due to a lack of education on the risks of sexual activity and access to contraception. Unintended pregnancies have been shown to lead to higher rates of depression and anxiety, lack of financial stability, and low educational attainment (Haider et al., 2013). In addition, babies born from unintended pregnancies have a higher likelihood of prematurity and low birth weight. Minority groups experience the dangers of pregnancies at higher rates. Specifically, black women are “ three to four times more likely to experience a pregnancy-related death than white women, and the risk spans income and education levels (Lenzen, 2022). Black women are more susceptible to obesity due to environmental factors, making them vulnerable to
Recognizing the Marginalization of Women in Healthcare 6 a variety of pregnancy complications. Despite women's fight against forced pregnancy, the United States continues to deny women their right to safe abortion procedures, a form of healthcare. The disregard for women’s voices has plagued their perspectives and experiences of the US healthcare system. The disparities within the United States healthcare system present significant impacts on women, which is particularly evident in the marginalized experiences of minority groups and the persistent disregard for women's health concerns. Women across racial, socioeconomic, and demographic lines continue to face systemic biases and mistreatment within healthcare settings, ranging from dismissive attitudes to inadequate treatment. The overturning of Roe v. Wade in 2022 and the subsequent proliferation of abortion bans further emphasizes the urgent need to reform women's reproductive rights. These experiences women face divert them from seeking healthcare treatment, resulting in vulnerability to profound health consequences. Addressing these disparities requires healthcare reforms that prioritize equitable access to care, challenge unconscious systemic biases, and empower women to make informed decisions about their health. Concerted efforts are required to rectify these injustices to achieve a healthcare system that truly serves the needs of all Americans, regardless of gender, race, or socioeconomic status.
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Recognizing the Marginalization of Women in Healthcare 7 References Haider, S., Stoffel, C., Donenberg, G., & Geller, S. (2013). Reproductive health disparities: A focus on family planning and prevention among minority women and adolescents. Global Advances in Health and Medicine, 2(5), 94–99. https://doi.org/10.7453/gahmj.2013.056 Lenzen, C. (2022, June 30). Facing higher teen pregnancy and maternal mortality rates, black women will largely bear the brunt of abortion limits. The Texas Tribune. https://www.texastribune.org/2022/06/30/texas-abortion-black-women/ Palasi, B. (2023, March 9). How much does a dental exam cost without insurance? Mira Health. https://www.talktomira.com/post/how-much-does-a-dental-exam-cost-without-insurance Paulsen, E. (2020, January 14). Recognizing, addressing unintended gender bias in patient care. Duke Health Referring Physicians. https://physicians.dukehealth.org/articles/recognizing-addressing-unintended-gender-bias-patient -care Peter G. Peterson Foundation. (2023, November 9). The share of Americans without health insurance in 2022 matched a record low. Retrieved from https://www.pgpf.org/blog/2023/11/the-share-of-americans-without-health-insurance-in-2022-ma tched-a-record-low#:~:text=Meanwhile%2C%2061.6%20million%20individuals%20were,peopl e%20age%2065%20and%20over .
Recognizing the Marginalization of Women in Healthcare 8 Szabo, L. (2024, January 15). Medical errors kill scores each year in the U.S., especially women and minorities. NBCNews.com. https://www.nbcnews.com/health/health-news/medical-mistakes-are-likely-women-minorities-rc na133726 Guttmacher Institute. (2022, August 24). Unintended pregnancy in the United States. Retrieved from https://www.guttmacher.org/fact-sheet/unintended-pregnancy-united-states Wyn, R., & Ojeda, V. (Eds.). (2004). Racial and ethnic disparities in women’s health coverage and access to care. Issue Brief An Update on Women’s Health Policy. Retrieved from https://www.kff.org/wp-content/uploads/2013/01/racial-and-ethnic-disparities-in-women-s-health -coverage-and-access-to-care.pdf