Healthcare Discrimination

Hi everyone!

I apologize for the late post! May 2nd and 3rd were my first two (and hardest) AP Exams, Chemistry & Environmental Science, and it was also the first day of Eid. Naturally, I was a little bit busy.

This week is AP Exam week, so a lot of my energy has been redirected to studying. However, this doesn’t mean I haven’t done any work on my project. In my redirection, I looked back at the information that I’d already collected in order to determine where I needed to fill in the gaps in order to properly write my op-ed. I’ve also found some Arab-American publications that I’d reach out to see if they’d be interested in my op-ed. None of them are in the triangle area unfortunately, but I think it’d be really cool to talk to them and see if they have any interest.

Lastly, I have scheduled my final presentation for Monday the 16th, location TBD. I’m so excited to see you all & see who will be interested!

Thanks for reading :^)

Goals for this Week:

1. Talk to Ms. Bessias & advisors about redirection

2. Talk to NGOs and gather info about what people in NC are facing

3. Reach out to Arab-American literature in the Triangle to see interest in an op-ed about healthcare inequity parallels in the Arab world and the West.

—

Hi everyone! I apologize for a long period of inactivity. To be honest, I was having a lot of difficulty with my study. For one, a lot of the original plans I had fell through— after a couple of emails to each of the professors that I had originally wanted to email went without any response, and I’d originally learned that I wouldn’t be able to individually talk to patients, a lot of the original content for my study was derailed. In my conversations with Mr. Klein, he suggested reaching out to local healthcare equity NGOs (which was a fantastic suggestion, and I’ve scheduled meetings with them).

In truth, my study had become both overwhelming and disappointing.

Continue reading “April 4 – April 21: Redirection + Making the Best of What’s Happening”

Goals for This Week:

1. Medicare for All Summary
2. Kafalah System Summary
3. Meetings w/ Mr. Klein

It is impossible to imagine a world without discrimination, but what we often don’t think about is why this discrimination ends up happening. For example, the kafalah system in Saudi wasn’t meant to be discriminatory— which we can see in the actual outline of the law itself. Originally, kafalah was established to solve a shortage of labor in Saudi, since culturally Saudi women were discouraged from working. However, like most laws, kafalah became warped and turned into a systemic form of discrimination. We see this parallel in America, however the origins are more sinister.

In America, the influx of undocumented immigrants came from the braceros movement, which allowed immigrants from Mexico and Central America to come in and fill the vacuum in the agriculture industry without the necessary paperwork. Subsequently, there was an influx of undocumented immigration to the United States, mainly because they were simply ‘cheap labor’ in the eyes of the corporations.

In looking at these laws in a more nuanced way— what they are vs. what ends up happening— then we can approach such a complex topic like healthcare discrimination into more than just a single-sided issue. It adds a level of complexity and nuance to this anything-but-simple topic.

In the coming weeks, I’ll be conducting more and more interviews with experts in the field as well as Mr. Klein. Thank you for tuning in!

Next Week’s Goals:

1. Finish Medicare for All
2. Compile thoughts about Medicare for All as a possible solution
3. Meet with Mr. Klein regarding kafala system laws.

Midterm Reflection:

So far, I’ve been looking into the legal systems in place that allow for healthcare to exist in the capacity that it currently does right now. This is both in America  and in Saudi Arabia, however, my focus is on disenfranchised groups like BIPOC in America and southeast Asian migrant workers in Saudi Arabia. However, there’s been more of a focus on America simply because resources to find for America are much easier. In order to have more of a Saudi focus, I’ll need to connect with professors specializing in the field. This doesn’t mean that I’m not going to talk to American professors, but it is easier to find resources on ways to fix the American healthcare system— a hot topic in recent years. This is also part of the issue, and something that’s stirring my emotions more. The politicization of healthcare is so frustrating and makes it all that much harder to find and implement a real and lasting solution, especially with both sides on the issue feeling incredibly strongly on their own stance. How is it possible (in both Saudi and America) that there is such a huge connection between those who suffer from medical discrimination and BIPOC or Southeast Asian migrant workers. Wouldn’t officials notice that there is more of a discrepancy in disenfranchised/marginalized groups? Do they even care?

I’ve learned that I find it really difficult to stay on track if I don’t have set & outlined goals that guide my learning. Without set goals, I don’t really stay on track because of the sheer amount of work that I have. This is something that Dr. Bayley recommended I start doing. Because my project is so ambitious, it’s hard to keep track of all the moving parts that I have going on. By setting goals at the beginning of each week, it makes it that much easier to keep track of everything happening. This is the one thing that I think I need to change to make sure I am hitting my 5 hour minimum every single week. Otherwise, everything is going great!

What’s Coming Next:

1. Interviews, hopefully starting soon!
2. Background research, abstract, literature review, and part of my findings done (with Medicare for All finished)

Thanks so much for reading :^)

Hi everyone! I decided to not make this week as strenuous due to the heavy workload I had in my other classes. So, I was mainly just talking to my parents (both doctors) as well as a family friend about possible solutions, as well as researching what solutions could be implemented.

In America, there are two possible solutions, completely switching to socialized system in which healthcare is centralized through the government, or switching to a free market with enough regulation to avoid human rights atrocities. To see how this would work, let’s look at two examples of other countries implementing these opposing methods: Canada, a world-renowned socialized/centralized system. However, there really is no model country for what free-market healthcare would look like, but I found this Forbes article which tells us what it would look like in an ideal world.

Canada is one Western country to boast socialized medicine. 68% of citizens voice trust in the healthcare system, but let’s look at some data points.

→ 80% of Canadians aged 15+ access specialty/first contact health care easily

→ Average wait time in the emergency department = 3-4 hours

→ Average MRI wait time = 2 months

→ Average CT wait time = 1 month

→ (Estimate) Value of time lost due to wait times in Canada = $1,200

→ Dr. Brian Day: “[d]elayed care often transforms an acute and potentially reversible illness or injury into a chronic, irreversible condition that involves permanent disability.” which is seen in Canada.

→ A recent report concluded that between 25,456 and 63,090 Canadian women may have died as a result of increased wait times between 1993 and 2009. 

→ Rural Indigenous communities still rely on outside sources of healthcare— Canadian centralization has failed them because they are the marginalized group of Canada

Now, what would free market healthcare look like?

→ Promotion of choice in healthcare: there is a high quality plan for more, or a low quality plan for less. You choose what you want to spend on.

→ Competition to lower prices among healthcare companies.

→ However, there could be a rise of healthcare modeling laissez-faire capitalism in which there are a rich few and a poor many.

→ Would discriminate against marginalized groups even more (poverty is a form of marginalization)

As we can see, there are pros and cons to both systems. Centralized healthcare offers access to much more of the population, but there is still a huge disparity in access for marginalized groups, and there are incredibly long wait times. Free market healthcare offers freedom of choice and competitive incentive, but there would be the creation of a larger wealth gap and even more discrimination.

There is no one size fits all that will benefit everyone. However, it is our jobs to create a system that will benefit as many people as possible, and filling in the gaps where others have failed.

Thank you so much for reading!

Sources:

1. Canada is Not a Good Example of Universal Healthcare
2. Access to Health Services as a Determinant of First Nations, Inuit, and Metis Health
3. Difficulty Accessing Healthcare Services in Canada
4. % of Adults in Select Countries Worldwide Who Agreed That Many People in Their Country Could Not Afford Good Healthcare as of 2021
5. % of respondents worldwide who were satisfied with their country’s national health system as of 2019, by country

Below I’ve attached my background research portion of my academic paper. Initially, I was going to do a masterlist of my findings, but I’ve decided against it because it wouldn’t really be productive (I’d have to condense it into a background research portion eventually anyways). I’m having some troubles with IRB, so moving forward I’ll be only working with medical school directors and academics close to the issue rather than with real human subjects until I can figure out what to do with the IRB. The last thing I want to do is cross any ethical boundaries, which is why I’ve held off on reaching out to actual patients.

—

There is clearly a huge disparity in the ways in which people are treated medically. Saudi Arabia and the United States both have glaring societal issues in the ways people are treated, both culturally and medically. In the United States, there is a deeply entrenched history of discrimination against marginalized groups— specifically black and Indigenous or First Nation people. In Saudi Arabia, Southeast Asian migrant workers are consistently treated as less-than in favor of ethnically Saudi people. This perpetuated in the kafala system (نظام الكفالة), which is a legal system used to ‘monitor’ these migrant workers in a way that furthers this unfair social hierarchy.

This is not only qualitative analysis of healthcare. There is statistical evidence that backs up the cultural discrimination against these groups. In GCC Countries, 18% of Indian interviewees in the ‘Undocumented Immigrants in Saudi Arabia: COVID-19 and Amnesty Reforms’ study of 2021 reported “in the case of a medical emergency, they had access to medical care through using their documented friend’s legal IDs.” 50% of Bangladeshi migrants interviewed “noted using friends’ legal papers to receive medical care.” One literature review of Nepalese migrant workers found that Nepalese workers had the highest rate of occupational injuries (28%), and that 17.9% were fatal in GCC Countries. In October 2019, 5,200 Indian migrant workers died of fatal heat exposure in Dubai. While these isolated incidents may not have all occurred in Saudi Arabia, there is a trend consistent with migrant workers in GCC Countries.

Furthermore, we see this trend paralleled in the United States with undocumented immigrants. Because undocumented immigrants are ineligible to apply for Medicare/Medicaid, huge amounts of them end up not getting medical care they desperately need in fear of deportation. 46% of undocumented immigrants are uninsured, in comparison to 9% of US citizens. These restrictions curb access to COVID-19 relief, and present multitudinous hardships for immigrants and their wellbeing.

Sources:

Arab Center DC: Migrant Workers & COVID-19 in GCC Countries

Health Coverage of Immigrants Factsheet

Undocumented Migrants in Saudi Arabia

The Economic and Psychological Impacts of COVID-19 on Indian migrant workers in Saudi Arabia

I will admit: I have not put as much time into my independent study as I should. Adjusting to suddenly having a 7 class workload is definitely a steep learning curve, but I’ve been getting better. I did sort of plan ahead for this by integrating reading for most of January, but the tediousness of IRB approval threw me off-guard. To account for this, I think I’m going to be doing the individual research and everything on my own, and eventually applying for an IRB over the summer when I have a little bit more free time to complete the necessary courses and steps in order to gain IRB approval.

Otherwise, however, the background reading has been going well. The Faces of Poverty in North Carolina has opened my eyes to how deeply entrenched in economics and capitalism the healthcare system is. Soon, I’ll be making a master-post of all the good information I found in background reading. One of my goals for February is to finish the background section of what will become my academic paper. Summarizing a good amount of the information I found will help with this!

So much of what I’ve learned has shocked and appalled me, and instilled even more of a passion for righting the wrongs that the world has continuously dished out to those who are less fortunate. This world is one of many atrocities, and I feel such an urge to fix them. This independent study is just the start of that.

As always, thanks for tuning in!

This week, I finished reading the Faces of Poverty in North Carolina by Gene R. Nichol, a well-known UNC professor who has been in the field of healthcare discrimination for most of his career. The Faces of Poverty in North Carolina has been an enlightening read— it’s shed light on a lot of the issues that North Carolinians face in gaining incredibly necessary access to healthcare. While there is a lot of analytical data, I feel that the most impactful and necessary parts of the book were those with first hand accounts of the ways in which people were effected by lack of access to healthcare. I’ve added a couple of really poignant descriptions that Professor Nichol added.

“The statistics of American poverty are straightforward and demoralizing. Almost 13 percent of Americans, over 40 million, fall below the federal poverty threshold… Our poverty is skewed sharply on the basis of race… 22% of African Americans and 19.4% of Hispanics, compared with 9% for whites…”

p. 1

“…small historic, mostly black town in Rowan County, where over 50% of the community lives in poverty… no high school, no library, no commercial district, and no grocery store.”

p. 9

“Tonya Hall, a fifty-five year old mother and grandmother… ‘It was instilled in me at a very young age if you want to eat, you have to work,” she says… But in 2011, she was forced to endure a six hour fusion operation for scoliosis… Losing insurance coverage after the surgery, she had to forgo physical therapy treatments because she couldn’t afford them.”

p. 40

Tonya’s story is one of many. The fact that her right to live a happy, healthy, and prosperous life is limited by this arbitrary idea of insurance is just preposterous to me. It is inherently a human right to gain access to healthcare, but this is obviously something that the United States neither believes, nor supports.

Now that I’ve identified the problem, in upcoming weeks I will be reaching out to medical school directors about ways in which we are solving the issue, as well as reading about replacements for the insurance system in America.

Thank you for tuning in!

One of the first things I set out to do, alongside preliminary background research, was applying for an IRB. IRB stands for institutional review board, and you must apply to one to be able to publish your paper. My paper is qualitative research: I’m not measuring data, merely observations and experiences. This makes the IRB process slightly less difficult, but difficult nonetheless. Because I am applying to such a large entity like the NIH (National Institute of Health), there are lots of hoops to jump through which make everything slightly more difficult. Here are some of their extensive guidlines:

Because my research spans two continents, that adds another layer of complexity as I have to apply for IRBs in both Saudi and the US.

However, IRB application is not the only thing I’ve been working on. I’ve been doing a lot of preliminary background reading that is comprehensive to the issues we currently face today in healthcare. I’m gathering a list of problems that we are facing, as well as statistics and data to prove that these problems truly do exist. Articles and studied I’ve been reading include (but aren’t limited to)

→ The Faces of Poverty in North Carolina by Gene R. Nichol 

→ Undocumented migrants in Saudi Arabia: COVID-19 and Amnesty Reforms

→ Civic Stratification and the Exclusion of Undocumented Immigrants from Cross-Border Health Care

Food for thought: how different would the world be without social media? In someways, social media is the only way for BIPOC to tell the world about discrimination they’ve faced in healthcare. Otherwise, they would be consistently ignored, or told that this is merely a figment of imagination like they were for centuries. Sites like Twitter have become tools for the disenfranchised, and I fear a world in which censorship becomes the norm.

Welcome to DA Sites. This is your first post. Edit or delete it, then start writing!