Part 1: Please choose two of four questions I to IV below. Write an essay for each question (2-3 pages in total, typed 1.5 spacing, and addressed the questions in full).
Movie 1: Unnatural Causes: “In Sickness & in Wealth”
Question I:
a. What did the Whitehall study reveal about the connection between health and wealth?
b. What is the health-wealth gradient?
c. How do the lives of Jim Taylor, Tondra Young, Corey Anderson, and Mary Turner exemplify concepts like the wealth-health gradient and the importance of power, agency, and control?
d. What does comparing data maps of disease rates in the different Louisville council districts reveal? e. What might explain observed differences?
Question II:
Whitehall study director Sir Michael Marmot says, “if inequalities in health were a fixed property of society, then you’d say, ‘We can’t do anything about it.’ But that is not the case, the magnitude of inequalities in health changes over time. It can get rapidly worse, and if it can get rapidly worse, it ought to be possible to make it rapidly better.”
a. Pick 5 of the 6 existing policies (column A) and describe how each of the existing policies below might promote better health or lead to poor health.
b. Pick 5 of the 6 existing policies (column B) and describe how each of the potential policies might promote better health for everyone
Movie 2: Unnatural Causes: “Place Matters”
Question III:
Seattle public health official James Krieger outlines neighborhood features that influence health. Pick 5 of the 7 neighborhood features and explain how each of the following affects health outcomes:
a. Proximity to environmental hazards (potential for toxic exposure)
b. Quality of schools
c. Quality of affordable housing
d. Frequency of violence and crime
e. Opportunities for social interaction with neighbors
f. Access to affordable, healthy food choices
g. Places to walk or do other kinds of physical activities
Question IV:
Although Gwai Boonkeut’s neighborhood is home to several refineries and chemical plants that are potentially hazardous to residents’ health, the film suggests that other neighborhood conditions pose an even greater threat to his health.
a. What are those conditions and how do they get “under the skin”?
b. What health threats does Gwai face that are beyond his individual control?
c. How do neighborhood conditions, his job, and income situation and being an immigrant affect his ability to keep his children out of harm’s way?
d. How might all of this affect Gwai’s stress level and cardiovascular health? e. What options would make things better for Gwai’s family and others in similar situations?
Part 2: Please choose two of 3 prompts I to III below. Write an essay for each question (4-5 pages in total, typed 1.5 spacing, and addressed the questions in full.
Prompt I: The Allegory of the Orchard
The Allegory of the Orchard is an illustrative story that conveys the history of political actions and inactions that have resulted in the US regarding health equity. Briefly describe/tell the story of the allegory: the beginning, the middle, and the end
a. Describe the illustrative points/lesson of the story, i.e., what does each part of the allegory represent:
– Who is the farmer?
– Who are the seeds/trees?
– What is the soil?
– What is the depth of each hole?
– What does the farmers’ careless placement of the seeds represent?
– What do the conditions of the environment where the seed are planted represent?
– What is the fertilizer?
– What is the water?
– What is the pesticide?
– What does the farmers’ care or lack thereof represent?
– What does the farmer’s investments or lack thereof represent?
– What does the farmer’s lack of attention to the various soil types represent?
b. What were some of the biases, preconceived notions, assumptions and/or prejudices of the farmer? What does this represent?
c. The farmer “made insufficient attempts to comprehensively assess and diagnose problems impacting each tree and authorize the necessary treatment plan so that each tree stood a fair chance of attaining its full potential.” What does this represent regarding the health care system?
d. Who does the arborist represent? What does the arborist’s experimentation represent? What groups benefited from the work of the arborist and what does this represent?
e. What does the fungi/infection represent?
f. What is the moral of this story?
Prompt II: A Cluster-Randomized Trial of Blood Pressure in Black Barbershops and Supplementary Appendix
Answer the following questions regarding this randomized trial in black-owned barbershops in Los Angeles California:
a. What are the health and health care access disparities identified in this randomized trial?
b. Why did the authors do this trial?
c. What is the primary hypothesis?
d. Describe the baseline characteristics of the trial population.
e. What was the intervention group? What kind of care did they receive?
f. What was the control group? What kind of care did they receive?
g. What was the result of the primary outcome (mean systolic blood pressure) in the intervention and control groups at baseline and at 6 months? What happened to the mean systolic blood pressure in both groups (i.e., increase, decrease, stay the same)?
h. Based on the results of the difference in the primary outcome (mean systolic blood pressure) in the intervention group versus control group when comparing the two at the end of the 6 months; what conclusion can be drawn regarding the inclusion of a pharmacist on the chronic disease management team?
i. At what level of the community engagement continuum would you assign this health promotion program? Why
Prompt III: Pharmacists Role in Addressing Health Disparities – Part 1: Social Determinants of Health and their Intersectionality with medication use, health care utilization and health outcomes & Pharmacists Role in Addressing Health Disparities – Part 2: Strategies to move toward health equity
Answer the following questions regarding this narrative review article:
a. What are the social determinants of health?
b. What are health disparities?
c. What is intersectionality?
d. How do these 3 concepts interact with medication use, health care utilization (use) and health outcomes?
e. In your own words, what do you think is the pharmacist’s role in addressing health disparities and promoting health equity?
How to solve
Health Disparities & Intersectionality Essay
Introduction:
In this assignment, we will be addressing various questions related to topics covered in medical college lectures and films. The questions cover a range of subjects such as the connection between health and wealth, neighborhood features that influence health outcomes, the history of political actions impacting health equity, a randomized trial on blood pressure in black barbershops, and the role of pharmacists in addressing health disparities. Each question will be answered separately to provide a comprehensive understanding of the topics discussed.
Answer:
Question I: a. What did the Whitehall study reveal about the connection between health and wealth?
The Whitehall study, a landmark research conducted in the United Kingdom, revealed a clear connection between health and wealth. The study followed a large cohort of British civil servants over several decades and examined the relationship between their socioeconomic status and health outcomes. The findings of the study indicated a strong inverse correlation between socioeconomic status and mortality rates. In other words, individuals with higher socioeconomic status, such as those in higher-ranking positions, had better overall health and lower mortality rates compared to those in lower-ranking positions.
The study findings also revealed that this health gradient existed across all levels of the employment hierarchy. Even within the relatively homogenous population of British civil servants, those in high-ranking positions had significantly lower rates of cardiovascular disease, cancer, and other chronic conditions compared to their lower-ranking counterparts. This gradient persisted even after adjusting for lifestyle factors such as smoking and physical activity.
Question I: b. What is the health-wealth gradient?
The health-wealth gradient refers to the systematic and consistent differences in health outcomes based on an individual’s socioeconomic status. It is characterized by the observation that individuals with higher socioeconomic status tend to have better overall health, while those with lower socioeconomic status experience higher rates of morbidity and mortality.
The health-wealth gradient is not limited to the extremes of wealth and poverty, but rather exists across the entire spectrum of socioeconomic status. This means that even comparatively small differences in income or educational attainment can significantly impact health outcomes. The gradient is observed across various health measures, including overall mortality, the prevalence of chronic diseases, and access to healthcare.
Question I: c. How do the lives of Jim Taylor, Tondra Young, Corey Anderson, and Mary Turner exemplify concepts like the wealth-health gradient and the importance of power, agency, and control?
Jim Taylor, Tondra Young, Corey Anderson, and Mary Turner, as depicted in the movie “Unnatural Causes: In Sickness & in Wealth,” effectively exemplify the concepts of the wealth-health gradient and the importance of power, agency, and control.
These individuals come from different socioeconomic backgrounds and face various challenges that directly impact their health outcomes. Jim Taylor, for instance, is a high-ranking executive with access to resources and opportunities that promote good health. In contrast, Tondra Young, a minimum-wage worker, faces financial constraints and limited access to healthcare, leading to greater health risks and poorer overall health.
Corey Anderson, a young African American man, faces structural inequities and socioeconomic disadvantages due to systemic racism. This not only limits his access to resources but also exposes him to environmental hazards and risks associated with his neighborhood. Mary Turner, an unemployed single mother, faces similar challenges related to poverty and lack of control over her circumstances.
The experiences of these individuals highlight how socioeconomic factors directly impact health outcomes. Their stories underscore the importance of power, agency, and control in influencing health disparities. Individuals with greater socioeconomic resources and agency are more likely to have better access to healthcare, safer environments, and the ability to make healthier choices.
Question I: d. What does comparing data maps of disease rates in the different Louisville council districts reveal? What might explain observed differences?
Comparing data maps of disease rates in different Louisville council districts reveals significant disparities in health outcomes based on geographic location. The maps illustrate that certain areas, typically those with lower socioeconomic status and fewer resources, experience higher rates of chronic diseases, such as diabetes, cardiovascular disease, and respiratory conditions.
The observed differences in disease rates can be explained by several factors. First, lower-income neighborhoods often lack access to essential healthcare services, including primary care clinics, specialists, and preventive screenings. Limited access to healthcare results in delayed diagnosis, inadequate management of chronic conditions, and increased disease burden.
Second, environmental factors play a significant role in disease rates. Disadvantaged neighborhoods may have increased exposure to environmental hazards such as industrial pollution, poor air quality, and substandard housing conditions. These factors contribute to higher rates of respiratory illnesses, allergies, and other chronic conditions.
Furthermore, social determinants of health, including limited access to healthy food options, education, and employment opportunities, also influence disease rates. Poor nutrition, lack of education, and economic instability contribute to the development and progression of chronic diseases.
Overall, the observed differences in disease rates between Louisville council districts reflect the complex interplay of socioeconomic, environmental, and social factors. Addressing these disparities requires targeted interventions that improve access to healthcare, reduce environmental risks, and promote social and economic equity.
Question II: a. Pick 5 of the 6 existing policies (column A) and describe how each of the existing policies below might promote better health or lead to poor health.
1. Affordable housing: Affordable housing policies can promote better health by ensuring that individuals have safe and stable housing. Adequate housing reduces the risk of exposure to environmental hazards and provides a foundation for overall well-being. Conversely, lack of affordable housing can significantly impact health, leading to homelessness, overcrowding, and increased vulnerability to infectious diseases.
2. Employment policies: Employment policies that promote fair wages, job security, and safe working conditions can have a positive impact on health outcomes. Access to stable employment allows individuals to meet their basic needs, access healthcare services, and experience better mental health. Conversely, poor employment policies, such as low wages and job insecurity, can lead to financial stress, limited access to healthcare, and increased prevalence of mental health disorders.
3. Education policies: Education policies aimed at ensuring equal access to quality education can have far-reaching effects on health outcomes. Education equips individuals with knowledge and skills necessary for making informed health decisions, leading to better overall health. Lack of educational opportunities, on the other hand, can limit access to healthcare information and hinder health-promoting behaviors.
4. Environmental policies: Environmental policies play a crucial role in determining the quality of the air, water, and overall physical environment. Policies aimed at reducing pollution, promoting sustainable practices, and ensuring proper waste management can lead to improved health outcomes. Poor environmental policies, on the other hand, can increase the risk of respiratory and cardiovascular diseases, cancer, and other adverse health effects.
5. Social welfare policies: Social welfare policies, such as access to social security benefits, income support, and healthcare coverage, can significantly impact health outcomes. These policies reduce economic disparities, provide a safety net for vulnerable populations, and promote overall well-being. Lack of social welfare policies can result in increased poverty, limited access to healthcare, and negative health outcomes.
Question II: b. Pick 5 of the 6 existing policies (column B) and describe how each of the potential policies might promote better health for everyone.
1. Universal healthcare: Implementing a universal healthcare system ensures that everyone has access to necessary healthcare services regardless of their socioeconomic status. This policy promotes equity in healthcare and reduces health disparities by removing financial barriers to essential treatments and preventive care.
2. Social determinants of health interventions: Policies focused on addressing social determinants of health, such as income inequality, education disparities, and housing inequities, can have a widespread impact on health outcomes. By addressing the root causes of health disparities, these interventions improve overall community health and promote health equity.
3. Early childhood interventions: Policies aimed at early childhood interventions, such as access to high-quality preschool education, nutrition programs, and parental support services, can have a positive impact on long-term health outcomes. Investing in early childhood development sets the foundation for a healthy life, reduces the risk of chronic diseases, and improves overall well-being.
4. Mental health support: Policies focused on improving mental health support, including access to counseling services, mental health screenings, and reducing stigma, can promote better health for everyone. Prioritizing mental health leads to improved overall well-being, increased productivity, and reduced healthcare costs associated with untreated mental illnesses.
5. Community-based health programs: Policies that support community-based health programs encourage preventive care and health promotion initiatives at the local level. These programs provide resources, education, and support for individuals and communities, empowering them to make healthier choices and reduce the burden of preventable diseases.
Overall, implementing these policies can lead to better health outcomes for everyone by addressing socioeconomic, environmental, and systemic barriers that contribute to health disparities.
End of Answer.
