00:05
Okay, so continuing on the focus
of why this is important?
Health inequities is a big reason.
00:12
So what happens is that we determine
based on bias sometimes and status.
00:16
How we're going to
distribute resources
to different people
or groups of people
based on multiple different things,
social conditions they live in
or born in, grow, live, work, age,
when we think about the
determinants of health, right?
Why did that happen?
Well guess what,
It happened as a result of those
structures we talked about earlier,
when we talk about
structural racism.
00:38
And I do like to broaden that
because it has gone way
beyond racism.
00:43
There are several isms
that create health inequities.
00:47
And also phobias.
00:48
So when we talk about
-isms and -phobias,
what am I talking about?
Racism, classism, sexism,
elitism, ableism,
lots of different things that
going back to
that word of relegation,
where we relegate people
to a lesser than space,
and we somehow decide
people don't deserve
equal rights and access
to these resources.
01:12
So the here come
the health inequities.
01:14
So case in point, sometimes it's
even based on flawed research.
01:19
When we think about
how some of these health
inequities show up as a result,
especially as a result of race.
01:27
When we don't think about
race being a social construct,
then we create certain myths.
01:33
A prime example of that
is using the estimated
glomerular filtration rate,
which is a test
that's used to determine
how well your kidneys
are functioning.
01:44
So that test,
there was a study done in which
black people were assigned
a different value
in terms of what the
value arranges for normal,
as opposed to non black people.
01:58
And what happens is it relegates
black people into a different space
where it falsely shows that
their results are higher
than other people
who are non black.
02:11
So it prevents black people from
getting on that transplant list
sooner rather than later.
02:17
And then what happens oftentimes,
is that by the time their numbers
reach the standard,
for the non black people,
it's too late
because they're too sick
to be on there,
based on that flawed number.
02:29
The reason why that number is flawed
is because these researchers decided
that black people have
larger muscle mass
than white people
or everybody else.
02:39
That's absolutely not true.
02:41
There's no scientific or
biological basis for that.
02:45
So that's just one prime example
of health inequities and
unfair distribution of resources.
02:52
And we'll talk about more of those
things throughout this series.
02:55
So another key concept
for us to understand
and look at is health disparities.
03:01
Well, health disparities are
higher burdens of illness
and injury, and disability,
and unfortunately,
mortality experienced
by one group
relative to another.
03:12
Now that could be a direct
correlation to racism
when we think about
the maternal mortality rate.
03:19
And it doesn't even matter
when we think about people
like Serena Williams,
who is rich.
03:24
So when we think about classism,
it doesn't even matter
how much money you have
when people allow their biases
to get in the way of health care
what can happen.
03:33
And you know,
that stories widely publicized,
if you want to look
deeper into that,
but people lose their lives
all the time
because of -isms and biases.
03:44
And I mentioned phobias earlier,
xenophobia, homophobia, transphobia.
03:48
Going back to in the
space of health care,
when you decide to become
a health care provider,
you decide to take care of humans,
regardless of all of that stuff.
03:59
It doesn't matter what you believe.
04:00
You decide that you're going
to treat people
with respect and dignity.
04:04
And then when we talk about
health care disparities.
04:08
That's another big problem
that I've seen a lot of
in my almost 30 years of practice.
04:13
So the differences in
how we treat people
based on their ability to pay
an insurance coverage, right?
We see those patients
Bill of Rights all the time.
04:22
Bills of rights
rather in those hospitals
all the time in clinics, right?
It says that we're going
to provide care to people
regardless of their ability to pay,
in general.
04:33
That's what it says.
04:34
Well, it doesn't say we're going
to decrease the quality of care
we're going to provide,
but we see it all the time.
04:40
We see providers
avoiding certain tests,
because people can't pay for it.
04:46
Well, the first thing I want
to just be frank and say is
it doesn't come out of our pockets.
It has healthcare professionals.
04:53
And I think that our
primary responsibility is
to see this as a service
and not a business.
05:00
People hate to hear me say that
but I'm always going to say it
because humans first.
05:05
So I need to treat
every single human being
that I come into contact with
that respect for human life
and dignity, and compassion,
and mercy,
and focus on the service of this.
05:16
So if I would order a test for
the richest man in the world
who came in here
with symptoms of XYZ,
and then this person who
does not have a home comes in
and they have the
exact same symptoms,
I'm going to order
the exact same test.
05:31
Why?
Because every human deserves
the right to optimal health care
and optimal health outcomes.
05:37
So healthcare disparities,
lead to sentinel events.
05:42
What are sentimental events?
Home cost to patients basically
even resulting up to death.
05:47
We'll talk about that a
little more in the series too.
05:50
But these disparities occur
as through acts of
omission and commission.
05:55
So just keep that in mind.