In a report presented last week by New York City Department of Health and Mental Hygiene (DOHMH) Commissioner Dr Thomas R Frieden, titled "Women at Risk: The Health of Women in New York City," it was found that there is a connection between race and socio-economic status and health behavior, health care access and health outcomes.
An article in Medical News Today gives us an overview of some of the findings:
-- The health of women in New York City has greatly improved over the past decade, but some groups of women - particularly black, Hispanic, and low-income women - still experience poor health.
-- Many women in New York City do not receive appropriate levels of preventive care, including regular cancer screenings and immunizations.
-- Women lag behind men in heart disease prevention efforts, such as exercising regularly and maintaining a healthy weight.
And some more specific stuff:
-- Women in New York City's poorest neighborhoods have a life expectancy 5 years shorter than those who in the highest income neighborhoods. Black women have a life expectancy almost 5 years shorter than white women.
-- Hispanic women and women with low incomes are less likely than most other women to have health care coverage.
-- Black women are more than twice as likely as white women to die from pregnancy-related complications.
-- Among women, 27% of years of potential life lost are due to cancer, while cancer is responsible for only 17% of the years of potential life lost among men.
-- Nearly one-quarter of women age 40 and older have not received a mammogram in the past two years; fewer than half of women age 50 and over have ever had a colon cancer screening; and 1 in 5 women have not had a Pap test in the past three years. Asian women are least likely to receive colon cancer screenings and Pap tests.
-- The rate of new AIDS diagnoses is 11 times higher among black women than white women and the rate of AIDS deaths is 7 times higher.
Interesting stuff. This really got me to thinking about cultural perceptions of health care and how that also affects frequency of doctor consultations. Any thoughts?
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Based on what I have seen, I believe that cultural perceptions of health care can definitely decrease doctor consultation frequency. My grandparents on my mother's side lived with us for several years when I was a kid. My grandmother, a very devout Catholic, was also a well-versed practitioner of the 'tawas', essentially Philippine-style Catholic faith healing. My mother and many of her friends, all men and women who would rather die than see a doctor, would visit my lola regularly for any and all kinds of ailments, and she would use many different traditional techniques to cure whatever ailed them. (You could imagine my surprise when paparazzi photos of celebrities like Gwyneth Paltrow started showing up of all these various famous people with the circular marks from 'cupping' on their backs -- that was something my lola would do for people very often, and I always thought it was -so weird-!) Even after my grandparents went back to the Philippines, I recall at least one instance where a very sick friend of my mothers went overseas to my grandmother rather than go to a doctor.
Despite the fact that Filipino medical colleges turn out many brilliantly talented and highly-skilled doctors, and despite the fact that my mother and her friends were all living in America, where skilled doctors are not a rare commodity, they would -still- rather go to my grandmother for faith healing than to a regular doctor. To this day, in fact, my mother -still- refuses to see a doctor, despite the fact that she has had, for the past five? eight? years, had something growing on the back of her neck, right over her spine, which started out as a little mole-like bimple, and now it's about the size of a ping-pong ball cut in half. I don't know if it's a cyst or a tumor or an abscess or what, but it's there and it's growing and getting worse, and she WILL NOT GO TO THE DOCTOR. In fact, I am 99% sure that the last time she went to one was 26, almost 27 years ago when she was pregnant with me. Beyond obstetrical care, which she was very good about receiving, she has not been to a doctor at all.
Obviously, not all Filipino people are this way. Why would so many Filipinos be in the medical career field, otherwise? Though I admit that observational and anecdotal evidence is never enough to base a hypothesis on, I can at least say that from my experience, there did seem to be a 50-50 split with my mothers friends when it came to those who'd see a doctor, and those who'd get 'tawas'. Where they came from before immigrating didn't seem to make a large difference with what camp they fell in, either -- some of the 'tawas' believers came from large cities like Alongopo or Metro Manila, while some doctor-visitors grew up in little villages out in the baguio somewhere.
As a white, middle-class woman, I'm not sure how much I can discuss the cultural perception of health care in any minority group, but I have some observations that may be more general to suggest.
1) I know a lot of women who are overweight, and are reluctant to see the doctor to avoid being lectured about the unhealthiness of carrying too much weight. I could suggest that, if there is a significant weight difference between different races (due to available and practical resources to manage weight, or due to cultural considerations regarding weight), this may be a factor.
2) Availablity of medical care may also be a factor, particularly for low income people who rely on public transportation or have to request unpaid time off to go.
3) There's been a fair amount of research done on the high rate of incidence of AIDS among black women. One of the key factors of that is a low rate of condom usage in their relationships. There's also been some research (I don't have references right now) about black men involved in bisexual relationships, but the anti-gay stigma is culturally very high, so it's common for them simply to not admit or discuss their gay experiences - or, more importantly, what risks they may have taken during those experiences.