Childhood Disparities
Biological Embedding
Interaction between genes and environment as involving epigenetic pathways
Racial composition of neighborhoods is associated
with ___
Disparities in a range of health outcomes
__ is the core defining characteristic that gives that doctor patient relationship meaning, importance, and substance
Trust
Collateral Damage
Marshallese health is partially compromised because of___
Long relationship with United States
69 percent of Ashkenazi Jewish women carry __
BRCA mutation for Breast cancer
Epigenetics are important
Because they affect the way a gene is expressed and are an important component of research on human diseases
Hispanic women have nearly the same rate of LBW, VLBW, and infant mortality as____ women
White women
Two principal factors contributing to patients who are clinically appropriate for care nonetheless not receive that care
1. Physician recommends care, patient chooses not to follow care
2. Physician does not recommend care
Not Just A Paycheck
The lower the grade the higher the ___ and ___
Mortality rate and shorter the life expectancy
Race disparities associated with pain (Todd and colleagues 1993)
A persons ethnicity was associated with the treatment they received for the pain of an isolated bone fracture
Research on the role of epigenetics in allergic diseases such as asthma...
Increased evidence pointing on the influence of prenatal and early life exposures on the development of allergic disease
Joint and colleagues (2011)
__ patients are more likely to be readmitted than __
1. Black patients
2. White patients
______ weaken the physician patient interaction
Mistrust of one's physician due to past experience of racial discrimination has been shown to
Place Matters
When the body pumps too much cortisol and adrenaline over time it.....
Raise Arterial plaque
Raise Blood Pressure
Weaken Immune system
Increases risk for almost every chronic disease
Back and Migraine pain likeliness to receive medication
Whites were found most likely to receive a medication for pain for back and migraine pain and Blacks were least likely
Allostatic load with chronic stress
In the event stressors are ongoing, the allostatic load will not have the chance to recharge
Residential Segregation is associated with ____
Worse health outcomes through increased stress and greater exposure to environmental toxins
Identify/Describe patient centered care
Patient centered care works by focusing fully on the patient's individualized medical needs. Patient-centered care is providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions
Not Just A Paycheck
Those who have little control over their lives are at an increase for......
Heart Disease
Mental Illness
Risk of absence from work
Risk of decrements in functioning
Race disparities and pain for Hispanics...
Hispanics are twice as likely as whites to receive no pain medication while in the ER
Allostatic load increase stress response hormones that play a role in ___
Allostatic load increases stress response hormones that leave biomarkers called C-Reactive Protein (CRP) that play a role in cardiovascular disease
_____ patients on Medicaid were more likely to be found in the "worst" hospitals than in the "best"
Elderly Hispanic
In A Walk From El Salvador and patient centered care
Dr. Appleton’s judgments towards this population caused him to turn away people with similar stories. Cruz and Dr. Appleton, were able to help Maria and Juana helping sign up for medicaid and he even wrote down the name of a free adult education class where she could learn English. Also food and clothing were arranged. Patient center care is highlighted in this story
Collateral Damage
How to eradicate TB on Ebeye for Marshallese
Medication, improving living conditions, alleviating crowding, improve nutrition to have strength to fight off disease
Race/Ethnicity in predicting risk or recommending treatment
1991 study found Blacks were 4-6x more likely to have glaucoma's
Breast cancer death rates are highest among Blacks than Whites and Hispanics