Journal of healthcare, science and the humanities最新文献

This paper examines African Americans' beliefs of psychosocial factors associated with racial HIV/AIDS and health disparities using an exploratory qualitative study. This research was conducted to determine how African Americans define their health and disease burden, the reasons for their plight; the problems they face; their coping strategies for providing daily necessities of shelter, transportation, and health care. If we ignore the voices of African Americans, we have dehumanized them, making their humanity invisible. Without hearing the voices of African Americans, our understanding of their social life and health issues is incomplete. Analyses from the top down miss the insights that only those experiencing racial health disparities can articulate. Their voices have important implications for policymakers interested in eliminating racial health disparities and promote equity in health. The focus groups discussions in the paper provide the voice, the presence, and the perspective of African Americans who live on the margins and are generally invisible to the rest of us. Issues surrounding racial health disparities are complex, difficult, and controversial. Results indicate that health insurance, lack of access to quality health care, environmental hazards in neighborhoods, poverty, lack of medical practitioners, unhealthy eating habits, poor life style choices, lack of African Americans in health care professions, lack of trust in white health care professionals and unemployment contribute substantially to racial health disparities in America. Health care is a by-product of the distribution of power and the organization of the society.

Documents obtained through the US Freedom of Information Act show that, in 1997, the US National Cancer Institute (NCI) funded an 18-year randomized controlled trial in Mumbai that used mortality endpoints to compare a discredited cervical screening test to no screening. The Mumbai trial required Indian and global health leaders to assume "no screening" would remain "standard care" throughout India for the duration of the trial, and thereby delayed the implementation of routine cervical screening among the general population of India for 18 years. During those 18 years, more than one million women died from cervical cancer in India, while Pap screening became "standard care" in other developing countries. Incorrect beliefs that Pap screening is not feasible in developing countries provide false justification for opportunity costs associated with the Mumbai trial and hinder cervical cancer prevention efforts in developing countries, where 90% of global cervical cancer deaths occur. Those incorrect beliefs also undermine World Health Organization policy guidelines, which should be corrected to acknowledge that good-quality Pap screening can be implemented in developing countries with reasonable investment. Tata Memorial Hospital and the US Office for Human Research Protections (OHRP) determined the Mumbai trial was unethical. That determination has been effectively covered up by false and misleading statements from US medical leaders. All surviving Mumbai trial participants, from both intervention and control arms, should finally receive good-quality cervical screening tests. NCI leaders should accept OHRP determinations, acknowledge the Mumbai trial was unethical, and apologize to trial participants.

Hispanics or Latinos constitute the largest racial/ethnic minority in the United States. They are also a very diverse population. Latino/Hispanic's health varies significantly for subgroups defined by national origin, race, primary language, and migration-related factors (place of birth, immigration status, years of residence in the United States). Most Hispanics speak Spanish at home, and one-third have limited English proficiency (LEP). There is growing awareness on the importance for population health monitoring programs to collect those data elements (Hispanic subgroup, primary language, and migration-related factors) that better capture Hispanics' diversity, and to provide language assistance (translation of data collection forms, interpreters) to ensure meaningful inclusion of all Latinos/Hispanics in national health monitoring. There are strong ethical and scientific reasons for such expansion of data collection by public health entities. First, expand data elements can help identify otherwise hidden Hispanic subpopulations' health disparities. This may promote a more just and equitable distribution of health resources to underserved populations. Second, language access is needed to ensure fair and legal treatment of LEP individuals in federally supported data collection activities. Finally, these strategies are likely to improve the quality and representativeness of data needed to monitor and address the health of all Latino/Hispanic populations in the United States.

Despite major advances and technological improvements in public health and medicine, health disparities persist by race and ethnicity, income and educational attainment, and in some cases are increasing (Jackson & Garcia, 2014). These health disparities among these populations have even worsened or remained about the same since the landmark 1985 Report of the Secretary's Task Force on Black & Minority Health released by then Secretary Margaret M. Heckler. Ensuring diverse public health and healthcare workforces to provide services to diverse populations, in combination with other strategies, can increase access to and quality of healthcare for vulnerable populations and decrease healthcare disparities. One mechanism for achieving a diverse public health and healthcare workforce is to establish, promote, and conduct student training programs in public health. The Office of Minority Health and Health Equity, Centers for Disease Control and Prevention (CDC), has partnered with institutions, colleges, universities, foundations, national organizations and associations to form and implement student training programs. This paper highlights a session "Public Health Professions Enhancement Programs" that was held during the 2015 symposium titled "National Negro Health Week to National Minority Health Month: 100 Years of Moving Public Health Forward" in Atlanta, Georgia. Presenters at the symposium consisted of interns and fellows who had participated in student programs in the Office of Minority Health and Health Equity at the CDC.