Social Conditions Affect on African-American Health

Social Conditions affect on African-American Health

Cara Roeck

University of Central Florida

It is fascinating to look at what actually makes us sick.  Are we simply victims or do we actually have control over what ails us?

The Biomedical Model of Health has been a primary guide for physicians to diagnosing disease since the middle of the nineteenth century.  It focuses on disease as coming from the environment or as involuntary changes within the body caused by various factors such as genetics, chemical imbalances, bacteria or viruses with the only means of curing an individual of disease is through medical interventions.  

As viewed through this model, a person is either healthy or sick.  There is no in-between or relationship – at no point does a transition exist from wellness to illness or vice versa.  

And just as the biomedical model looks at illness and wellness as a start and stop, it also views the mind and body as two separate entities that do not influence one or the other and are completely independent of each other.  The mind is seen as dealing only with thoughts and feelings and body is consisting of physical substance such as bone, derma, muscle, vessels and organs.  The biomedical model of health focuses on solely biological factors, and excludes social, psychological, and environmental influences.  But while it refutes psychological factors as the cause of disease, it does acknowledge that biological disease does have psychological consequences.  

On the other hand, there is the Structural Model of Health that suggests that the human system should be viewed as one entire complex system where wellness and illness is dependent on a multitude of factors, including social, psychological and environmental influences.  Unlike the Biomedical Model of Health, the Structural Model of Health says that we can have either a negative or positive influence on our health.  That it is not just biologic that controls our health, but our environment and behaviors.

As viewed through this model, a person progresses from healthy to sick and vice versa.  

Humans can choose behaviors that will keep us healthy and help heal our disease.  Humans are not victims to genetics, bacteria, viruses or chemical imbalances, but rather have an active role in our personal wellness.  Additionally, our wellness not only depends on our behaviors but also the perspective of treatment is the whole person approach, where the body and the mind are seen as interactive and having influence on each other.  

However, the challenges of both models are still access, education and social factors.   People still need to have access to healthcare, they need to be able to afford health care and make better educated decisions for themselves to live healthier, longer lives and they need to have support to do that.  Data shows that the racial/ethnic group with the largest health disparities is African-Americans.  

Most telling of the health disparity suffered by African-Americans, is the extraordinary rates of chronic disease, the highest of all race/ethnicities in the US.  When looking at what challenges are present for African-Americans, it is evident that access is a significant factor.  African-Americans are least likely to have health insurance or a job that offers insurance.  African-Americans are more likely to report their chronic disease, but least likely to visit a physician on a regular basis and not as likely to be an advocate for health related concerns and health habits.  

Heart Disease is the leading cause of death among African-Americans in the US.  In the article, Life at the Top in America Isn't Just Better, It's Longer, which tracks three individuals with varying social statuses through the aftermath of a heart attack, we can begin to understand the difference as to why African-American health is the poorest in the nation.  Access, education and social (employment) are the biggest challenges.  

As a result of lower education levels, African-Americans’ have less opportunities to gain employment with employers who offer health benefits.  This also contributes to low income levels and high rates of government funded health benefits, welfare and housing.  These factors make it hard for an African American to get access to better healthcare in hospitals more equip with current technologies and procedures and little community efforts are done to educate this population.  There is segregation within the community for housing, education and employment.  

Furthermore, the African-American population education is a critical factor in prevention and/or treatment of heart disease.  Either because of lack of understanding symptomology or lack of access health care is often postponed for inability to pay or not able to be provided due to financial or discriminatory reasons.  

Because of the income and insurance factors within the communities of the African-American population, hospitals servicing those areas don’t invest in latest equipment or technology (i.e. Cath Labs) and recruiting and program development, (i.e. Heart Valve Centers and Cardiac Rehabilitation Centers) efforts are low. More advanced technology, less invasive techniques are not provided because they cost more.  Length of stays are longer and risk of infection or reoccurrence is higher.  Long term outcomes are not as positive because home health behaviors usually don’t change.