Response to Shultz and Abraham, Reaction Paper Example

Summary

Abraham (p. 12) states that in America “health care is treated as a commodity available to those who can afford it, rather than a public good, like education”. In the case described in the article, Robert is “not parent or poor enough” to get help and his low-paying jobs do not provide health insurance. Another important statement of Abraham (p. 13) is that health care does not embrace “commitment to equality”. Comparing the health outcomes of white middle-class people and the poorest black people in Chicago, the article states that diabetes in poor black neighborhood is a disease of middle-aging. (p. 19) Quoting d Dr. Harold Freeman, the article states that poor neighborhoods in large cities are “consistent disaster areas”. (p. 20) Further, the author signifies the issue of health disparities: blacks are four times more likely to suffer kidney failure than whites. (p. 28) Further, they are more likely to lose their kidneys as a result of failure than whites. (p. 29) Robert does not seek help early enough because he does not have the funding for hospital fees. This is one of the constraints of positive health outcomes in low income population. Now, because of his dialysis appointments, as well as his condition, he is unable to work, therefore, the illness further impacts his financial situation. The main statement of the article is that patients’ ability of paying for healthcare determines their health outcomes.

Shultz and Lempert also bring up the lower life expectancy of ethnically diverse populations and the health disparities. Focusing on women’s health, the authors are trying to find a connection between neighborhoods and health disparities. Racial segregation is the main theme of the article, alongside with the effects of poverty on health access. Racial disparities are not only looked at from the economic perspective, like in Abraham’s article; more importantly the authors investigate the impact of segregation. Social dimensions of health are looked at by the article from a multi-disciplinary aspect. The authors state that health can be determined as ““[Being healthy is] your everyday participation in the world really” (p. 445). Therefore, the ability to participate in the society impacts individuals’ mental and physical outcomes. Still, instead of simply describing the impact of society, neighborhood and race on health outcomes, the authors outline strategic recommendations: this being the main strength of the study. Tackling “broken-down” communities and engaging them in actions to reject the common “closed door policy” is the task social workers need to complete, in order to support the successful implementation of health education programs in ethnically or socially diverse neighborhoods.

Reflection

While Abraham’s article focuses mainly on the impact of poverty on health access and outcomes,  Shultz and Lempert looks at health disparities from the social perspective. Indeed, both of the authors note that statistical reports confirm lower life expectancy of blacks and whites, and different health outcomes, Abraham blames the U. S. health care system for these disparities: dividing poor and rich. Shultz and Lempert blames racial segregation for the same problem. Indeed, the problem is more complex than that: social status and economic situation, education level and attitudes together create health disparities. As some socio-economic problems affect particular groups more than others, health disparities are created.

Themes and Current Issues Related To Course

In this course, we investigated why health disparities are present among disadvantaged groups of urban societies. The social and economic approaches of the above articles have provided important information for investigating the relationship between socio-economic status, quality of housing, community engagement and health outcomes.

References

Abraham, L. (1994) Mama would be better off dead. Chapters 1-2. University of Chicago Press.

Shultz, A. & Lempert, D. (2004) Being part of the world. Detroit women’s perceptions of health and the social environment. Journal Of Contemporary Ethnography pp. 437-465