Health Disparities and Underserved Populations
Mr. Yost is a sixty-three-year-old Korean American who has been in the United States for seven years. Dr. Yee is a thirty-one-year-old second-generation Chinese American family physician who has been seeing Mr. Yost for three years. They have a good relationship, but early in their relationship Mr. Yost mentioned that he occasionally used “traditional” medications from Korea and India. Dr. Yee expressed his disapproval. Mr. Yost was somewhat surprised by Dr. Yee’s reaction, given the doctor’s Asian ancestry, but Mr. Yost liked the doctor so he decided he would continue to see him, but would never mention traditional medicine again.
Mr. Yost was feeling extremely ill. He suffered from general weakness, dizziness, nausea, and muscle pain. He came to see Dr. Yee. After a number of tests Dr. Yee had great difficulty finding a cause for Mr. Yost’s illness. Dr. Yee began to suspect lead poisoning, but that is very rare among adults, unless exposed at work. Given Mr. Yost’s job as an office worker, occupational lead exposure seemed unlikely. And Dr. Yee had not prescribed any drugs or other treatments that would elevate Mr. Yost’s lead levels.
After blood tests, the doctor was able to determine that Mr. Yost was suffering from lead anemia (lead poisoning). But he could not figure out how this would have happened. What Mr. Yost never told Dr. Yee is that while on a recent trip to Korea, he visited a traditional Ayurvedic medical center where he obtained herbal medicines that he had been taking. Mr. Yee never connected his lead poisoning with the herbal medicines he took. After being treated for lead poisoning, Mr. Yost went back to taking the herbs.
TABLE A.1. RACE DIFFERENCES IN USE OF ANALGESIC (PAIN) MEDICATION.
|
|
Patient’s Race |
|
|
Analgesic received |
White |
Black |
|
Yes |
67(74%) |
73(57%) |
|
No |
23(26%) |
54(43%) |
|
Total |
90 |
127 |
Discussion Questions
1. Given that Mr. Yost did not tell Dr. Yee about the herbal medicine, he will likely get lead poisoning again. What needs to happen to get Mr. Yost to give Dr. Yee the critical information he needs?
2. What role did Dr. Yee play in creating a scenario in which Mr. Yost will likely suffer lead poisoning for a second time?
3. Consider the various aspects of cultural conflict involved in this case. Eastern versus Western culture. The culture of medicine versus the lay public Acculturated versus less acculturated APIs
Directions
Students will read a brief case study from LaVeist – Chapter Twelve for which they will submit a 4-page analysis in APA format (no more than 4 pages). In addition to chapter twelve, students will include and apply what they learned from the course by also citing the textbooks and at least “two” journal articles no more than five years old.
Below are the guidelines for the case study. Be sure to include subheadings to identify each section, e.g., Summary, Critical Information Required, The Role of Dr. Yee, Cultural Conflict, Comparison, Analysis
- Introduction – summary of the LaVeist case
- Answer the questions within the textbook. You want to include subheading as oppose to including the actual questions. g., Critical Information Required, The Role of Dr. Yee, Cultural Conflict.
- Acknowledge health disparities among underrepresented populations. (CLO 3,4)
- Recognize issues related to the health of American Indians, Alaska Native, Asian, and Pacific Islander populations.
- Compare the LaVeist case to what you learned from the two journal articles.
- Do you agree with the authors’ findings? Why or Why not?
- What did you find that was missing from the “LaVeist” case study?
Suggested Journal Articles
Journal Articles
- Adaki, M., Sandoval, M., Xu, F., Aseret, T., Allison, M., Greenlund, K. J., & Barbour, K. E. (2018). Health disparities among American Indians/Alaska Natives. (Links to an external site.)Morbidity and Mortality Weekly, 67(1), 1314-1318. doi:10.15585/mmwr.mm6747a4
- Guo, M., Quensell, M., Chang, A., Miyamura, J., & Sentell, T. (2018). Understanding of key obstetric quality terminology by Asian and Pacific Islander subgroups. (Links to an external site.)Maternal and Child Health Journal, 22(1), 1543-1549. doi:10.1007/s10995-018-2597-8
- Patel, M. R., Israel, B. A., Song, P. H., Hao, W., Teher, L., Tariq, M., & Lichtenstein, R. (2019). Insuring good health: Outcomes and acceptability of a participatory health insurance literacy intervention in diverse urban communities. (Links to an external site.) Health Education and Behavior, 46, 494-505.
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