A Community Mobilizes to End Medical Apartheid

Golub, Maxine; Calman, Neil S.; Ruddock, Charmaine; Agarwal, Nisha Rani; Davis, Joyce; Foley, Robert; Purcaro, Ellenrita; Backer, Barbara A.; Devia, Carlos; Linnell, Jill; Mathur, Ruchi; Sachdev, Neha

doi:10.1353/cpr.2011.0041

Cited by 13 publications

(8 citation statements)

References 12 publications

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“…19 These findings led the New York Lawyers for the Public Interest to file a civil rights complaint in 2008 alleging that three NYC AMCs discriminated on the basis of insurance and race—a complaint that then-Attorney General Andrew Cuomo declined to pursue. 28 In 2011, the Health Disparities Workgroup commissioned by (now) Governor Cuomo urged the state Department of Health to address disparities in care at NYC AMCs by patient insurance status. 29 …”

Section: Discussionmentioning

confidence: 99%

“…29 Second, state authorities should challenge NYC AMCs’ maintenance of separate clinical units for Medicaid patients and the privately insured. 28 At the hospital level, faculty physicians should be required to accept patients regardless of insurance status. Third, officials could enforce requirements that AMCs that are governed as nonprofit, tax-exempt entities must deliver substantial amounts of free care as a condition for retaining their nonprofit status.…”

Section: Discussionmentioning

confidence: 99%

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Hospital Payer and Racial/Ethnic Mix at Private Academic Medical Centers in Boston and New York City

et al. 2017

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Academic medical centers (AMCs) are widely perceived as providing the highest-quality medical care. To investigate disparities in access to such care, we studied the racial/ethnic and payer mixes at private AMCs of New York City (NYC) and Boston, two cities where these prestigious institutions play a dominant role in the health care system. We used individual-level inpatient discharge data for acute care hospitals to examine the degree of hospital racial/ethnic and insurance segregation in both cities using the Index of Dissimilarity, together with recent changes in patterns of care in NYC. In multivariable logistic regression analyses, black patients in NYC were two to three times less likely than whites, and uninsured patients approximately five times less likely than privately insured patients, to be discharged from AMCs. In Boston, minorities were overrepresented at AMCs relative to other hospitals. NYC hospitals were more segregated overall according to race/ethnicity and insurance than Boston hospitals, and insurance segregation became more pronounced in NYC after the Affordable Care Act. Although health reform improved access to insurance, access to AMCs remains limited for disadvantaged populations, which may undermine the quality of care available to these groups.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hospital Payer and Racial/Ethnic Mix at Private Academic Medical Centers in Boston and New York City

et al. 2017

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“…Third, hospital administrations and institutions can provide accessible information about profit gains for cesareans, tests, and procedures during delivery. Building better relationships and accountability between hospitals and their patient populations can limit institution mistrust, especially for Black families who are at greatest risk for preterm birth [3] and have been historically and presently abused within the U.S. healthcare system [39][40][41][42].…”

Section: Discussionmentioning

confidence: 99%

What about the men? Perinatal experiences of men of color whose partners were at risk for preterm birth, a qualitative study

McLemore

Baltzell

Hodgkin

et al. 2020

BMC Pregnancy Childbirth

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Background: Preterm birth in the United States is associated with maternal clinical factors such as diabetes, hypertension and social factors including race, ethnicity, and socioeconomic status. In California, 8.7% of all live births are preterm, with African American and Black families experiencing the greatest burden. The impact of paternal factors on birth outcomes has been studied, but little is known about the experience of men of color (MOC). The purpose of this study was to explore the experiences of MOC who are partners to women at medical and social risk for preterm birth. Methods: This study used a qualitative research design and focus group methods. The research was embedded within an existing study exploring experiences of women of color at risk for preterm birth conducted by the California Preterm Birth Initiative. Results: Twelve MOC participated in the study and among them had 9 preterm children. Four themes emerged from thematic analysis of men's experiences: (1) "Being the Rock": Providing comfort and security; (2) "It's a blessing all the way around": Keeping faith during uncertainty; (3) "Tell me EVERYTHING": Unmet needs during pregnancy and delivery; (4) "Like a guinea pig": Frustration with the healthcare system. Participants identified many barriers to having a healthy pregnancy and birth including inadequate support for decision making, differential treatment, and discrimination. Conclusions: This study shows novel and shared narratives regarding MOC experiences during pregnancy, birth, and postpartum periods. Healthcare providers have an essential role to acknowledge MOC, their experience of discrimination and mistrust, and to assess needs for support that can improve birth outcomes. As MOC and their families are at especially high social and medical risk for preterm birth, their voice and experience should be central in all future research on this topic.

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“…Many pastors also advocated from the pulpit, [ 39 ] mobilizing community members to confront segregated and disparate access to specialty medical care. The result was the filing of a legal complaint with the New York State (NYS) Attorney General against a number of New York City academic medical institutions [ 40 ]. Later on local Bronx state elected officials also sponsored a health equality bill in the NYS Assembly and Senate seeking to integrate outpatient specialty care services in NYS teaching hospitals [ 40 ].…”

Section: Methodsmentioning

confidence: 99%

Advancing system and policy changes for social and racial justice: comparing a Rural and Urban Community-Based Participatory Research Partnership in the U.S.

Devia

Baker

Sanchez-Youngman

et al. 2017

Int J Equity Health

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BackgroundThe paper examines the role of community-based participatory research (CBPR) within the context of social justice literature and practice.MethodsTwo CBPR case studies addressing health inequities related to Type 2 Diabetes and Cardiovascular disease were selected from a national cross-site study assessing effective academic-community research partnerships. One CBPR partnership works with African Americans in rural Pemiscot County, Missouri and the other CBPR partnership works with African American and Latinos in urban South Bronx, New York City. Data collection included semi-structured key informant interviews and focus groups. Analysis focused on partnerships’ context/history and their use of multiple justice-oriented strategies to achieve systemic and policy changes in order to address social determinants of health in their communities.ResultsCommunity context and history shaped each partnership’s strategies to address social determinants. Four social justice approaches (identity/recognition, procedural, distributive, and structural justice) used by both partnerships were identified. These social justice approaches were employed to address underlying causes of inequitable distribution of resources and power structures, while remaining within a scientific research framework.ConclusionCBPR can bridge the role of science with civic engagement and political participation, empowering community members to become political agents who integrate evidence into their social justice organizing strategies.

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A Community Mobilizes to End Medical Apartheid

Abstract: Community groups and professionals with relevant expertise can tackle complex systemic problems, but they must be prepared for a long and difficult fight.

Cited by 13 publications

References 12 publications

Hospital Payer and Racial/Ethnic Mix at Private Academic Medical Centers in Boston and New York City

Hospital Payer and Racial/Ethnic Mix at Private Academic Medical Centers in Boston and New York City

What about the men? Perinatal experiences of men of color whose partners were at risk for preterm birth, a qualitative study

Advancing system and policy changes for social and racial justice: comparing a Rural and Urban Community-Based Participatory Research Partnership in the U.S.

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