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"Health Policy United States Personal Narratives."
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How we do harm : a doctor breaks ranks about being sick in America
Dr. Brawley exposes the underbelly of healthcare today--the under-treatment of the poor, the over-treatment of the rich, the financial conflicts of interests physicians face, insurance that doesn't demand the best (or even cheapest) care, and a pharmaceutical behemoth concerned with selling drugs, not providing health.
Book
Losing Tim
Paul Gionfriddo's son Tim is one of the \"6 percent\"—an American with serious mental illness. He is also one of the half million homeless people with serious mental illnesses in desperate need of help yet underserved or ignored by our health and social-service systems. In this moving, detailed, clear-eyed exposé, Gionfriddo describes how Tim and others like him come to live on the street. Gionfriddo takes stock of the numerous injustices that kept his son from realizing his potential from the time Tim first began to show symptoms of schizophrenia to the inadequate educational supports he received growing up, his isolation from family and friends, and his frequent encounters with the juvenile justice system and, later, the adult criminal-justice system and its substandard mental health care. Tim entered adulthood with limited formal education, few work skills, and a chronic, debilitating disease that took him from the streets to jails to hospitals and then back to the streets. Losing Tim shows that people with mental illness become homeless as a result not of bad choices but of bad policy. As a former state policy maker, Gionfriddo concludes with recommendations for reforming America's ailing approach to mental health.
eBook
Health in the United States
The United States suffers high rates of preventable lifestyle disease despite widespread calls for people to take responsibility for their health. The United States also stands out in its rejection of government action to guide industry practices and consumer choices. Why? We examine how deeply rooted cultural narratives about “free choice” and “personal responsibility” infuse policymaking, advertising, media, social norms, and individual attitudes about health in the United States. We argue that these narratives contribute to ill health in the United States: They encourage stress and worry over health, blame and stigmatization of the unhealthy, widened health disparities, and the failure to adopt policies that could save lives. Psychologists can play a major role in expanding narratives about health so that they include the role of personal choice and responsibility but also reflect current science about the physical, social, and cultural drivers of health. These broader narratives can be used to promote a more comprehensive understanding of health and to better inform the design, communication, and implementation of effective health-supportive policies.
Journal Article
Early Crowdfunding Response to the COVID-19 Pandemic: Cross-sectional Study
As the number of COVID-19 cases increased precipitously in the United States, policy makers and health officials marshalled their pandemic responses. As the economic impacts multiplied, anecdotal reports noted the increased use of web-based crowdfunding to defray these costs.
We examined the web-based crowdfunding response in the early stage of the COVID-19 pandemic in the United States to understand the incidence of initiation of COVID-19-related campaigns and compare them to non-COVID-19-related campaigns.
On May 16, 2020, we extracted all available data available on US campaigns that contained narratives and were created between January 1 and May 10, 2020, on GoFundMe. We identified the subset of COVID-19-related campaigns using keywords relevant to the COVID-19 pandemic. We explored the incidence of COVID-19-related campaigns by geography, by category, and over time, and we compared the characteristics of the campaigns to those of non-COVID-19-related campaigns after March 11, when the pandemic was declared. We then used a natural language processing algorithm to cluster campaigns by narrative content using overlapping keywords.
We found that there was a substantial increase in overall GoFundMe web-based crowdfunding campaigns in March, largely attributable to COVID-19-related campaigns. However, as the COVID-19 pandemic persisted and progressed, the number of campaigns per COVID-19 case declined more than tenfold across all states. The states with the earliest disease burden had the fewest campaigns per case, indicating a lack of a case-dependent response. COVID-19-related campaigns raised more money, had a longer narrative description, and were more likely to be shared on Facebook than other campaigns in the study period.
Web-based crowdfunding appears to be a stopgap for only a minority of campaigners. The novelty of an emergency likely impacts both campaign initiation and crowdfunding success, as it reflects the affective response of a community. Crowdfunding activity likely serves as an early signal for emerging needs and societal sentiment for communities in acute distress that could be used by governments and aid organizations to guide disaster relief and policy.
Journal Article
Utilization of Standardized Mental Health Assessments in Anthropological Research: Possibilities and Pitfalls
In the past decade anthropologists working the boundary of culture, medicine, and psychiatry have drawn from ethnographic and epidemiological methods to interdigitate data and provide more depth in understanding critical health problems. But rarely do these studies incorporate psychiatric inventories with ethnographic analysis. This article shows how triangulation of research methods strengthens scholars’ ability (1) to draw conclusions from smaller data sets and facilitate comparisons of what suffering means across contexts; (2) to unpack the complexities of ethnographic and narrative data by way of interdigitating narratives with standardized evaluations of psychological distress; and (3) to enhance the translatability of narrative data to interventionists and to make anthropological research more accessible to policymakers. The crux of this argument is based on two discrete case studies, one community sample of Nicaraguan grandmothers in urban Nicaragua, and another clinic-based study of Mexican immigrant women in urban United States, which represent different populations, methodologies, and instruments. Yet, both authors critically examine narrative data and then use the Center for Epidemiologic Studies Depression Scale to further unpack meaning of psychological suffering by analyzing symptomatology. Such integrative methodologies illustrate how incorporating results from standardized mental health assessments can corroborate meaning-making in anthropology while advancing anthropological contributions to mental health treatment and policy.
Journal Article
El Nacimiento del Pueblo Mestizo: Critical Discourse on Historical Trauma, Community Resilience and Healing
Purpose. Historical trauma has been widely applied to American Indian/Alaska Native and other Indigenous populations and includes dimensions of language, sociocultural, and land losses and associated physical and mental disorders, as well as economic hardships. Insufficient evidence remains on the experiences of historical trauma due to waves of colonization for mixed-race Mexican people with indigenous ancestry (el pueblo mestizo). Research Question. Drawing from our critical lenses and epistemic advantages as indigenous feminist scholars, we ask, “How can historical trauma be understood through present-day discourse of two mestizo communities? What are public health practice and policy implications for healing historical trauma among mestizo populations?” Methodology and Approach. We analyzed the discourse from two community projects: focus groups and ethnographic field notes from a study in the U.S.–Mexico border region (2012–2014) and field notes and digital stories from a service-learning course in northern New Mexico (2016–2018). Findings. Our analysis describes the social and historical experiences of Mexicans, Mexican Americans, Chicanas/os, and Nuevo Mexicano peoples in the southwestern border region of the United States. We found four salient themes as manifestations of “soul-wound”: (1) violence/fear, (2) discrimination/shame, (3) loss, and (4) deep sorrow. Themes mitigating the trauma were community resiliency rooted in “querencia” (deep connection to land/home/people) and “conscientizacion” (critical consciousness). Conclusion. Historical trauma experienced by mestizo Latinx communities is rooted in local cultural and intergenerational narratives that link traumatic events in the historic past to contemporary local experiences. Future public health interventions should draw on culturally centered strength-based resilience approaches for healing trauma and advancing health equity.
Journal Article
Sociocultural and Structural Barriers to Care Among Undocumented Latino Immigrants with HIV Infection
Timely entry into HIV care is critical for early initiation of therapy, immunologic recovery and improved survival. However, undocumented Latinos are more likely to enter HIV care late in the disease course and with concurrent AIDS. We conducted a qualitative study to examine the circumstantial, situational and social factors that uniquely affect entry and retention in care for this population. Between June and August 2006, we conducted semi-structured, in-depth, individual interviews with 22 undocumented Latino immigrants living with HIV infection. The interviews were audiotaped, transcribed and reviewed for accuracy. Data was analyzed using a grounded theory approach. Word content was coded and sorted by themes using AnSWR software. Emergent themes related to health care barriers include (1) the challenges of dealing with HIV stigma and rejection from family and community; and (2) the experienced and perceived structural barriers of accessing care as an undocumented individual. Societal intolerance of HIV and stigma-related experiences result in feelings of secrecy and shame. In addition, the undocumented state complicates the situation even further. These unique barriers include fear of deportation, work restrictions, inadequate translation services and difficulties meeting paperwork requirements. This study offers insight into the unique sociocultural and structural barriers faced by undocumented Latinos with HIV infection. Understanding and addressing these barriers will prove vital in the development and implementation of strategies to promote early entry into HIV care.
Journal Article
The painful truth about pain
A harrowing medical experience gave Travis N. Rieder more insight than he would have wished for into how people end up hooked on opioids.
A harrowing medical experience gave Travis N. Rieder more insight than he would have wished for into how people end up hooked on opioids.
Journal Article
Extended US travel ban harms global science
From preparing for pandemics to boosting crop yields, Nigerian scientists who work and train abroad are making the world safer. Now that’s under threat.
From preparing for pandemics to boosting crop yields, Nigerian scientists who work and train abroad are making the world safer. Now that’s under threat.
Journal Article
Cutting collaborations will not put ‘America first’
Screening measures implemented in West Africa by stafffrom the US Centers for Disease Control and Prevention during the Ebola outbreak kept infected people from entering other countries, including the United States. [...]Fogarty support helped US academics to develop links with Middle Eastern scientists to study electronic cigarettes and to produce evidence that will be crucial for the US Food and Drug Administration to regulate sale of the devices and protect Americans' health.
Journal Article