Monday, June 14, 2010

Mix it Up Mondays: S.L.C.- Disparities in Healthcare in Urban America

Our next guest writer for Mix It Up Mondays is S.L.C. one of the bloggers from In Poppy's Closet

In “Mama Might Be Better Off Dead” Laurie Kaye Abraham follows one Chicago family’s struggle to receive adequate medical care using the system. Abraham shows the glaring errors in the United States healthcare system as a whole, but especially for the poor who must constantly attempt to navigate all the red tape that comes along with relying on Medicare.  The book delineates a failing system whose consumers are not only becoming sicker and sicker, but younger and younger, which results in an extreme increase in young Black women being responsible for the care of a whole range of family members/problems.  The health tribulations that the Banes face, from husband Robert’s kidney troubles, to grandmother Cora’s several chronic conditions, and the fight to vaccinate the children are the same for millions of poor families across the nation who lack the education, resources, and time to properly care for themselves. 

Age is very much an important factor in Laurie Kaye Abraham’s analysis of the poor and healthcare. The Banes family in general is relatively young, and considering the age of the members on a whole suffers from very poor health.  The diseases that they are experiencing “among poor and blacks they {diabetes, high blood pressure, heart disease] are more accurately called diseases of middle- aging,” (19) as opposed to affluent whites where they just come along with the aging process. In addition to issues arriving at a younger age, evidently the burdens of caring for the ill fall often times on young Black women. In the case of the Banes’ Jackie is responsible for the care of her grandmother, husband, and after her grandmother passes her father, not to mention her three young children.

 Irregular care is the cause for the rise in medical problems in many youthful African Americans.  Many of the poor do not have access to regular appointments and checkups, so often times problems are not noticed until they have exacerbated to the point of being uncareable, or in the case of the Banes’ too expensive to properly treat. There is this idea of not being sick enough to receive care, and instead waiting until they get to a point of hospitalization to seek treatment.  Abraham explores the usage of the emergency room as a doctor’s office in many poor urban areas.  She notes that “the emergency room is where the inequities and distortions of a health-care nonsystem—one driven more by patients’ ability to pay than by their medical need—are most obvious” (93).  Gross underfunding and understaffing contribute to the hectic atmosphere of the emergency room, and often lead to inefficiency and improper diagnosis or treatment plans.

If there is one thing that the reader takes from this book, it is that “many poor blacks do not understand the gravity of their situation, and doctors do not properly explain to them their condition or how the medicines work” (33). It is clear that a lack of education and time are clear factors here on the end of the patients and physicians. Patients often do not understand that something such as high blood pressure can lead to diabetes, which could eventually lead to forced amputation. More often than not doctors are not taking the time to properly explain the seriousness of an illness, or how it can be abated with proper treatment and medication.  Perhaps with education patients and their families would take care to seek treatment before the situation becomes dire. Of course, it is clear that money is the most important factor that is keeping many poor African Americans from receiving the proper healthcare that they deserve.

For many families like the Banes’ the caregivers, in this case Jackie, do not properly understand the programs that are available to them that would abate some of the homecare expenses that they provide for their sick family members. For Jackie, her days revolve around worries on stretching her welfare and her mother’s social security money to accommodate all of the families basic needs in addition to healthcare.  While Jackie would love to get off welfare and make a better life for her and her family unfortunately that is just not an option.  “When Jackie and other poor mothers get job opportunities, they must weigh whether they can afford to leave welfare and lose the automatic Medicaid coverage for themselves and their children” (257).  The care her mother needs is extensive, but Jackie does not know that there are welfare options that would offer her homecare, or extra money towards her mother’s care.  Many times, women like Jackie are too tired, too overworked, too poor, too stretched-to-the-limit to spend the time learning how to milk everything they can get from the system.

North Lawndale, Chicago might as well be any major, poor, urban area in the United States in Laurie Kaye Abraham’s “Mama Might Be Better Off Dead”. By following the Banes family Abraham exposes the great disparities prevalent in the American health care system, and the hopelessness that comes with trying to operate literally and figuratively within the bureaucracy of Medicare. The book dispels any preconceived notions about welfare and those who are dependant on it, by showing the reader just how hard it is to receive adequate medical care in the United States. Jackie Banes represents the poor Black women essentially doing what she has to do to get by. Every day is a struggle, and they live in constant fear that their benefits will be cut in any form, and that they will no longer be able to support their families. “Mama Might Be Better Off Dead” demands for massive reform in not just the healthcare system, but also the way in which we look at healthcare as a commodity for the affluent in the United States; the only developed nation besides South Africa that does not find a way to provide its citizens with some sort of basic medical care. 

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