Archive for the ‘Inequality’ Category

By: Fatima Maiga

Before college, I had never been treated by a white physician. I was delivered by a Hispanic OBGYN, my pediatrician was Black, my current primary care physician is Black and my OBGYN is Black. All of my bases had been covered, but I never really thought why, until I studied the history of the intersection between medicine and African Americans. If you have ever studied the record of racism in America, you most likely know about segregated hospitals and doctor’s offices; however, history books do not always chronicle Mississippi Appendectomies, the Tuskegee Syphilis Study or Henrietta Lacks.

The Mississippi Appendectomy was a term used to categorize the involuntary sterilizations of women of color during the 1920s and 30s. These procedures were performed without informed consent, and/or through coercion: some of the women who signed agreements could not read or write and others were threatened that their social insurance would be revoked if they did not participate. While white women, especially those within the upper and middle classes, were denied or delayed voluntary sterilization, Black and poor women were forced into it.


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By: Emily Kirwin

The first time I heard about the rising maternal mortality rate (MMR) in the United States, was after Serena Williams’ birth, and this story about a family struggling to cope after a new mother died after childbirth:

While it is no surprise to learn that black women are 3 to 4 times as likely as white women to die during childbirth, it was shocking to me to learning that 700 U.S. women do not survive to the next day with their newborn (Centers for Disease Control and Prevention). In 2000, the United Nations signed a document declaring to improve maternal health worldwide by the year 2015 (World Health Organization, 2018). Since then, many countries – both lower income and higher income – have decreased their MMR drastically. However, the United States has observed an increase of maternal deaths from 23 in 2005 to about 28 maternal deaths per 100,000 births (Tavernise, 2016). A majority these deaths were preventable (Martin & Montagne, 2017).


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By: Morgan Duffney

Today, when we watch cable news and see the banner ‘Crisis in Pakistan’ shoot across the television screen, a few thoughts and fears come to mind: terrorism, political instability, and loosely controlled nuclear weapons. What no one ever thinks about is the public health disaster currently looming over the country, which is already in a fragile state. What never appears on a breaking news banner on Fox News or CNN, but does appear on the front pages of Pakistan Today is that in Pakistan, an estimated . The inability to treat contaminated water, supply its citizens with this basic necessity to live, and stem the tide of human suffering is not only a problem faced by the Pakistani government, but is currently a global public health crisis.

Pakistan is just one country out of the many throughout the world currently struggling to relieve the suffering of their people and resolve this public health emergency. To put this crisis into a global perspective, as of 2014, the United Nations estimated that 2.5 billion people receive their drinking water from sources without improved sanitation, with roughly two million tons of sewage and other pollutants entering the world’s water system each day. Without an adequate response and action on the part of public health organizations throughout the world, the future looks quite bleak; as the World Health Organization (WHO) now predicts that by 2025 half of the world’s population will live in “water-stressed areas” (2017).


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By Cassandra Sunga

In December 2015, the Philippines announced that it would be the first country to launch Sanofi Pasteur’s brand new dengue vaccine Dengvaxia. As dengue infects 200,000 Philippine citizens per year and treatment for the disease costs about 18,000 pesos per patient, this intervention has the potential to save hundreds of thousands of dollars and several lives across the equator. Although this medical feat is one that should be celebrated, one fundamental question remains on its delivery however: who will ultimately be able to obtain this vaccine in the Philippines?

According to a report made by the Philippine Statistics Authority in 2013, poor households are 18.2% less likely than non-poor households to obtain their mandatory first dose of the Hepatitis B vaccine. Furthermore, the World Health Organization (WHO) in 2011 reported that only 55.5% of households in the lowest income bracket were able to obtain a full round of mandatory, WHO EPI vaccines in comparison to 83% of households in the highest income bracket. While the cyclical nature of income disparity and health is a constant in most countries across the globe, the poor in the Philippines are especially susceptible to the consequences as there is essentially no public safety net to ensure that they receive quality health care when needed. Although current President Benigno Aquino has overseen a number of positive reforms in healthcare policy since assuming office in 2010 (e.g. the expansion of their national health insurance program Phil Health and the appropriation of birth control to the public), differential access to quality health care amongst various income groups is still a major issue.


Even though the country’s situation seems bleak for the poor and geographically isolated, one NGO has risen above the rest to find a valid solution to the problem. Gawad Kalinga (GK), which means, “to give care” in English, aims to “end the poverty of 5 million poor families by 2024”. The organization started by building quality housing structures and communities for poor families in the early 1990’s, and has since launched about 2,000 different communities across the country. To make each community economically sustainable, GK also partners with business schools and entrepreneurs around the world to empower Philippine citizens with viable livelihoods based on their working skills and what’s naturally available in the environment around them.

In 2010, Center for Disease Control (CDC) head Dr. Thomas Frieden published an article in the American Journal of Public Health on his 5-tier intervention pyramid. The pyramid creates a framework for understanding how impactful public health interventions will be depending on what factors they target. The idea is that if you have an intervention that targets broader segments closer to the bottom of the pyramid (i.e. socioeconomic factors), you will thereby have a broader impact on society. Although simple on the surface, the idea does come with a catch; targets listed towards the bottom are often times the most difficult areas to address or change in public health. Thus, the obstacles and difficulties that ultimately lie in changing the bottom of the pyramid are what largely deter interventions from aiming to make socioeconomic factors a main target.

As Dr. Frieden elaborates within his article, previous models and current interventions often times fail to address infrastructure in health systems. However, this framework is exactly what makes GK’s model so fascinating and exciting! Rather than using interventions that are too focused on the individual or are largely non-preventative, GK is trying to solve health disparity in the country by attacking the root of the problem: income disparity. While GK will most likely be unable to provide all of the people living in its communities with the dengue vaccine, they are providing them with something that is arguably just as essential for community health: hope. By finally creating the quality, sustainable infrastructure this country has needed for the poor, GK has laid down the groundwork for improved population health in the country. They took a leap of faith and started at the bottom of Dr. Frieden’s pyramid. Now, all they simply have to do is continue climbing upwards.



  1. Frieden, Thomas R. “A Framework for Public Health Action: The Health Impact Pyramid.” American Journal of Public Health 100.4 (2010): 590–595. PMC. Web. 26 Feb. 2016.
  2. “Breastfeeding, Immunization, and Child Mortality.” Philippine Statistics Authority. Philippine Statistics Authority, Oct. 2013. Web. 26 Feb. 2016.
  3. “World’s First Dengue Vaccine Now Available in PH.” CNN Philippines. CNN, 12 Feb. 2016. Web. 26 Feb. 2016.
  4. “Welcome to Gawad Kalinga.” Welcome to Gawad Kalinga. Gawad Kalinga, n.d. Web. 26 Feb. 2016.


Image Citation:


  1. In the Philippines. Digital image. Gawad Kalinga. Gawad Kalinga, n.d. Web. 26 Feb. 2016.



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By Sherylle Estrellas

Across the world, many developed countries supply universal health care, allowing everyone the health coverage and service he or she needs at no or little cost to the consumer. Meanwhile, America, among the most developed and richest countries in the world, still has yet to implement an equitable and efficient health care coverage system. Although the Affordable Care Act means to improve the system, one can only wonder why it has taken so long for America to change its ways. Economist Victor Fuchs suggests a few reasons why.


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-By Sarah Boyd

The Inuit population is an indigenous group inhabiting Greenland, parts of Artic Canada, and the United States (Alaska). Following centuries old tradition within harsh and chilling conditions, the Inuit obtain food through hunting, fishing, and gathering. This includes hunting fish, seal, caribou, whale, walrus, polar bear, musk ox, fox, and wolf (1). “Because the Inuit in Canada and Greenland eat top predators such as beluga whales and seals, they are among the world’s most contaminated human beings” (4). (more…)

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-By Katherine Storer

Video: 4 Shocking Facts about US Healthcare http://www.youtube.com/watch?v=dqLdFFKvhH4

As someone with a chronic illness the healthcare system is something I’ve had a lot of experience with. Since I was 9 years old I’ve never walked away from a doctor’s appointment feeling anything other than frustration. I was always met with endless hours waiting for late doctors, copious amounts of obscure tests, and never-ending stares of disbelief. I had large co- pays for each useless visit, expensive prescriptions, uncovered tests, and never any answers. I always knew it was a flawed system, but I never quite understood why. (more…)

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By Hannah Parrish

One’s annual income and socioeconomic status is an unsettling predictor of health in the United States. More advantaged individuals are commonly in better health, but why? Health should not be a luxury but rather a human right – rich, poor, black, white, young, old. At the end of the day we are all people. So why is it that in the US wealth = health?

First off all, your environment is a critical determinant of health as it determines what you are exposed to on a daily basis. When deciding what neighborhood to live in (if you are lucky enough to have that choice) you are ultimately deciding what physical, chemical, and social agents you are exposing yourself too on a daily basis. People living at or below the poverty line rely on subsidized government housing, which provides a toxic environment to health. (more…)

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By Emily Klotz

“The answer of course is…drumroll…no.”1 In response to the question of whether we should adapt to climate change, Andrew Revkin, writer of the “Dot Earth” blog in The New York Times, gives the preceding answer. I understood his sarcastic response to imply two things: one, that rather than adapting to climate change we should be trying to mitigate and prevent climate change, and two, the issue of adapting lifestyles in response to climate change is not an imminent issue. He is absolutely right (mitigation and prevention should trump adaptation), but here is where the problem lies: who is “we”? I initially thought “we” referred to humans in general. However, in this video about adapting to climate change, Mr. Revkin, climate scientist Alex Hall, and environmental historian Jon Christensen fail to include all of humanity in their “we,” and focus primarily on the people living in developed countries, such as the United States. What about the majority of the world’s population that lives in developing nations? (more…)

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By Grace E. von Maluski

While exploring the front page of the World Health Organization website, I noticed an unavoidable theme among recently reported health controversies. The fundamental theme that I wanted to investigate further involved the nature and process of instituting a public health policy. In order for a policy to be successfully executed, it must be supported through a series of governing institutions. Public health policies must balance any demands that exist between these governing institutions involved in the political and cultural decisions of a country. When implementing public health policies, the ever-present problem that exists in the inter sectional cycle of policy-making is that many institutions refuse to accept and support the policy based on ideological differences, and ultimately provide staunch resistance against that policy.


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