When reading this chapter, I was alarmed at the fact that HIV/AIDS is the leading cause of death among African Americans aged 25 to 44. I think what surprised me about this is that the United States is believed to have such advanced medical care, but this isn’t always accurate. African Americans are more likely to suffer from chronic illnesses at higher rates than Whites, with race and ethnicity playing a large role in our healthcare system because this determines what care one receives if any. This shows that health and illness are not evenly distributed in the United States. Regardless of race, heart disease is the highest cause of death in the United States, with White men dying at higher rates than African Americans. In 2005, the FDA approved a drug called BiDil that was meant to treat African Americans with cardiovascular (heart) disease. This drug was proven successful in treating African Americans, but not Whites. While heart disease kills more Whites than African Americans, diabetes affects African Americans at higher rates. African Americans are 1.6 times more likely to have diabetes. Because African Americans experience higher rates of most chronic diseases, they experience higher mortality rates with exception to heart disease.
Further addressing the authors’ remarks on HIV/AIDS, HIV is an important health issue in the African American community because it is a leading cause of death in African Americans, is a preventable disease, is directly linked to other issues such as incarceration, and can be examined as a symptom of other issues of well-being such as drug use, poverty, and sexual practices. African American males are more likely to contract HIV through IV drug use while African American women most commonly contract HIV through sexual activity with HIV infected African American men who were likely infected during consensual (or non-consensual) sex with infected men during incarceration. The prevalence of HIV in the African American is obviously preventable. The authors discuss how HIV infection among African American women has been caused by African American being on the DL (Down Low). Because homosexuality is stigmatized in the African American male community, these men choose to be on the DL. Reasons that the authors present for this include male-to-male prostitution, habitual men-having-sex-with-men, and the desire to reject the homosexual identity and instead maintaining an appearance of heterosexuality within African American culture. The fifth leading cause of death among African American men is homicide, with HIV following at sixth. Another area of death within the African American community is infant mortality. Infant mortality rates are twice as high for African Americans as for Whites. I find this alarming because this means that twice as many African American infants don’t make it through a year of life. Looking at mortality later in life is not much better. White women have the longest life expectancy while African American men have the shortest life expectancy. Although this is alarming as well, I can’t say that I was surprised to read this. The authors say that African American men live an average of 12 years less than White women. At first, I thought that it wasn’t that big of a difference, but then I realized that 12 years is longer than you’d think, especially when discussing it in these terms.
Another factor that plays into health and well-being of Americans is lifestyle. Impoverished individuals are less likely to have access to things such as healthy food and exercise. This means that their social class negatively affects their physical health and lifestyle. Living in poverty and having access to a lot of food that’s bad for you or even just excessive amounts of food shows that diseases of overconsumption are a concern in American society. Diseases of overconsumption are caused by poor health, examples of these are diabetes and heart disease.
The last factor that affects the health and well-being of Americans is health care. An issue with health care is how companies give it to their employees, if they do at all. The authors mention Wal-Mart tactics, a way for companies to not give their employees health benefits by giving them less than 40 hour work weeks. This causes high rates of either unemployment or underemployment and leaves many people (40 million to be exact) without health care. Other barriers to receiving health care include the high cost of medical treatment and the lack of qualification for the insurance (unemployment for example). Two main types of health care include private insurance and Medicaid. Private insurance has a lot of flexibility in allowing patients to see any doctor at any hospital with relatively reasonable co-pays, usually under $50. In contrast, Medicaid is a government health insurance system that is very limited in participating facilities. Thee limit patients to likely low ranking hospitals with ridiculously high premiums. Most individuals or families receiving Medicaid are African American. This shows how something as simple as our health care is discriminatory toward African Americans. There is a mistrust of medical establishments among the African American community for two main reasons: the Tuskegee Experiments and the Eugenics Movement. The Tuskegee Experiments were a set of experiments that involved letting poor African American men with syphilis go untreated in order to study the long-term effects of syphilis. These experiments were horribly problematic because these men were being told that they were being treated for syphilis, but in reality, they had never received treatment. No matter how much these experiments are discussed in other classes, I am always disgusted by the deception. The Eugenics Movement was the forced and non-consensual sterilization of African American and Native American men in order to filter out “unfit” parents while also preserving White nationalism in the early 20th century.