There are an abundance of medical resources available to African-American and Latina women in New York City that other urban areas do not provide, not only because of political, economic and social structures that are in place, but primarily due to the diverse population that inhabits NYC’s metropolitan area. Trying to make the best decisions within the limitations of the health care system can be especially rough for patients who are in the low socio-economic status (SES) bracket and for patients who come from an ethnic minority background.
“Lower SES is associated with lower life expectancy; higher overall mortality rates and higher rates of infant and perinatal mortality. It’s associated with each of the 14 major cause-of-death categories in the International Classification of Diseases, as well as many other health outcomes including major mental disorders.” – Bruce G. Link & Jo Phelan (Social Conditions as Fundamental Causes of Disease)
Looking at reproductive health through the eco-social perspective is crucial to examining reproductive health education and treatment accessibility for ethnic minorities, specifically African American and Latina women, in New York City. Many people who live in NYC’s metropolitan area and come from a low socio-economic household are women of ethnic minority (African-American and Hispanic women). African American women receive less qualitative reproductive health education and have limited accessibility to quality treatment, which may be the reason why African-Americans tend to have higher rates of infections and/or diseases associated to their reproductive health than other women.
I find that reproductive health education and reproductive treatment accessibility is interesting because, often times, reproductive health care decisions aren’t necessarily based on diseases like it is in other realms of medicine. Reproductive health care decisions are based on natural occurring bodily processes that involve the reproductive anatomy, such as maternity care, menstruation or menopause. Making medicalization (medicating a part of a natural occurring bodily processes, that doesn’t need medicating) a threatening variable in attaining reproductive health treatment.
Reliable reproductive care is becoming less attainable with increasing costs from superfluous medical treatment, the imminent threat that treatments being received are ineffective, and the looming fear of exposure to other ailments that may rear its head in the future. Although patients need to find and attain the resources to make best use of the quality of treatment received, not everyone has feasible access to treatment. Financial incentives are hard wired into the health care system, which values and prizes the utilization of certain medical machinery and prescriptions above “talk time” along with preventative care.
Urban public health considers social inequality as “a fundamental cause of disease”. Social inequality of health care ripples from municipal level determinants of health such as urban living conditions, to individual public health interventions. Gathering community based participatory research on this topic entails gathering cross-sectional data on reproductive health education received by African American and Latina women who live in NYC’s metropolitan area, as well as gathering longitudinal data on reproductive health treatment received by African American and Latina women. Educating African-American and Latina women on available reproductive health services can strengthen doctor-to-patient relationships, allowing more informative consultations and quality treatment.
Norsigian J. Our bodies, Ourselves The Boston Women's Health Book Collective. New York, NY: Touchstone; 2011.
Freudenberg N, Galea S, Vlahov D. Cities and the health of the public. Nashville, TN: Vanderbilt University Press; 2006.
Geronimus, A. To Mitigate, Resist, or Undo: Addressing Structural Influences on the Health of Urban Populations. American Journal of Public Health. 2000;90(6):867-872. doi:10.2105/ajph.90.6.867.
Link, Bruce G., and Jo Phelan. Social Conditions As Fundamental Causes of Disease. Journal of Health and Social Behavior, 1995, pp. 80–94. www.jstor.org/stable/2626958.
Krieger N. Theories for social epidemiology in the 21st century: an ecosocial perspective. International Journal of Epidemiology. 2001;30(4):668-677. doi:10.1093/ije/30.4.668.