2021 Edition
"At the end of the day, we can endure more than we think we can."
-Frida Kahlo
ABOUT US Here at AMWA UTD, we want to do our very best to inform you of all of the issues relevant to women and healthcare, together and separately. We hope that our monthly newsletter becomes an enlightening source to you all as we learn about the multitudes of important topics and issues that we all need to be aware of.
IMPORTANT CLUB EVENTS
4/7 @ 8 PM - WPL Collab: Challenging Gender Norms with Haleh Banani
4/13 @ 6 PM- TPR Medical School Admissions Workshop
4/21 @ 5 PM- Graduate School Student Panel
4/28 @ 5 PM- AMWAUTD Banquet
RSVP UNDER OUR CALENDAR TAB
NATIONAL OBSERVANCES
-Alcohol Awareness Month
-National Autism Awareness Month
-National Minority Health Month
-Sexual Assault Awareness and Prevention Month
-Stress Awareness Month
-Public Health Week; April 5th-11th
-Infertility Awareness Week; April 18th-24th
-Immunization Week; April 24th-30th
-World Health Day; April 7th
DISPARITIES IN HEALTHCARE
By: Shraddha Trehan and Megan Zachariah
During the months of February and March, we polled the AMWA community on some pretty complicated questions. We asked our peers to confide in us their deepest insecurities and misunderstandings. Now, we are going to try and help you all navigate a path where we know what the destination is supposed to be, but not necessarily what it will be. We hope that as we all get older, things will start to make a lot more sense. The goal of this Mythbusters edition is to try and start helping you all figure out which things really deserve the right to stress you out and which scenarios really don’t need to be that dramatic. Further, we’re going to talk about our healthcare disparities poll at the end which reminds us all that there are usually more globally important things to put our lives into perspective. So, here are our answers to some of your burning questions, hopefully, we get 1 or 2 right.
First, let’s address one of the major categories to our questions: Trying to stay sane in the cut-throat/judgment culture. The balancing act of aggressively standing out and yet coming off completely calm and cool in the cut-throat culture of pre-health is one that a lot of students have mastered, and we are all worse off for it. For a whole lot of people that claim they want to spend the rest of their days helping other people, we spend a whole lot of time making sure that our “friends” never do better than we want them to. Yes, medical schools will only take a certain amount of us, and yes, a certain drive of ambition is required in this field. However, mixing ambition with the desire to stop others' success is a dangerous game, and it is not okay to play it. Pre-health students do not and should not have to be jealous or worry about others’ success. Instead, we should be helping each other out and fostering an appreciation for each other’s brilliance.
Furthermore, creating a helping-based type community instead of a judgment-based one can also solve the second group of answers to these questions: How to deal with not feeling intelligent enough/burn out/time management. If people had to worry less about how others around them were doing, they would have a lot more time to figure out what they need to do to manage their time better. Taking the time to figure out how to balance your life first requires you to figure out what you want in your life. Once you’ve got this down, you’ve solved more than half of the battle. You know what you want to (if you’re on the right path or not), when you want to do it, and how you’re going to get it done. All the other parts of medicine and the graduate process will fall right into place.
And now, we arrive at the final group of answers: Insecurity about the experience. Let me be very clear: A community, or person, that is open about where it stands and what it does not understand is not weak. It is not weak to not understand, it simply means one requires growth, and growing is something only the strong do. In the end, nobody knows how medical schools are going to judge you. Nobody knows what kind of coffee the application reader had that morning, what their drive to work was like, or who just entered/exited their life. But the really important thing to remember is that this whole process is meant to be for you not against. None of the things that you all asked/answered to these questions are mutually exclusive; in fact, all of your stresses are inextricably linked. Spacing out our lives and making time for the things we enjoy must be done in order to avoid burnout, manage our time well, and gain worthwhile experiences.
Congratulations! Indeed, this statement is FALSE. We as individuals hold much more power in facing such issues than we realize. Here are some ways you can promote equity in healthcare:
Advocate for preventative care
Minorities are disproportionately affected by substance abuse disorders. By spreading awareness about the harms of alcohol and drugs you are helping one of the leading causes of hospitalization in these communities.
Volunteering in clinics that serve underrepresented communities
Healthcare accessibility is highly correlated to socioeconomic status. Communities with a low SES are chronically underserved and, as a result, many clinics are saturated with patients. Supporting these communities helps support both the medical staff and the community.
Destigmatizing mental health resources
One of the areas of medicine facing the most disparities in mental health. Minority communities seek mental health services significantly less than other demographics due to cultural and ethnic constructs. We can mitigate these stigmas by normalizing the mental health conversation and showing our support to those that are seeking help.
ALCOHOL ABUSE
BY: Zarah Rahman
Alcohol abuse and alcoholism disproportionately impact men and women. Numerous studies have been conducted to determine the impact of alcohol on various groups. The results indicated that alcohol abuse is more frequent in men, with nearly twice as many men reporting binge drinking or alcohol use disorders. The statistical difference in the number of men affected by alcohol abuse disorders overshadows that of women, thus resulting in poor recognition or association of the same condition within women. The effects of alcohol consumption, abuse, and alcoholism among women are exceedingly distinct from their male counterparts in terms of behavior and biological/physiological factors. By assessing these differences, researchers have proposed targeted treatment options based on the cognitive, social, and biological differences exhibited between genders.
The DSM-5 defines alcohol abuse as “a maladaptive pattern of drinking, leading to clinically significant impairment or distress” and is usually manifested with one of the following:
“Recurrent use of alcohol resulting in a failure to fulfill major role obligations at work, school, or home
Alcohol use in situations in which it is physically hazardous
Alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol”
(General, 2007)
According to the World Health Organization, alcohol is historically ranked as one of the highest abused substances worldwide. Factors contributing to an increased likelihood of alcohol abuse include stressful environments, early exposure to drinking, diagnosis of one or more mental disorders, and a family history of alcoholism. While these factors equally affect the likelihood of males and females developing alcohol abuse disorders, the impact on the mind and body vary.
In recent years, alcohol use and alcohol-related issues have increased among women. With increased consumption of alcohol, women are at greater risk of developing liver damage, brain damage, heart failure, and even breast cancer. Biological factors contributing to the increased risk of disease in conjunction with the misuse of alcohol are body structure and body chemistry. Women’s bodies typically retain more fat and less water than men’s bodies. The higher fat content within women’s bodies holds onto alcohol and exposes organs to higher concentrations of alcohol over a long period of time. This indicates that even if a woman and a man were the same weight and drank the same amount of alcohol, the woman's blood alcohol concentration (BAC) would be much higher than the man's. Additionally, enzymes responsible for the breakdown of alcohol prior to entering the bloodstream (known as alcohol dehydrogenase) exist in fewer quantities in women than in men, also resulting in a higher BAC.
Recognizing the impact of alcohol misuse by women is becoming considerably important as increased consumption of alcohol affects behavior and brain health. According to a study analyzing sex differences in alcoholism, men exhibit behaviors associated with excessive drinking such as aggression, drinking to alleviate stress and antisocial tendencies. Women, on the other hand, experience more physiological complications such as insomnia, severe motor impairment, and neurotoxicity. The most significant behavioral issue in women is a lack of impulse control.
The importance of addressing and combatting alcohol abuse is to ensure the cycle does not repeat. By encouraging educational institutions to provide resources on alcohol use and misuse, student populations consisting of both men and women may see a reduction in alcohol consumption or a decrease in poor alcohol-related behaviors. Additionally, research has shown that counseling support or rehabilitation centers for alcohol-dependent behaviors can ultimately help both men and women overcome alcohol abuse disorders and regain a higher quality of life.
I'M STRESSED
By: Janvi Patel
The start of April marks the last full month of college and with it comes the stress that the end of the school year typically brings. Stress is a part of life. Whether in school, in the workplace, or in personal lives, stress is something that we must learn to face and overcome. Though easier said than done, here are some strategies to help mitigate stress during this trying time:
Exercise Regularly. With COVID-19 came a new sedentary lifestyle but we must work to counter this. It’s generally important to stay active but exercise is also a great stress reliever! Exercise can provide an escape and environment to clear your mind and focus on yourself. Furthermore, certain activities such as aerobic-based exercised have been shown to release endorphins- neurotransmitters that promote a positive attitude.
Study and practice relaxation techniques. When confronted with a problem, circumstances may seem much bigger and scarier in the moment than they actually are. Being aware of what techniques work for you to relax completely is important! Taking an effective breather from the problem then going back to it with a clear mind is often helpful in finding an effective solution. Some common relaxation techniques include going for a walk, reading a book, or meditation!
Assert yourself. Most people have the tendency to overbook themselves in terms of commitments and workload. Simply recognizing your limits and utilizing the word “No” can help make a big difference and offer a better balance in life.
Eat and drink to optimize your health. There is a popular saying that goes “you are what you eat” and this is fairly true! What we eat has a very big impact on us in terms of gut health and energy levels. That being said, it’s important to make sure we eat as clean and as balanced as we can so that we’re properly energized to tackle all of our commitments!
Boost yourself. You’re great, remember that! You got this! Remind yourself this from time to time to motivate yourself to achieve all of your goals!
Being able to recognize and manage ourselves when we’re stressed is extremely important. Not being able to properly manage stress levels can lead to mental health issues such as anxiety, depression, and physiological issues such as physical illnesses and unhealthy weight gain. Use the strategies above or put your own twist on them to help mitigate stress!
AGEISM IN THE TIME OF COVID
By: Megan Zachariah
Source: KHN Illustration
Yoga pants or flared leggings? Skinny jeans or straight leg? These are the questions that drove a generational division between millennials and gen Z after a viral TikTok trend that emerged in recent months. Though ultimately harmless, this trend rekindled the salient topic of ageism, or the discrimination of individual’s on the basis of their age. Ageism is typically seen in the workplace, misguided quips on social media platforms, and increasingly in health care. From higher insurance premiums to quality of care in geriatric and palliative care facilities, the prevalence of ageism has devastating consequences, victimizing the most vulnerable of our population.
Ageism in medicine has both behavioral and systemic manifestations. Oftentimes, the quality of care a patient receives from their healthcare provider varies significantly with age. These differences can be attributed to preconceived biases against older patients in which physicians may attribute certain symptoms to age rather than investigating potential underlying conditions. This often results in underdiagnosis of serious health issues that would have been detected had a standard for diagnostic screening taken place. One study found that 80% of doctors reported they would relentlessly treat pneumonia in a 10-year-old girl, but only 56% reported the same if the patient was an 85-year-old woman. Self-reports of subjective conditions such as fatigue, pain, anxiety, and depression are also undermined when they are delivered by older patients. In addition to underdiagnosis, the elderly are also vulnerable to overtreatment in which physicians may order unnecessary lab tests and procedures in order to reap insurance kickbacks. It is estimated that nearly $158 to $226 billion dollars is spent as a result of overtreatment, an alarming figure considering that the target patient population has limited income and access to alternative healthcare options.
The harsh reality of ageism in healthcare was further illuminated by the rise of the COVID-19 pandemic. Nearly 4 million people have died of COVID in the US, and 3.7 million of them were over the age of 50 according to the CDC. Further exacerbating the disproportionate mortality rate was the string of tragic deaths in nursing homes and palliative care facilities across the country. Andover Subacute, a senior living facility, was one of the first stories that emerged regarding the gross negligence that the elderly community faced during the onset of the pandemic. A scathing editorial by The New York Times revealed that 68 residents had passed away, 17 of whose bodies were being stored in a storage shed due to lack of funding for proper burial preparations. Elderly residents were not COVID tested, were not provided proper PPE, and those expressing symptoms were not quarantined. Following a state mandate that closed such facilities from visitors, many elderly residents lost contact with the outside world, including the family. It was not until an anonymous caller reported to the police the horrific conditions facing the elderly residents where the bodies of those who had tragically passed discovered. Unfortunately, such stories are not uncommon for geriatric patients who are more likely to have cognitive impairments or be dependent and thus more likely to be neglected.
Change begins with initial medical training. Misconceptions must be overwritten and biases must be erased. However, combating ageism is not a task reserved for healthcare professionals. With the mask mandate lifted in Texas, many residents are enjoying the freedom to be maskless in public areas. However, there seems to be some cognitive dissonance between this newfound freedom and those that are most susceptible to the virus and thus those that benefit most from CDC recommendations. The elderly population faces ageism in the healthcare industry and now by the general public. As aspiring physicians, we will be trained to prevent the former, but now as students, we can combat the latter.
A PART OF THEIR HUMAN EXPERIENCE- NATIONAL AUTISM AWARENESS MONTH
By: Shraddha Trehan
“Wanting to be free. Wanting to be me. Trying to make people see. And accept the real me.”
– Scott Lentine
April is a month that celebrates 1 in 54 children and 1 in 45 adults. April celebrates Autism. Though many of us have heard about autism, and most have probably spent some time with someone who identifies on “the spectrum,” Autism is still not a well understood or, in some parts, accepted disorder. But this part of regular, otherwise everyday people doesn’t have to be scary to the rest of us. Parents should not need to feel a sense of panic that society has instilled in them if they discover their child to be autistic. Because Autism isn’t scary or different or unnatural; it’s just, for some, a part of their human experience.
According to the Autism Society, “Autism is a complex, lifelong developmental disability that typically appears during early childhood and can impact a person’s social skills, communication, relationships, and self-regulation.” This disorder is defined by sets of behaviors and can vary among those who display it; thus, it is considered a spectrum condition. Sometimes, it can be difficult to detect when someone around you has this condition. Other times, it is easier to recognize. Usually, characteristics such as “differences in communication, interpersonal relationships, and social interactions” that are noticeable to most come across and that is how most people notice this condition. Other behaviors, such as atypical speech patterns and trouble understanding nonverbal communication, may also be displayed by these individuals.
Furthermore, Autism can usually be diagnosed as earlier as infancy, with more obvious behaviors being displayed by 2 or 3. Overall, if one believes their child may have autism, some things to look for include:
few to no big smiles and limited eye contact by 6 months of age
little or no back-and-forth sharing of sounds/smiles by 9 months of age
little or no babbling by 12 months of age
very few words by 16 months of age
and very few or no meaningful, two-word phrases by 24 months of age.
All of these points, of course, are to be taken with some leniency. Considering not all children with autism show the same signs and even perhaps no signs at all, it is always best to get a professional evaluation rather than make personal assumptions. This rule goes for those in the general public even more than for parents of those children. Though some may find it to be common sense, it goes without saying that people generally like to be treated as normal and equal as possible. Pointing out whether or not you believe someone has Autism without knowing for sure is not okay. More than anything, it is important to remember that words matter, and that what you say, whether intentional or not, can have a great deal of effect on the person listening.
For those of you who would like to ally yourself more to the cause of acceptance and understanding, there are many things one can do. For example, in 2004 the Autism SourceTM Resource Database was created so that credible and reliable resources can be reached easily for people to learn more. Further, the Autism Society has multiple local affiliates across the nation which “provide a number of ways in which individuals and families can get involved, obtain support, and share their experiences with others in their communities.” Even more convenient, anyone can watch films, attend events like the annual National Conference on Autism Spectrum Disorders, take a free, 30-minute online course called Autism 101 provided by the Autism Society, and/or take a full-semester elective course on the subject.
There are so many things the Autism community is fighting for. From help needed with health insurance to more theories and solutions for the many characteristics and conditions that lie amongst the spectrum, the community works for a greater understanding every day. More than anything, however, this community yearns for acceptance. Without acceptance, there cannot be understanding or growth. Kindness, patience, and will to learn are all that are required to make the lives of so many that surround us easier and more bearable. A condition such as Autism does not need to be seen as different, people with autism do not have to be misunderstood. We outcast them only because we do not know them, and that can be changed with effort and time. Differences should be celebrated not persecuted; people should be welcomed not turned away.
SOURCES:
ZARAH:
MEGAN:
SHRADDHA:
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