If you’re anything like me, you avoid the dentist’s drill like the plague. I hadn’t been to the dentist in quite a while thanks to traveling around without insurance. But, I finally bit the bullet and made an appointment at a dental office within walking distance of my apartment. Although I’m relieved I don’t need any further work done, this trip got me thinking about how people take care of themselves in the neighborhood where I live and teach.
Down the street from Popeye’s wedged in between a small pharmacy and a liquor store, I was greeted with a locked door to the very small dental office. Another patient opened the door before the receptionist could get up from her cramped desk. She looked for a new patient form; “Christina, right?” Err, not quite, but I let it slide this time. I sat in the waiting room/receptionist area/filing room while I answered the standard questions.
As I waited for the doctor, a small boy went in through the partition with his father. He couldn’t have been older than 4 years old but I distinctly heard the word “abscess” and wondered how a kid without any of his adult teeth could already have an infected tooth.
The doctor prescribed a pain medication and told them to have the tooth removed and come back the next week. (I could overhear the conversation from where I sat). The woman who would be seen after me was following up because her tooth had also been removed; she was having pain and wanted the doctor to take a look.
The dentist seemed overworked and she had a chronic hunch in her back. Without a dental assistant to help her take x-rays and perform routine cleanings, she tried to work as quickly as possible.
I left with a prescription for mouthwash and an appointment for a cleaning the next week. Disclaimer: I am no exemplar of perfect dental health. My teeth have enough fillings to remind me everyday of my poor brushing habits as a child. However, common sense eventually came knocking and I developed healthy preventative habits.
My question is this: what will it take for people of color in poor neighborhoods to have access to holistic healthcare that doesn’t just address symptoms, but supports a healthier mindset and perspective?
In the broader sense of healthcare, preventative medicine gets pushed to the back burner to make room for heart disease, cancer, and diabetes treatments (3 of the leading causes of death among African-Americans, according to the CDC). Once you tie in the host of mental issues that plague the community (considering the culture of embarrassment/shaming when discussing depression), it goes without saying that preventative care could go a long way in helping people live longer, healthier lives.
In theory, and from one’s privileged background/perspective, that sounds easy. Get people to healthcare providers who will help them make healthy changes. 3 major things that make this so much more difficult are:
Health Insurance
Without going into my rant on why the United States’s whole 
healthcare system is a**backwards, let’s just say that America could learn a few things from other countries when it comes to taking care of its citizens. If you are unemployed, you are much less likely to have access to affordable healthcare (note: the Emergency Room does not count).
Access to Information
You don’t know what you don’t know until you know it. This could be applied to a slew of different situations: job opportunities, health care, college/financial aid resources, etc. This is what makes it nearly impossible for communities to become informed on things that can make their lives exponentially better. Sure, common sense tells us that eating healthy and exercising is good for us. But what does healthy eating look like? “Where do I find fresh fruits and vegetables? (link to my previous post about this exact issue) And how in the world can I find time to exercise when I work during the day and take care of my kids at night?”
Essentially, without the resources to attack these issues, some people feel helpless. In terms of healthcare, many uninsured Americans consider the ER to be their insurance. If they don’t feel sick, why should they go to the doctor (if they even have time)? There is no real feeling of urgency with preventative care which may explain why many people don’t see it’s significance.
Generational Curse
I grew up going to the dentist every 6 months. This habit has faltered a bit, but my mother still reminds me to get a cleaning every so often. For children who either don’t have a consistent family structure, or don’t have access to healthcare (see above), these habits don’t come as easily. If you only attend the dentist for an infected tooth, or see the doctor for a broken arm, these habits develop in adulthood.
So what can we do amid all these obstacles?
Affordable Healthcare Act:
The recent federal mandates to our health care system have been a welcome change. Especially when you consider the fact that “new estimates from RAND suggest that 3.8 million African Americans who would otherwise be uninsured will gain coverage by 2016 through the expansion of Medicaid eligibility and the creation of Affordable Insurance Exchanges” (aspre.hhc.gov) To put this number into perspective, 44 million Americans identified as African-American in 2012 (about 14%). Of that number, 9 million are uninsured (about 20 percent).
That means the Affordable Care Act can cut the number of uninsured African-Americans by 1/3 by 2016!
As for the lack of access to information and the generational trends seen in most poor neighborhoods, there isn’t 1 strategy that could solve these issues. These are symptoms of a much larger problem that can’t be solved with one piece of legislation. How can we get information out to people who need it the most without imposing significant cultural barriers on communities?
I’m interested to hear your thoughts/feelings/responses to this issue.
What types of strategies can be implemented in order to promote the significance of preventative medicine?
Musings of a Burgeoning Brooklynite 