3rd March, 2018
Alzheimer’s Disease in the African American Community
The mind is a terrible thing to waste. For the African American community in Texas, this has become especially true for its aging residents who hold the second largest death-rate in the United States by Alzheimer’s disease, which is a neurological illness that kills the brain by growing plaque between the synapses of neuron cells. With the racial diversity of Texas being roughly White, Hispanic and other races out of its 28 million people 2016, African Americans make up 12% and are twice as more likely to develop Alzheimer’s. The intent of this paper is to focus on the African American community and the biological and social impacts affecting their medical care to treat Alzheimer’s. The ability to obtain a good lifestyle and medical insurance are fundamental towards accessing options for treatment and without proper medication and services made available, the African American community particularly in Texas may die from the lack of such provisions. In analyzing the effects, there are 3 concepts from the course that will explain the growth of Alzheimer’s in Texas such as, syndemics, medicalization and culture theory, all of which will be further examined. The critical part of understanding Alzheimer’s is that it is financially, ethnically and socially caused in the lives of the African Americans.
To begin, health insurance companies have an assortment of medical plans for Alzheimer’s disease spread widely across the United States. The most common type of insurance plan from the US government is a health program called Medicaid, which provides medical treatment for individuals unable to afford insurance. While a small margin of people who are enrolled in the program are elderly and government employees, the rest are from impoverished neighborhoods and cities like, Dallas, Texas where the majority of patients come from the African American community AAC. The main issue with the Medicaid program and the AAC is the lack of support on how to register for it specifically, as caregivers who currently take care of Alzheimer patients face tedious amounts of paperwork and confusion. According to Sheridan Kingsberry who wrote, Misperceptions of Medicaid Ineligibility Persist among African American Caregivers of Alzheimer’s Dementia Care Recipients, the relationship between caregivers and the patient was that caregivers were actually their relatives, meaning that although they had attempted to sign-up for the program, some did not in fear of financial hardship on their family (Kingsberry and Mindler, pg 175-6). As a result, the application of the Alzheimer’s program was never completed due to the complexity of the paperwork, and since caregivers also thought that the patient’s financial status was not be eligible for such programs, this left families of the AAC to live in impoverishment (Kingsberry and Mindler, pg 175). In Texas, Alzheimer’s remained prevalent in the AAC, not only due to the confusion of registering for Medicaid but because caregivers did not want to face financial repercussions. In support, Kingsberry’s analysis of the relationship between patient and caregiver is that signing-up for Medicaid also decreased the likelihood of family members registering the patient for the program.
On another note, a recent study regarding the quality service provided by healthcare professionals, concluded that the lack of care and moral respect for African American patients was due to racial discrimination and bias. In the medical industry, patients are to receive high-quality medical services for their ailments, but for people of color this is not entirely true. According to the 2014 survey detailing Alzheimer’s patients with cultural and ethnic backgrounds, black patients received less care from nurses and physicians and were more disrespected, compared to their white counterpart. In Lisa M. Lines’ Racial and Ethnic Disparities Among Individuals with Alzheimer’s Disease in the United States: A Literature Review, racial bias and discrimination was caused by the physician/nurses’ lack of empathy for one’s social and cultural background, thereby resulting in bad quality service (Lines, pg 15-8). Further, medical physicians and nurses reported that they supposedly treat every patient equally, regardless of racial background, yet confessed to giving better treatment to white patients because they were more cooperative than blacks. This supports the argument that the AAC is unable to receive proper medical care for Alzheimer’ because health professionals treat black patients badly due to being not trained on a social/cultural level. It also supports there is a cultural barrier between healthcare professionals and black patients, as the lack of cultural/social awareness that physicians and nurses had has led to “stereotyping as a shortcut and the lack of empathy in the patient’s culture, has resulted in bad service” (Lines, pg 18). The AAC in Dallas is greatly affected by this discrimination because the city has one of the highest black populations in Texas, and since the loss of high quality medical service was absent, this left them unsupported both medically and socially.
The additional social impacts of Alzheimer’s disease on the AAC is that they are from a single culture seeking help from a multicultural healthcare system. Western hospitals treat cultures as if they are from single a social construct, meaning, that hospitals will not allow culturalism, which is the focus and separation of cultures in a society. They treat everyone equally, no matter their cultural background, but in reality, multiculturalism in a medical environment is ineffective because of racial bias and discrimination caused by their healthcare workers. There is a solution to evade treating cultures the same way, and that is by a social theory called culturalism. In anthropologist Didier Fassin’s, Culturalism as Ideology, culturalism is a social construct that preserves physical cultures from becoming the vernacular in a society (Fassin, pg 301). Multiculturalism is essentially the cutting down of social differences and traditions to treat them all the same, like in western hospitals. In simpler terms, it is like removing the brand labels from soda cans to make them look the same. Fassin’s theory, culturalism keeps cultures from being mixed in modern society by treating each of them differently (Fassin, pg 306). This may be effective for treating Alzheimer’s in the AAC because it could help focus the public’s attention to African American communities who need the most help in solving this disease, as it is the most common one inflicting their race. In the same fashion that TV shows are able to target a specific racial audience, culturalism can do the same for the African American community in focus of curing Alzheimer’s.
Another theory that is relevant to the social effects of Alzheimer’s is the deciphering of healthcare systems culturally. It’s difficult to determine precisely what type of objectives they have in society other than saving lives, because of their usage of multiculturalism. By attempting to care for different cultures equally in a diverse social system, they instead create a gap for their workers in deciding which option would be better for the patient like, quality care vs. cultural/social understanding, healing using western medicine vs herbal medicine from another culture, etc. all contain complications in determining which social belief healthcare systems really care for. They are an entirely different culture on their own, they follow certain rules and customs that fit and represent their beliefs, one of which is to provide medical care to those who need it. In anthropologists Clifford Geertz’s reading, The Interpretation of Cultures, certain cultures, in this case western hospitals, “operate in a manner acceptable to its members” (Geertz pg 11). What this means, is that in order to fulfill the beliefs of the healthcare system like saving lives, they need to treat patients with equal care and the only way it can do that while operating with in an appropriate manner in relation to their workers, is by adopting the social theory of multiculturalism. This has an impact on the African American community because it lowers the quality of medical service for Alzheimer’s patients to establish good credibility and equality for the other races. In addition, it creates an imbalance in the fairness for black patients because attempts to reconstruct their culture from a system that uses multiculturalism, are far from possible. While hospitals do follow a set of rules in treating a diverse population, the reality is that workers will overall treat patients more differently as they must adhere to the health system’s social structure and rules.
. Instead, western healthcare systems should not treat different cultures the in same social context, rather, they should treat cultures as if they are their own separate
Fassin, D. “Culturalism as Ideology.” In Cultural Perspectives on Reproductive Health, Jan. 2001, pp. 300–17.
Geertz, Clifford. The Interpretation of Cultures: Selected Essays. 3rd ed., Basic Books, 2017.
Kingsberry, Sheridan Quarless, and Philinda Mindler. “Misperceptions of Medicaid Ineligibility Persist among African American Caregivers of Alzheimer’s Dementia Care Recipients.” Population Health Management, vol. 15, no. 3, June 2012, pp. 174–80. CrossRef, doi:10.1089/pop.2011.0028.
Lines, Lisa. Racial and Ethnic Disparities Among Individuals with Alzheimer’s Disease in the United States: A Literature Review. RTI Press, 31 Dec. 2014. CrossRef, doi:10.3768/rtipress.2014.RR.0024.1412.