LGBTQ+ Disparities in Health Care

By Mansavi Meka

Published 4:16 EST, Fri December 31st, 2021

June was pride month: the month where we promoted self-affirmation, dignity, and equality of lesbian, gay, bisexual, and transgender people. Pride rather than shame or stigma promotes and bolsters LGBTQ+ rights movements. However, even in the field of health care, this community faces significant disparities. This article is about debunking those disparities, for a chance to bring change. 

Status-Quo

LGBT individuals are from different religions, cultures, and social classes. Research suggests that LGBT individuals face health care disparities that are correlated to social stigma. Discrimination against LGBT people has been associated with an increased chance of psychiatric disorders, substance abuse, and suicide. The Healthy people 2010 document highlights the need for more research to understand and address the needs of these hidden health disparities. A large study named the Pediatrics compares mental health of transgender and/or gender non-conforming individuals to their peers. The result is as expected: youth were several times more likely to have less attention and depressive disorders than non-transgender and/or gender-conforming individuals. In fact, statistics show that 28 percent of trans and gender non-conforming individuals have postponed medical care due to discrimination and disrespect. As a result of continuous discriminatory policies that often affect the minority, many LGBTQ individuals are left out of care. A 2017 national survey of LGBTQ+ people conducted by the Center for American Progress (CAP) found that nearly 1 in 10 LGBTQ individuals reported that a health care professional refused to see them because of their actual or assumed sexual orientation. Laura Durso, executive director of Washington DC’s nonprofit, Whitman Walker institute, which aims to advance social justice and equality in health care, reports that “Lack of access to health insurance and quality coverage, greater vulnerability to poverty, and unwelcoming and discriminatory social environments all play a role” (health.com). Having poor access to a vital need like health care can be horrifying, but the impact of poor access would hurt minorities, and make a severe impact on lifestyle and society.

Acknowledging the impact 

In the domains of mental health, physical health, and access to care, these disparities are evident for this social group. Due to these inequalities, the LGBTQ population is prone to a higher risk of poor mental health, drug misuse, and addiction. And since LGBTQ lack access to quality care, research shows that they are more susceptible to various illnesses, diseases, and infections. It is also more likely that LGBTQ+ people report a lack of quality care and unfair treatment (cigna.org).  Many social determinants that are continuously affecting the LGBTQ population include legal discrimination in health insurance, employment, housing, adoption, etc. Lack of social programs targeted at the LGBT community and a shortage of healthcare providers all play a role in the impact of the community. The impact of continuous discriminatory policies on a minority solely due to their sexual orientation is nefarious in itself.

Bringing change

There are multiple ways that society can take action to reduce existing health disparities in the LGBTQ community. Ranging from expanding access to health care to promoting organizations and social programs that specifically target this minority community. The Center for American Progress explains that giving adequate training to health care professionals would prioritize cultural competency. Not only should we train medics, but we also need to focus on bringing change in society. Educating our community of these disparities can go a long way to respect and treat the LGBTQ community equally.  Additionally, many LGBTQ individuals lack access to health insurance, current efforts in Congress have the potential to bring change. Although this issue cannot be tackled overnight we must make efforts to change the status quo. Even though we come from different socioeconomic backgrounds, cultures, religions, and sexual orientations, we are all humans and we can bring change. 

Manasavi Meka, Youth Medical Journal 2021

Sources

1. Gillespie Claire. “6 Major Health Disparities Affecting the LGBTQ+ Community.” Health.com, 12 June 2020, www.health.com/mind-body/lgbtq-health-disparities. 

2. Becerra-Culqui, Tracy A., et al. “Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers.” American Academy of Pediatrics, American Academy of Pediatrics, 1 May 2018, https://pediatrics.aappublications.org/content/141/5/e20173845. 

3. “10 Statistics You Need to Know about LGBT Healthcare & Discrimination.” Lighthouse, 20 Nov. 2018, https://blog.lighthouse.lgbt/10-stats-lgbtq-healthcare/.

4. “CDC Confirms LGB People at Greater Risk of COVID-19.” HRC, .https://www.hrc.org/press-releases/cdc-releases-report-confirming-lesbian-gay-and-bisexual-people-at-greater-risk-of-covid-19-illness-calls-for-more-data-collection. 

5. “Lesbian, Gay, Bisexual, and Transgender Health.” Lesbian, Gay, Bisexual, and Transgender Health, Healthy People 2020, https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health#one

6. Krehely, Jeff. “How to Close the LGBT Health Disparities Gap.” Center for American Progress, https://www.americanprogress.org/issues/lgbtq-rights/reports/2009/12/21/7048/how-to-close-the-lgbt-health-disparities-gap/. 
7. “LGBTQ+ Health Disparities.” Cigna, https://www.cigna.com/individuals-families/health-wellness/lgbt-disparities

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A Look Into India’s Black Fungus Epidemic

By Manasvi Meka

Published 11:35 PM EST, Wed July 14, 2021

What is it?

The black fungus infection of India, also known as “mucormycosis,” is a very rare infection. It isn’t contagious and doesn’t spread from one person to another.  It is caused by exposure to “mucor” that is found in soil, plants, manure, and decaying fruits or vegetables. It affects the sinuses in the brain and causes severe damage in immunocompromised and diabetic patients. Diabetes not only increases a person’s risk for COVID-19 but can also provide conditions in which fungal infection can occur. Mucormycosis begins as a skin infection, but it later progresses to the eyes, lungs, jaws, face, and even to the brain. Dr. Hemant Thacker explains that “One of the ways mucormycosis travels is by invading the blood vessels.” Mucormycosis also blocks blood flow which kills infected tissue, once it dies or becomes necrotic, the tissue has a black discoloration. Thus the term “black fungus” has spread.

Fatality Rates + Process of Attack

Doctors currently believe that the mortality rate of the black fungus is 50%, which may be triggered by the steroids used to treat COVID-19. While steroids help to fight against COVID-19, they also happen to make the body less immune and spike up blood sugar levels. For example, dexamethasone, a drug used to treat COVID-19 suppresses the immunity of an individual, providing a greater leeway for the fungal infection to prevail.   Since there is a drop in immunity when a body gets attacked by COVID-19, patients are becoming far more susceptible to this deadly disease. Dr. VP Pandey, head of the hospital at Maharaja Yeshwantrao Hospital, says that “The black fungus infection has now become more challenging than Covid-19. If patients are not treated in time and properly, then the mortality rate can go up to 94%. The cost of treatment is expensive, and the drugs are in short supply.” 

Symptoms + Treatment

Dr. Anita Mathew, an Infectious disease specialist from Fortis Hospital explains that some of the common symptoms of mucormycosis include sinusitis (nasal blockage or congestion), pain on the cheekbone, facial pain, numbness or swelling, black discoloration over the nose, loosening of teeth (jaw involvement), blurred or double vision with pain, chest pain, or severe respiratory problems.  Mucormycosis is treated with anti-fungal medicines, such as Amphotericin B, taken intravenously. Demand for Amphotericin B is rising continuously every day in India. Other medications like posaconazole or isavuconazole (anti-fungal medicines) can also be taken either intravenously or by mouth.  Another potential treatment is to have surgery in order to remove the necrotic tissue. The disease itself is pretty rare and, according to the San Francisco Bay Area, during 1992-1993, the number of mucormycosis cases was around 1.7 cases per 1 million people. However, due to the prevalence of COVID in India, the risk of getting diagnosed with this disease is on the rise. Even though mucormycosis is a rare disease, please do not disregard it as it could have serious consequences. Additionally, many doctors believe that the most effective way to combat mucormycosis is to wear a mask while venturing out especially to gardens or dusty areas (where chances of inhaling mucor are on the rise). Also, diabetic and immunocompromised individuals should take efforts to control glucose levels. And most importantly, if ANY of the symptoms written above persist, please call your local doctor immediately to get help.

Manasvi Meka, Youth Medical Journal 2021

References

1. Biswas, Soutik. “Mucormycosis: The ‘Black Fungus’ Maiming Covid Patients in India.” BBC News, BBC, 9 May 2021,.https://www.bbc.com/news/world-asia-india-57027829

2. Biswas, Soutik. “Black Fungus: India Reports Nearly 9,000 Cases of Rare Infection.” BBC News, BBC, 23 May 2021, https://www.bbc.com/news/world-asia-india-57217246

3. Yeung, Jessie, and Vedika Sud. “They Recovered from Covid, Only to Die of ‘Black Fungus.’ Here’s What We Know.” CNN, Cable News Network, 24 May 2021, https://www.cnn.com/2021/05/21/india/black-fungus-mucormycosis-covid-explainer-intl-hnk/index.html

4. “Mucormycosis Statistics.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 27 May 2020, www.cdc.gov/fungal/diseases/mucormycosis/statistics.html. 

5. Citroner, George. “How COVID-19 Surge Is Related to a Black Fungus Outbreak.” Healthline, 26 May 2021, https://www.healthline.com/health-news/how-covid-19-surge-is-related-to-a-black-fungus-outbreak

6. “’Black Fungus’ (Mucormycosis) and COVID-19: Myths and Facts.” Medical News Today, MediLexicon International, 4 June 2021, https://www.medicalnewstoday.com/articles/black-fungus-and-covid-19-myths-and-facts
7. R, Nivedita. “Black Fungus: Why Is It Dangerous And How to Prevent It: Doctor Explains.” India News, Breaking News | India.com, 20 May 2021, www.india.com/health/black-fungus-why-is-it-dangerous-and-how-to-protect-ourselves-from-it-doctor-explains-4677817/ 

Alzheimer’s Disease: Symptoms, Causes, and treatment

By Manasvi Meka

Published 3:51 PM EST, Sun April 18, 2021

Symptoms

Alzheimer’s is often a slowly progressive disease, so it’s indeed more difficult to spot definitive symptoms. According to Mayo Clinic, some of the symptoms of Alzheimer’s include: repeating statements, forgetting conversations, getting lost in familiar places, forgetting names of family members, difficulty concentrating, inability to make a judgment. The effects of Alzheimer’s on the brain can also affect moods and behaviours such as depression, apathy, mood swings, and wandering. Alzheimer’s can still be treated, so it’s important to get treatment as soon as possible.  

Diagnosis

To diagnose the severity of Alzheimer’s doctors run multiple types of tests. They will most probably do a physical and neurological exam by testing: reflexes, muscle tone, coordination, balance, sense of sight and hearing, etc. Doctors are likely to do an MRI scan or a CT scan to produce detailed images of brian.  

Causes

While the exact cause of Alzheimer’s isn’t fully understood, the idea is that the brain proteins tend to fail to function properly, which then disrupts the work of neurons. When neurons are damaged, they eventually lose connections and die. In many ways, Alzheimer’s is connected to a combination of genetic, lifestyle, and environmental factors. 

Treatment 

There are two types of drugs that are currently used to help with Alzheimer’s:

Cholinesterase Inhibitors – Cholinesterase inhibitors aim to increase communication between the nerve cells to improve the symptoms of Alzheimer’s.  

Memantine – Decreases the abnormal brain activity, it also improves the ability to think and slows down the loss of abilities for people who are diagnosed with Alzheimer’s disease. 

In conclusion, Alzheimer’s disease is a common yet disheartening disease that affects a living body of people across the world. Although there aren’t direct solutions, treatment can improve it. Make sure to contact your local doctor if the symptoms seen above persist. 

Manasvi Meka, Youth Medical Journal 2021

References

“What is Alzheimer’s Disease?.” CDC, 02 Jun. 2020 https://www.cdc.gov/aging/aginginfo/alzheimers.htm Accessed 24 Mar. 2020. 

“Alzheimer’s Disease.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 Dec. 2020. https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447 Accessed 29 Mar. 2020. 

https://medlineplus.gov/druginfo/meds/a604006.html#:~:text=Memantine%20is%20in%20a%20class,in%20people%20who%20have%20AD. Accessed 28 Mar. 2020. 

“How Do Drugs for Alzheimer’s Disease Work?” Alzheimer’s Society. https://www.alzheimers.org.uk/about-dementia/treatments/drugs/how-do-drugs-alzheimers-disease-work Accessed 26 Mar. 2020. 

“Memantine: MedlinePlus Drug Information.” MedlinePlus. U.S. National Library of Medicine.