Journals
#1. Six Word Sentence
A curious thinker who keeps searching. To me, this means when I find something I'm truly interested in, I will scour the depths of the internet to learn as much as I can about it.
#2. First Mistake at the Summer Meeting
Based on the big post it note activity, I have a better idea of the paths I could take with my topic. However, it would've helped me to write a narrower topic than "Healthcare in America" like "Drug Prices in America vs. Elsewhere". This way I could've had more specific feedback. Regardless, some of my classmates were one step forward and jotted down to research other countries' healthcare systems.
#3. Oh the Different Ways of Learning
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One way our country's healthcare system peaked my interest was through my fondness for comedian and television host Hasan Minhaj. He came out with his comedy political show on Netflix called "Patriot Act" in 2018 with episodes covering major topics from Saudi Arabia's involvement in Jamal Khashoggi's death to affirmative action to censorship in China.
As I sat down to inform myself of a new topic one Sunday afternoon, I found myself taking in every image on his screen and pausing every few minutes so that I don't miss a statistic on drug pricing in America. Learning that the high price of insulin causes people to ration their doses leading to possible death is the frank reality for many Americans. Diabetes is not a new disease where pharmaceutical companies can play around with the prices of a treatment due to a high and brand-new demand in it (not that that should be allowed anyway). Diabetes has been around for centuries and centuries! The first known case was 1552 B.C.! Even now in 2019 people are dying from an easily treated disease.
Another way I became interested in healthcare was through my older brother who spent the last 10 months working for Public Consulting Group (PCG) in Albany informing himself on Medicare and Medicaid policies in Massachusetts and New York so that he could take part in revising them. He had to work closely with several different hospitals in the nearby states and learn their policies when it came to healthcare (insurance, etc.)
Albany is a great hub for people in health and policy fields what with our Department of Health, consulting groups, and health research institutions.
#4. What was I thinking choosing such a broad topic?
How does one tackle the gargantuan umbrella that is the American healthcare system? Perhaps, this intimidation is the reason no radical change has occurred (no time for moderation is always my motto) . Do I focus on pharmaceutical companies or verbatim Medicare/Medicaid policies or comparing a portion of America's system to its respective system of another country like Sweden or Bangladesh or Cuba, or universal healthcare and its complexities or what!? Better figure it out within the next few weeks!
#5. So like insurance?
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Private health insurance is insurance given by a company. Medicare is the federal health insurance program offered to people over 65 and some younger people with disabilities. Medicare is split into three insurances: hospital, medical, and prescription drug. Okay blah blah blah that's enough talk about boring insurance especially because most of the sites online look too boring for me to skim through much less read.
I understand that Medicare and Medicaid are fairly new policies in America as LBJ passed them in 1965 along with the Social Security Act (Mrs. Rudolph would be so proud if she knew I remembered this :')) However, healthcare as a whole has always been lacking for the lower and working classes and definitely not just in this country, but virtually everywhere.
Let's talk a little bit about the Cuban healthcare system. Cuba is a Communist country and all of its health services are government run. The Cuban government has a national health system and it takes responsibility for the healthcare of every Cuban. Life expectancies for both men and women are higher in Cuba than in the U.S. Diagnostic tests and medication for hospitalized patients in Cuba are free; however when a patient has a sufficient economic status, he pays for hearing, dental, and orthopedic processes, wheelchairs, and crutches.
#6. More on drug pricing (09-09-19)
I decided to try to listen to a podcast on drug pricing after the first official session of EMC got my brain back on track for my topic. I thought I'd research a little bit about how drug pricing works in hopes of narrowing down my topic. I listened to about 20 minutes of "Drug Pricing in America" on Deep Dive with Laura Arnold. Arnold emphasized the dangers of how the high cost of insulin has been proven dangerous to type 1 diabetics; a 600% increase in the price since 2002.
#7. Medical Tests Extravaganza (09-19-19)
Surprisingly enough, I'm learning quite a fair amount of my topic in health this year. Mr. Jensen showed our class a documentary called "Medicine and Money" where the main focus was on how some doctors order more tests than needed for patients, which racks up their medical bill. Also, some doctors and hospitals keep patients for longer periods of times than other places, depending on the region of the country. The video specifically honed in on the University of California Los Angeles (UCLA) Medical Center and Intermountain Hospital in Colorado.
For example, a patient who is in the last two years of her life will stay in the hospital for 28 days at UCLA , whereas in Intermountain, she would stay for 16 days. Both patients have similar conditions. Patients at UCLA spend 3x the time in the Intensive Care Unit (ICU) than those at Intermountain. Medicare costs at Intermountain total to about $54,000 compared to $98,000 at UCLA. https://tubitv.com/movies/312523/money_and_medicine
The documentary also talked about the increasing number of women who decide to opt for a Cesarean Section (C-Section) during the end of their pregnancy instead of a vaginal birth, which apparently is costing the country trillions of dollars.
#8. Mary Oliver Reboot? (09-24-19)
I wrote my poem for the Person/Place/Thing assignment on Sunday. I have shared it with fellow EMC students, as well as a couple of non-EMCers and Mr. Gnirrep. It's so easy for me to get carried away with the abstract aspect of writing a poem and I think that having some peer review is extremely helpful because it helps ensure that what I'm writing actually makes sense and has a point to it.
Writing a poem about something as fact-based and concrete as healthcare and insurance was a challenge for me, which is why I chose to do it. I can't even remember the last time I wrote a poem. Whether it was the last time an English teacher handed out a mandatory assignment for it, or I pieced together a quick haiku on a sheet of pink construction paper for a Valentine's Day card, I felt out of my element writing one for the first ever EMC assignment. Regardless, the clock has been ticking on the due date for this assignment, and when the writing flow hits you, you certainly can't ignore it!
I had two options on the paths I could've taken to write this poem: write it about my older brother, Reza or tell the story of someone who may struggle with having proper healthcare/health insurance. I wanted to be able to write a good and powerful poem of my brother because if it wasn't for him and the jobs he's had at the NYS Department of Health and PCG, I may not have wanted to pursue public health. He's the major inspiration for this huge life decision by which I have to stick. However...I really tried to write a poem about him. I spent a few days on it. I would have small pangs of ideas and I would be typing them quickly onto my Google Doc, but after rereading it to myself, I knew it wasn't the story I wanted to tell through a poem. The whole task of writing about Reza wasn't elastic enough for me to play around with and try out different literal devices. So on a new page in the same doc, I decided to see what I could get down about someone else in my life who doesn't have good health insurance, but has crippling health problems. A family friend I've known for years and years, but not someone I know too well.
It took me about 45 minutes to get 302 words down. One thing about me is that I am extremely picky of the writing I produce and share with people. If I don't like the way I wrote a phrase or the diction I used, I will stop to no end to fix it and make it sound as good as it can. Poetry is so intimidating to write because if it isn't good, then you've failed. If the metaphors you're using don't work or make sense, then you've written a different poem from what you were supposed to. Even reading another poem by a poet is intimidating because every reader wants to be able to successfully pinpoint what the author was trying to get by referencing lily pads to a poem about something totally not about lily pads. However, I felt good about what I had written. I knew it needed some work and that some sentences needed to get fixed, but at least I had gotten farther with this topic than writing about Reza.
I asked Mr. Gnirrep take a look at it and he got back to me with the kindest words and most helpful feedback. He printed out a copy of my poem and hand wrote his thoughts and suggestions. Mr. G said my writing style reminded him of one of his favorite poets, Mary Oliver. He very conveniently had a rectangular cut of paper right at my eye level of a Mary Oliver poem pinned onto his board in the back of his room. "Spring" I believe it was titled. I also made some silly mistakes like including flowers of different seasons (something only he would pick out lol) and extrapolating on a metaphor that didn't entirely fit my poem despite it sounding "poetic". His words were, "I really like this paragraph. Save it for another poem." Who knows? Maybe this is the beginning of my interest in poetry. All it takes it is a teacher doing his job: inspiring his students.
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#9. PPT Reflection (10-02-19)
I cautiously highlighted every section in the criteria under "Exceeds Expectation" and I was thinking to myself: Am I just doing this because it'll show Bott and Gergen what an annoying tryhard I am? and the answer is no. This class is way differently structured than any other class I've ever taken. I don't need to worry about losing a point, or falling under the "I think I nailed it" category because it ultimately won't be added to a gradebook. I truly am proud of myself for the initiative I took in writing a poem (something I haven't done in at least five years, and definitely something I've never ever done well) and reaching out to Mr. Gnirrep. I've always had trouble trying to talk to teachers. This assignment not only allowed Mr. G to get to know me better both as a writer and thinker, but also fostered an entirely separate interest in poetry for me. I just have to wait for my bedroom to get painted on Sunday before I can pin "Spring" by Mary Oliver on my wall above my desk!
Clearly, I want to challenge myself in ways no other class could provide for me (because let me tell you, I definitely had a CHALLENGE or two or ten on my second BC Calc test), which is exactly why I signed up for this independent inquiry course. What other way to begin that journey than to write a poem. I'm excited for what's to come since this poem is now setting the bar for the quality of my work, but that will only motivate me further.
#10. Let's Play Catch-Up (10-16-19)
So it has been a little while since my last journal, which sucks because my motivation for this project has nearly disintegrated what with the stresses of college and BC Calc (please someone tell me why I did that to myself) and simply not knowing what path EMC is supposed to be taking me. I thought it could be a cool idea to have Guilderland High School students take a poll on how much they know about healthcare and then make a podcast on the results. When I went to sit down at my Chromebook and begin researching survey questions, I realized that I didn't care to do that (like at all) and I didn't think it was smart to waste this month's SDA on something that wasn't going to lead me anywhere further into my public health journey.
Anyway, moving forward...I went on a college visit to Barnard College today and during my time in the Upper West Side, I decided to sign up to visit a class. The only class that fit my schedule was Urban Studies: Cities in Developing Countries taught by Marcela something. Today's class talked about three different kinds of justices: distributional, recognitional, and procedural. Some students brought up good questions about which justices were more equitable (recognitional justice) versus more equal (distributional justice). This talk about inequity amongst the population of minorities got me thinking about the inequity in healthcare. So this month, I have set out to learn as much as I can about how people feel about healthcare, what improvements they think should be made, and most importantly, how to make it the most equitable.
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According to Yale Insights, there is barely any correlation between a hospital's reputation and its prices. The best hospital may charge for tests similarly to a mediocre hospital. When hospitals can monopolize or duopolize, they tend to charge way higher than if they had competition. One way to reduce these charges is to regulate how much hospitals can charge their patients and set national rules. https://insights.som.yale.edu/insights/why-is-healthcare-so-expensive
#11. Starting Research on Nordic Healthcare (10-17-19)
I feel good about spending the rest of this month gathering as much information on Scandinavian health results and their healthcare and comparing it to the American system. Perhaps, I can make an SDA on "Would Sweden's policies work in America?" because there's a lot to unpack and analyze there. Bott raised a good point, one that every counter argument to universal healthcare (I'm abbreviating to UH because I don't want to keep spelling this out) is made, Sweden is a much smaller and more homogenous society than America. Even though I want immediate and drastic social and policy change, I know that that's not realistic. Some hypothetical questions to ask include: what if you implemented UH regionally? (with the ultimate goal of the entire nation), or what if you started even smaller in communities that nearly lack healthcare? Here are some constraints to UH...
Even with Sweden's population, their healthcare system costs $58 billion (according to a podcast I listened to coming home off the late bus called The Walter Show). There are ways to pay for the system in America, but it would cost way more than that what with the much larger population. In this episode "Saving Swedish Healthcare with Doktor.se Co-founder & CEO Martin Lindman", the guest, Lindman, was emphasizing how important it was to maximize the utility of doctors, nurses, and medical staff, making sure not to waste time scheduling appointments, going to see the doctor when you don't actually need to, etc.
One thing that is starting to take off in Sweden is online patient care. I want to research the efficiency and logistics of this system more thoroughly before I make conclusions after listening to one 40 minute podcast, but this theoretically sounds like a feasible option in America. As a developed nation, many Americans may not have access to healthcare, but, in this day and age, a (probably) larger percentage of them have access to a smartphone, or maybe a public library with desktops and Wi-Fi. This way, for those contacting potential patients, more jobs are opened up to those that may not have a bachelor's degree- definitely a portion of our unemployed peoples. Not everyone in a hospital has a bachelor's or medical degree. Plenty of technicians (pharmacy technician, electrocardiogram (EKG) technician, anesthesiology technician, etc.) go through one more more trainings before being able to independently carry out their jobs. Plus there are many administration and sanitary jobs in hospitals; you need everyone from all kinds of backgrounds and trainings to run a hospital. Now, you can add medical dispatchers onto the list after giving them trainings or opening up the opportunity to nursing/medical students if you take it as advanced as that. However, from the sound of it, it seems like more of an administrative thing where someone takes your medical history, symptoms, etc. down and then has someone else decide what to do with you.
#12. Ultimate Technology Takeover in the Form of Healthcare (10-21-19)
I was interested to see what a Swedish online doctor visit website would look like so I did a quick Google search and hopped onto https://virtual.swedish.org/. Under FAQs, the "what?" question gets answered. Swedish Virtual Express Healthcare offers a telehealth solution to people who don't have time to run into the doctor's office or the means to wait for their scheduled appointment to come up. A board-certified member (all of this provider's members are nurse practitioners) chats with the patient through secure, live video; they can diagnose and treat minor medical concerns, and prescribe medicine and/or lab tests. WAIT WAIT WAIT this is an American site! People living in Washington state are eligible to access this online service. They are available seven days a week from 8 AM to 8 PM. Each virtual visit totals up to $49 depending on healthcare providers. On the site, there is a list of providers in Washington state and surrounding states such as CA, AK, MT, and OR that pay for the virtual visit. Scheduling appointments is not necessary. I couldn't find any reviews on the virtual care, but Swedish Express Healthcare is a company available to access in various Walgreens pharmacies and clinics.
#13.Let's Play a Game of Telehealth (10-23-19)
According to Harvard Business Review, telehealthcare and virtual healthcare are gaining momentum because of the rising costs of healthcare, shortage of physicians, and the aging population. https://hbr.org/2018/04/virtual-health-care-could-save-the-u-s-billions-each-year
#14. October SDA Reflection (11-05-19)
October was the trickiest month of probably my entire high school career thus far. Starting off the month with my Chem SAT Subject Test (that I didn't even do well on) and for which I missed my last ever high school Homecoming football game. Then, stressing over last minute college visits, road tests, ACT exams, college essays, etc. I didn't prioritize this month's SDA just as how I didn't prioritize any of my other classes over the college application process. I submitted this assignment at like 10:45 PM on Halloween night after getting home from my friend's house (I literally hit submit on my Barnard application at Grace's house.) I quickly scrambled to put together a pamphlet of minimal information on telehealth, which was something I spent a little bit of time researching throughout the month.
This month's rubric definitely looks as polar opposite as it can get from September's rubric. Going from highlighting everything in the "Exceeded Expectations" boxes to a combination of the "Hey, I tried" and "I Phoned It In" boxes gives a clear image of the kind of work I produced with a thousand other assignments and deadlines on my shoulders. My regression doesn't account for a dwindling sense of motivation or interest. However, it does account for my lack of time/assignment management
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#15. And I'm Back! For Good! Hopefully! (11-10-19)
This month, I intend on focusing on different areas of healthcare inequity. For example, one thing I've started reading about it how new immigrants applying for visas are now expected to provide their insurance cards within 30 days of being in the US or at least have the ability to afford health insurance. I want to inform myself on this topic as widely as possible covering overprescription of drugs and doctors ordering unnecessary tests to how organ donations work in terms of how people can receive them.
Researching various aspects of our healthcare system gives me a better understanding of how it works. As an aspiring health policymaker, this helps me understand the continuity of its inequities. Healthcare as been a hot button topic for a little while now and even more so now that we have precisely a gazillion presidential candidates, all with different points of view. My sense of curiosity and drive haven't decline over the course of October, only my outlet of time had. Regardless, time management is still something I have yet to make progress on. Every week or two weeks, I will spend my time researching one topic and one topic only. It's very easy to get carried away in as broad a topic as inequitable healthcare. Once my time is up, I'll switch over to something different. For my next SDA, I want to talk to someone who has had firsthand experience with the ethics of medicine.
#16. History of Healthcare from 1900 (11-17-19)
Providing healthcare to the masses has always been something that is considered far-fetched, unnecessary to some people and unobtainable to others. When the demand for healthcare was low, doctors actually provided their care for free up until the 1900s when they were expected to charge people. There have always been more impeding events that have sidetracked this country from having this conversation. It was first put on the back burner in the 1910s during WWI followed by the Great Depression. It wasn't until FDR's presidency when this issue had a national platform backed by a democratic president and his administration.
Over the last century, many people in this country have been pushing for a more government provided healthcare system to ensure that more people are taken care of. Our country has been very slowly transitioning into normalizing this concept by President Truman proposing one health insurance plan for every American in the 1940s (which got shot down), creating private insurance for people who can afford it, insurance companies selling health insurance, President LBJ signing Medicare and Medicaid into law, President Nixon's national healthcare plan, and more. Yeah.........Nixon had a national healthcare plan. It was actually far more liberal and "radical" than Obama's Affordable Care Act. Had Nixon's plan gotten passed, in the last 30 years, more than 1/3 of our population would've been insured.
17. Could Universal Healthcare be Implemented in America? (11-19-19)
Canada offers free universal health coverage to all of its citizens. Universal healthcare proponents like Bernie Sanders and Elizabeth Warren have further hopes for the system than what Canada currently provides. While residents don't have to worry about paying out of pocket, there are some drawbacks such as long delays for receiving elective surgery and seeing specialists. https://www.washingtonpost.com/health/americans-have-questions-about-medicare-for-all-canadians-have-answers/2019/11/18/7971c78e-d4d6-11e9-9610-fb56c5522e1c_story.html
18. First Collaboration of the Year (11-24-19)
For my next SDA, I plan on collaborating on a podcast with Stella on the ethics of FDA products. Stella's topic this year focuses on Eastern medicine vs. Western medicine and this month she has researched FDA approved products/the process in getting them approved. The ethics of this process is where I come in. This podcast will be centered around the grounds for which the FDA approves products and how some suppliers may "cheat the system." I have lots of research to do on this topic before partaking in a podcast, but I'll spend the next two weeks collecting information and simultaneously drawing up plans for a podcast during the secondish week of December. Stella and I are going to have some logistics like when to record, the length of the podcast, layout of information, etc. Despite not having researched this area of possible unethical practices yet, this is one of the few things that remains relevant for both of our topics and something I would be able to collaborate on with her. I'm interested to see what kinds of things she will be able to weave in.
19. Can just anyone get their drug approved by the FDA? (11-25-19, 12-05-19)
Under the Ethics Laws and Regulations tab on the fda.gov (which looks annoyingly professional which automatically turns my eyes from "read mode" to "skim loosely mode"), it basically said that employees cannot be bribed by someone to have their products approved by the FDA. The only rule companies need to follow is that they need to test their product and send their results to the FDA's Center for Drug Evaluation and Research (CDER). If the results of the drug prove that its benefits outweigh the side effects and known risks...that's kind of it. The CDER doesn't conduct its own tests; their role extends to researching the area of drug quality, safety, and effectiveness standards. The drug companies themselves have to laboratory and animal tests to determine if there's any hope for their drug. If it shows some promise and is safe/effect enough, the drug is tested on humans. (https://www.fda.gov/about-fda/ethics/ethics-laws-and-regulations, https://www.fda.gov/drugs/development-approval-process-drugs)
The approval process consists of the analysis of the target condition, assessment of benefits and risks, and strategies for managing the side effects.
20. Higher Order Thinking (12-06-19)
Knowledge: How would you show how the FDA approves and regulates products? Can the FDA select any product based on a different motive? and Can you select the types of different medicine being approved?
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Comprehension: How would you compare the restrictions to which Eastern medicines and Western medicines are held to? Is there a stigma attached to either one or the other? Does the market favor one or the other? Do professionals want one or the other to be more prevalent in our society?
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Application: What elements would you use to change the approval or testing process of the drugs?
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Analysis: What conclusions can you draw between the approval process for Eastern medicine and Western medicine?
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Evaluation: What would you cite to defend the actions of the FDA and the CDER (and perhaps more organizations)?
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Synthesis: Can you elaborate on the reason Eastern medicine products are halted from being used in a widespread manner in the West? (side note: some of my friends have mentioned that when they're sick or have the flu, they take some Chinese medicine they have found at the local Asian supermarket....only a certain demographic may be using specific products, but if they're beneficial and natural, why shouldn't other people have the awareness about their existence?)
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Question Focus: The FDA's approval process when it comes to the vast selection of medicines from all over the world is not very inclusive or diverse. (another side note: It's not like Eastern medicine and scientific advancements are a current product of the time. For hundreds of years, we have heavily relied on certain methods and techniques that originate from Asia and Africa such as acupuncture, herbal medicines, cupping, various surgical procedures, and more. Why do we tend to prefer Western medicines or even Western brands? Why do we tend to discount Eastern developments?)
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21. Podcast Reflection (12-18-19)
1. I'm really happy with my first podcast using the Audacity software. I'm glad I learned the basics so that I can continue to use it for future podcasts. Planning our recording was easy with Stella because we had an overlapping study hall and we would talk about our plans for the podcast in our other classes. We shared our higher order thinking questions with each other and showed each other our research so we knew what topics to cover.
2. The week we recorded was tricky because I had a lot of other big assignments (when don't I? so this isn't even an acceptable excuse anymore) and I had other mandatory meetings for other clubs. Not having any other free blocks meant sticking to my music study hall and the following activity period for recording purposes and coming into the library during lunch/homeroom to finish up tedious editing. I was able to learn all the editing tools I needed from Bott and Gergen helped me export the file so I was all good with finalizing our podcast. Thankfully, I didn't need to tinker with our raw cut of the entire conversation all that much.
3. After my last SDA, I definitely believe that this podcast was a much better product. I felt excited about using the podcast room for the first time and collaborating with Stella, but it didn't match the excitement I had from September's SDA of writing my poem. BUT! That's okay because that tells me that I prefer storytelling and delving into the personal stories instead of talking about the nitty gritty (sometimes boring) facts about the FDA and blah blah blah. So, for January Day at least I know that I want to tell an overarching story of some kind.
4. I still need to work on talking more in any upcoming podcasts. I know that Stella talked way more than me, but when we were planning it out, we agreed that one of my bigger roles was going to be steering the conversation because Stella knew she was going to ramble a lot. I just didn't know how to insert myself in there. For any future projects, I'll have to work on making sure I get my own time.
5. I wish Stella and I had spent more time planning the kind of content we would cover in our podcast so that our findings could overlap more. It would've been nice to research the same topics under different lenses; it could've made the recording better.
22. January Day Planning (1-7-20)
I think the best way for me to connect and reach the audience and judges is by creating a hypothetical situation and maintaining local ties so I could create a story around a hypothetical GHS student who doesn't have health insurance. I don't want to focus on facts and statistics, but I definitely want to throw a couple in there to help put some things in perspective. I really liked Bott's suggestion of putting a physical copy of health policy in front of the panel. I have to continue brainstorming what other props I can use to enhance my presentation. I'm also unsure of how to utilize my tri-fold. I want the point of my presentation to be a way for people to realize or at least recognize how our very community members neglect going to the doctor or picking up a prescription due to copays and deductibles. Our very own neighbors have no option but to watch their health deteriorate. I still feel as though that might not be enough to connect with my panel...so I'll have to draw from local ties.
23. More Planning (01-09-20)
I want to focus on something local so that everyone on the panel can connect to it, instead of feeding them a story that originates hundreds of miles away. The goal for talking about something close to home is that hopefully there will be less glossing over this topic.
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I got my hands on the 2018 Annual Program and Services Report for Albany County Dept. of Health. Commissioner of the Dept. of Health, Elizabeth F. Whalen says, "Public Health is a science and an art that connects us all. Our team of dedicated staff is committed to working with the community we serve to ensure they receive the highest quality public health services; to limit health disparities; and to promote healthcare equity, quality and accessibility for all the citizens of Albany County." in the very first page titled "Message from Commissioner." On page 17, it says that low-income children in urban areas don't have access to fluoridated water, which calls for their need of preventive dental health services. When have we ever thought about the impact our (non)fluoridated water has on our teeth? (Maybe I'll have two bottles of water, one fluoridated one not? I could asked members of my audience whether or not they have ever thought about the impact non-fluoridated water would have on their dental health and their bank account.) Well, maybe not since dental insurance is sometimes supplementary. Gears are still turning on this... http://www.albanycounty.com/Libraries/Department_of_Health/2018_AnnualReport_FINAL_1.sflb.ashx
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24. Visuals for Presentation (01-16-2020
I want to trace the map of Albany County on my trifold, highlighting areas like Guilderland, Altamont, etc. Each of my three stories has a base in a town. Story #1 will be about my family friend (the woman in my poem) so an image of her silhouette will be tacked onto Guilderland. Story #2 will be about Stella's late pastor so an image of him will be tacked onto Altamont. Story #3 might be a hypothetical person since I've been having trouble finding a story about one specific person in the area online, but he or she will be a diabetic since there's a large prevalence of diabetes especially in Albany and Schenectady. I also want to include this graph somewhere on a poster. Not sure how to upload the pdf of my map onto here so it'll be attached to the Classroom post.
25. January Day Reflection (01-29-2020)
January Day was an interesting experience for me, in terms of my presentation. I went for a narrative/story that I wanted to tell so I basically had to memorize the majority of my script instead of just like giving an oral report of my research and findings because I didn't want to skip any integral pieces of the story. For example, I think in my first round of judges I forgot to mention that Seema has breast cancer in the midst of talking about her hobbies and stuff...I realized when my judges had confusing looks on their faces so I tried to backtrack naturally, but it probably wasn't as seamless as I had hoped. As for where I want to go for May, I have finally figured out that I want to focus primarily on the quality of life aspect of public health. Now, I can think about any officials in the field to whom I want to reach out. Not entirely sure what my goal is for the Symposium, but there's ample time for me to figure that out. I think I managed my time for this project somewhat well. It could've been worse, but it could've been better. The practice sessions with Bott and Alan were really nice because I'd hadn't really had combined meetings with another EMCer and I liked being able to bounce ideas off of both Alan and Bott. I'm proud of how my presentation turned out. I liked the way I laid out my stories and the addition of silhouettes (credit goes to Bott.) If I could change my approach to planning this out, I'd have spaced out my time better, but if I could change my approach to my presentation, I don't' really know what I'd do. I thought it would be boring if I stood in front of my judges and just listed facts, which is why I liked that my narrative included both facts and condensed stories. Dr. Wiles and another judge (who I didn't recognize) in my first panel had many questions about Seema and they wanted me to share my poem and this presentation with her. Their interest in my connection to Seema definitely took me by surprise. The most important question I want to explore next is how qualities of life differ among racial groups? I don't know what to do next...is anyone surprised?
QFocus (02-10-2020)
I want to focus my research on the working poor. My QFocus for this week is focusing on accessible healthcare for the working poor. One question I can focus on is "Why don't people apply for Medicaid?" As many as six million Americans qualify for it, but don't apply for a bunch of reasons like believing they don't need it and that their medical conditions will improve. Private insurance coverage may result in quicker and better healthcare. Some Americans may not want inferior healthcare and opt for not having it at all over a worse version. At this point, proper healthcare for everyone is just not in the budget. Also, there is sometimes fluctuations amongst who is eligible for Medicaid as people's incomes change. These discontinuities result in Americans living without any coverage for long periods of time.
https://www.forbes.com/sites/johngoodman/2014/09/02/dont-trap-people-in-medicaid/
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Lower income Americans have reportedly more chronic illnesses, heart disease, diabetes, stroke, etc. than higher income Americans. Not only is physical health affected in lower income Americans, they are five times as likely to be sad; their conditions taking a toll on their mental health. Poorer Americans live in areas where more unhealthy options are advertised more such as tobacco and fast food restaurants. They may not have the option to purchase healthy food as that costs more.
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https://www.healthaffairs.org/do/10.1377/hpb20180817.901935/full/
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Another thing I can look into insurance that employees are eligible for. Lower income Americans typically don't have access to health benefits offered by their employer.
Refocusing After Midterm (02-12-2020)
I want to focus on low income working households for the remainder of the year and different minority groups may fall into that research, but I don't really want to hone in on how different races are affected by the healthcare system. Workers with short/long term disability may fall into this. I have an aunt that is unable to work from chronic arthritis pain and I think her disability claim was rejected the first time she filed and that put a strain on her healthcare. I'm not sure of the exact details on all of that, but the purpose of that is to also shed light onto this side of inequity instead of the usual overwhelmingly high prescription drug costs or medical exam billing. I'm going to further investigate state insurance policies and how they differ from a federal policy like Medicaid or ACA,
1. Which Americans (part time or full time employees, which organizations) have access to healthcare benefits through their workplace? How many of them use that plan?
2. I was kind of avoiding the politics of universal healthcare, but I guess I should address how our country feels about socialized healthcare. Which people (not just politically, but what kinds of working class citizens) are for it? Against it? How would the U.S pay for it?
3. Why get rid of the private health insurance options when some employees like theirs? Why completely switch over to a public option? Benefits and drawbacks?
Goal Post (03-04-2020)
The plan for the March SDA is to create a board game that's similar to the Game of Life. There would be four players who are all growing up, going to college, getting married, etc. Along the way, health issues or accidents occur. Some cards will say that the player has insurance, while other cards will say he or she doesn't. In the player's manual, I will write down all my facts and statistics that pertain to my cards. If one card says "You got into an accident on the highway and you're 50 miles away from the nearest hospital. The ambulance to the hospital costs $1,000 due to mileage and being uninsured. Will you call 911 or tough it out?" Then, in my manual, there would be a small section on costs society has to pay for. Another card could be "You got diagnosed with diabetes. You don't have health insurance because you have been healthy all your life and didn't feel as if it was necessary. Now, you have to spend about $475 a month for your insulin or your health will deteriorate. Will you spend the $475 or will you put that money into the cost of your daughter's wedding that is coming up in three months?" Then, I'll include a couple of facts on diabetes. The cards will have random scenarios.
I'm not sure how I will build my board in terms of materials, but I can just buy little figures from the dollar store to serve as my characters. I would like to laminate my cards, so I'll have to design my own cards and type out all my random cases.
The Show Must Go On (03-16-2020)
We've been out of school for only a couple days, but I'm already getting bored. I hope the book I've started reading will keep me occupied at least for a little. Regardless, there will always be Public Policy assignments (more like busy work) to complete. I never realized how quickly this virus would spread to Albany. What's going to happen will happen. Shutting school down was definitely the right call. I'm hoping for some nice weather so that I could at least sit outside to annotate my dumb review book.
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A question worth asking is how aggressively should we be handling this crisis? South Korea began preparing test kits before there were major cases present there. South Korea has made it easy for people to seek out testing as it's free and accessible. More than 230,000 have gotten tested. The health minister, Park Neung-hi, said that the reason for widespread testing is to preserve the people's right to move around rather than social distance themselves. Their assay kits contain different chemical solutions; patients' samples are mixed with them and reactions occur if the specific genes are present. Swabs from the mouth are sent to labs where they try to match the genetic sequence. They were able to create this method of testing in part of their artificial intelligence-based big data system. It took one week for authorities to approve of the test when normally it takes more than a year to get all necessary documents approved. https://www.cnn.com/2020/03/12/asia/coronavirus-south-korea-testing-intl-hnk/index.html
https://www.theguardian.com/world/2020/mar/13/coronavirus-testing-us
Billionaire Jack Ma is donating 500,000 test kits and 1 million masks to the U.S.
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My brother goes to graduate school in London and his classes have been changed to an online format. He's scared that if he flies to NY he might bring the virus with him and the lack of test kits adds to his worry since people aren't getting tested to the extent that they should be.
March SDA Reflection (03-25-2020)
I've been thinking about making something tangible all year and I didn't know what to do until a fellow EMCer gave me the idea to create a board game. I have no idea how Saurabh even thought of that idea, but I loved it and was excited to do something hands on. I didn't manage my time very well, but that isn't unusual. I created my board the day the SDA was due and it took me five hours. Five hours to trace straight lines with a ruler, measure out 2 inch x 1.75 inch squares, outline the boxes with colors, etc. It probably didn't help that I was rewatching House M.D. at the same time. It probably wouldn't have taken me that long if I had no other distractions, but hey, it's coronacation. I aimed for Creativity with this project. This assignment didn't necessarily make me think really deeply about my topic itself, but more on how I should execute the board game with its layout and rules. My research consisted of the costs of various medical procedures for both insured and uninsured patients. https://health.costhelper.com/cost-medical-depts.html had the info for most of my scenarios.
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My goal moving forward is focusing on how COVID-19 is affecting people of all kinds: treatment/testing of both insured and uninsured people, ethics of doctors deciding who to test/treat/provide beds for in hospitals, etc. Since healthcare revolving this pandemic is all new and unprecedented, there wouldn't be much for me to compare it to, but it would be more ongoing research.
Moving Forward (04-02-2020)
I have two interviews with professors of UAlbany's School of Public Health. They're both associate professors of Health Policy, Management, and Behavior. I have questions more centered around quality of life, but I still want to see how their professions have changed in the last month with COVID-19.
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My mom works as an EKG Technician at Albany Medical Center and she keeps us pretty up to date on what's going on there. Her temperature gets checked every morning when she enters her floor and everytime she goes to a different section of the building when she goes to administer an EKG test on a patient. Since COVID-19 affects the cardiorespiratory system, she often has to work with potential and positive patients. With the overflow of positively tested patients down in NYC, many of them are being transferred up to both St. Peters and Albany Med. Not only are beds running out, so are personal protective equipment (PPE) like masks and ventilators, and intensive care units (ICU.) With these shortages, rationing has begun.
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Mary Van Beusekom at the Center for Infectious Disease Research and Policy for the University of Minnesota says that one priority hospitals should be making is collaborating with other nearby hospitals to increases regional bed capacity by 200% in two weeks.
http://www.cidrap.umn.edu/news-perspective/2020/03/what-can-hospitals-still-do-prep-covid-19
China dealt with COVID-19 in a way that American will never be able to. They occupied stadiums and other makeshift shelter to house patients.
Interview #1 (04-03-2020)
My first interview is complete. Professor Bohn has done a lot of work in spreading awareness for reproductive and sexual health, abortion, and HIV. We talked a lot about accessibility for programs for pregnant women with drug addiction. Many of them often had childhood trauma and were sexually abused. Professor Bohn has continued with her work for children and families as she's a director at Council on Children and Families. She introduced me to the term "social determinants of health" (SDOH) which is the conditions in places people grow up in, and it's similar to quality of life. https://www.cdc.gov/socialdeterminants/index.htm
TED Talk Review (04-08-2020)
I watched both TED talks that Bott and Gergen linked and I honestly liked both of them. However, I felt much more connected with "The danger of a single story" by Chimamanda Ngozi Adichie, which was published in July of 2009 with more than 21.5 million views. Adichie's main point was about how people's perspective are formed when they only have one story to base it off from. Adichie grew up surrounded by literature in Nigeria. She cracked jokes and she kept mentioning the term "the single story" which didn't feel annoying in its repetition. It solidified her message every time she says the term in a powerful and meaningful way. Her experience in writing and being a literature professional must play a role in her public speaking skills. She mostly drew from personal experiences which contributed to the pathos and ethos aspects. Her message forces others to think beyond themselves and to open their minds to different lifestyles and ideas.
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I watched a couple differed TED talks on healthcare and I found things I didn't like it all of them. Although Stephen Klasko's idea was really cool in "What healthcare will look like in 2020", he spent at least half of his twenty minutes bragging about himself or the new technologies Thomas Jefferson University's academic medical center had implemented. I really liked his mention of healthcare in the future and how it would be different, but his jokes weren't funny and him talking about all the achievements he had a role in got boring. I understand that it's important for him to talk about his successes, but he could've been more eloquent. I ended up liking the first video the most because of its content. Jeanne Pinder talked about how we're all in the dark on healthcare costs in "What if all US health care costs were transparent?" She talked about how simple, common things differed in cost within the same area. Being a journalist herself, she set out to research which hospitals and medical companies would tell her the price points of different equipment and tests. Her story wasn't groundbreaking, but for something like healthcare and its issues, more stories like Pinder's need to be heard because of its common denominator. More people can relate to her story. Her TED talk was recently published on March 11, 2019 and it has just over 300,000 views. I think that she could have found a more interesting way to present her information, but I learned a lot from her video. https://www.youtube.com/watch?v=esugL07XANg, https://www.youtube.com/watch?v=ZjeZ8r7yWOk
Will we be able to go back? (04-09-2020)
During this pandemic, the government has been attempting to cut the American people some slack by allowing for people who work part-time or who are currently unemployed to suspend their mortgage payments for the moment and reassuring everybody that their medical costs will get taken care of. Different states are pressuring their insurers to cover COVID-19 treatment costs. Oregon is even trying to waive costs for a future vaccine. In March, Congress passed the Families First Coronavirus Response Act requires employers to allow paid sick leave, allows insurers to cover the diagnoses, and more. Uninsured patients don't have to worry about testing-related costs. https://www.kff.org/global-health-policy/issue-brief/the-families-first-coronavirus-response-act-summary-of-key-provisions/
The price of insulin is being dropped to $35 a month by drugmaker Lilly and Company. Coronavirus is hitting everybody from Boris Johnson to Chris Cuomo to a 26 year-old asthma patient in Jackson Heights, NY. Two of those three people don't have to worry about costs when it comes to his treatment, but more and more people are beginning to agree that three of the three people shouldn't have to worry about their bank accounts when they fall ill. Maybe this pandemic will make some of these liberal health policies stay like the reduced cost of insulin. https://khn.org/news/khn-podcast-what-the-health-who-will-pay-for-covid-19-care/ https://kimatv.com/news/nation-world/insulin-costs-capped-at-35-by-drugmaker-during-covid-19-pandemic
COVID-19 Continuing to Plow Its Way (04-16-2020)
It seems as though I hear news about another one of my family members or family friends getting affected by COVID-19 everyday. Two of my family members in the Bronx have tested positive and are in quarantine. Both of them are essential workers so they have been working in the city until they got diagnosed. Another one passed away a few weeks ago in Jamaica, NY. I have loads of family members on strict lockdown all over Bangladesh as the country starts getting hit by the pandemic. One major reason for the inevitable spread of COVID there will be from people not ceasing going to Mosques for prayer everyday. Many of them believe that the virus can't touch them in the House of God............I...don't even know how to respond to that. The Adhan, or call to prayer, has actually changed to prevent Muslims from leaving their homes with the line "hayya alas-salah” (come to prayer) changing to “as-salatu fi buyutikum” (pray in your homes.) But this continued action of praying in Mosques worries me and everyone in Bangladesh taking quarantine seriously since they don't have the ability to flatten the curve the way other larger countries can with the limited number of intensive care units and beds in hospitals. Muslims are definitely not standing six feet apart on their prayer mats, especially since you're supposed to pray shoulder to shoulder. People will only realize when it's too late.
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As for my research, the U.S. is contemplating different methods of tracking the health of the people on a massive scale to detect where the virus will hit next, slow down the progress, and to analyze changes in symptoms. Singapore, Taiwan, and Ireland have begun using technology like this to help their efforts of managing the spread, but it won't be easy to implement this safety measure in the U.S. with Americans' concerns of privacy. Many people argue that if everybody's health condition could be monitored on a continuous basis, then their information could be hacked into and sold leading to identity theft. Contact tracing happens when a public health official contacts those who have recently been in contact with the virus through traveling, the workplace, etc. and notifies other people who have been in contact with a potential patient and ensures that those with the disease manage it safely. Aggressive contact tracing has helped manage the virus in South Korea and Singapore. When my brother flew from London three weeks ago, he received a call from someone with Albany's Department of Health asking him about the details of his flight like how crowded the flight was, if he sat next to anybody, if he worse a mask, etc. She also asked him about his current living situation: whether he's self-isolating, if he has a separate bathroom that nobody else uses, etc. The call lasted for a maximum of 5-7 minutes, but that's what contact tracing is. With a virus at this scale, it's not possible for a public health official to make the amount of calls she/he needs to make so any app that tracks people's health would help. https://khn.org/news/big-brother-wants-to-track-your-location-and-health-data-and-thats-not-all-bad/
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Employer-based Insurance (04-30-2020)
Towards the beginning of the second semester, I wanted to talk about employer-based insurance. I don't remember what happened, but clearly I got derailed. What better time to tackle this than now?
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About 49% of Americans of the total population have employer-based, or group, insurance while 6% have some other non-group insurance. For a long time, my family used the insurance from my mom's employer, Albany Med. New York State's statistics are the same as the national ones. Currently, in the midst of this pandemic, 26 million out of about 328.2 million Americans have lost their jobs. Nearly 8% of Americans are unemployed and the security of their health insurance hangs on by a thread. 9.2 million workers were at risk of losing their coverage according to an estimate provided by the Economic Policy Institute. Laws are being passed centering COVID-19 testing and easing the burden of hospitalization and its costs, but what about the other things that many of these recently unemployed workers have always needed. The money to pay for commonly needed medications for diabetes, blood pressure, cholesterol, etc is dwindling. Free clinics have become the lifesavers for Americans all across the nation. Tree of Life Free Clinic in Mississippi opens twice a month and focuses mostly on prescription drug refills right now. Many of these clinics don't receive federal funding and they aren't given proper personal protective equipment. Tree of Life treats patients regardless of their insurance, immigration, or residence statuses. As more and more people lose their jobs, the longer the waiting lines at these clinics get.
https://khn.org/news/free-clinics-try-to-fill-gaps-as-covid-sweeps-away-job-based-insurance/
How easy is it to hack into medical records? (04-30-2020)
I have already talked about the role technology plays in this current pandemic when it comes to predicting and detecting the virus in the future (contact tracing.) While some people believe that people can easily get into personal medical records, researchers have come up short handed trying to gather data to see whether hydroxychloroquine is a viable treatment for the virus. The problem is occuring because "software built by rival technology firms often cannot retrieve and share information to help doctors judge which coronavirus treatments are helping patients recover." Researchers who analyze medical data are saying that this lack of pulling information is hampering their ability to understand and prepare for the rest of this pandemic. The systems that have been installed with the electronic health records (EHRs) seem to be built more suited for billing rather than planning for future emergencies that involve the health of the entire public. The lack of a national database has resulted in a lot of time lost in finding EHRs.
Demographics (05-11-2020)
Those with underlying conditions such as heart disease, obesity, diabetes, high blood pressure, etc. are targeted by COVID-19 than people without them. The disproportionate number of African Americans getting COVID-19 than whites has to do with the higher prevalence of obesity, high blood pressure, and diabetes already in their lives. There is even prior research that states obese patients with flu vaccines get sicker from the flu even though they have been vaccinated because the excess weight makes the metabolism fluctuate which shifts the immune system.
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Essential Question: Why are people of color disproportionately affected by COVID-19 than whites?
Format: maybe a VoiceThread?
Comorbidities (05-26-2020)
Essential Question: Why are people of color disproportionately affected by COVID-19 than whites in NYC?
So what???? The goal is to bring out the gaps in quality of life for people of color. I’m still not sure whether to focus on NYC or NYS, but I have a lot of research on the Bronx and its quality of life differences to the other boroughs so it might be a better idea to stick to the city.
For this journal, I researched comorbidities because Bott and I talked about that in our meeting last week. Google defines comorbidity as “the simultaneous presence of two chronic diseases or conditions in a patient.” I had already been looking into underlying conditions for COVID-19 patients and many of them include diabetes, hypertension, obesity, asthma, and more. If someone has comorbidities then they are at a higher risk of COVID-19. Minority races such as African Americans and Hispanics are more likely to get these comorbidities than whites. This is what makes neighborhoods, such as the Bronx, at a larger disadvantage when it comes to their proportion of positive-tested cases. Journal of the American Medical Association (JAMA) found that out of 5700 patients, 94% had one chronic condition while 88% had two or more. This study ran from March 1st to April 4th in NYC hospitals.
Webb's Depth of Knowledge (05-31-2020)
As part of this final project, my research/claim/essential question should all be pointing to a Rashmina Original theory of some sort, something that can't be found online with a quick Google search. Here's where Webb's Depth of Knowledge comes in.
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Level 1: Identify race/comorbidities
Level 2: Get into the quality of life/care gaps--cause and effect
Level 3: Develop a logical argument/theory; People of color, specifically African Americans, are disproportionately affected by COVID-19 because they are treated differently from the beginning of the situation as there are quality of care and life gaps.
Level 4: Analyze argument, provide theory/solution; One solution to prevent disparities is having more diversity within medical staff including increasing proficiency in other languages.
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T minus five days until the final project!