Part I of Health Disparities, we discussed health disparities caused by food deserts and the role they play in chronic health conditions. We addressed the treatment gaps between whites and blacks when treated by the same providers. We detailed the enormous cost of ethnic and gender health disparities in the U.S. health care system. We wrote about improving the overall quality of care and how this would eliminate disparities in care. We concluded Part I with how improvements in information technology, performance measurements, provider incentives and translating science into cures would be a start in the right direction toward mitigating health disparities.
In part II, We will examine the disparaging health effects of how information distribution aids in poorer health outcomes. Information dissemination affected both the obesity epidemic and the handling of mental illnesses in society. Concluding with how information distribution can benefit health disparities or make them worst.
A national survey reports that US adults search online for medical and health information before talking to a medical provider. Adults trust their medical providers; however online medical research is on the rise. In fact, consumers report investigating medical concerns before they visit a doctor. Consumer’s proactive research is affecting how medical information is consumed. Entertainment and soft news programs have increased their health and wellness programming much of which spotlighting a particular expert’s opinion. Pharmaceutical companies have employed directly to consumer advertising campaigns for decades. This level of jostling for consumer eyeballs creates a ripe environment for disinformation.
Health Information: Online and Trust
Trust in information sources is divided by generations. Baby boomers (born 1944 to 1965) trust their physicians to provide them with accurate information. Younger generation’s confidence in a single source of information is not very high. Popular media sources are not likely to facilitate understanding helpful to all populations and are likely to perpetuate social and political differences concerning health inequities. The media historically marginalize ethnic minorities, women and those with lower socioeconomic status fueling distrust in single sources of information.
Media can influence health both at the personal and public levels. The media can provide information that stimulates changes in health-related attitudes and behaviors, both positive and negative. The media can raise awareness of health concerns among elected officials, contributing to changes. The influence of the media can produce predetermined outcomes like health education campaigns; however, they can produce unintended consequences like unfavorable behaviors portrayed by entertainment personalities smoking and excessive drinking in movies. Worst of all is when stereotypes are perpetuate causing deeper schisms in attitudes. There is a famous Axiom; we are susceptible to suggestions, 100% of the time.
Did the Media cause the Obesity Epidemic
In the article, “Obesity Epidemic was Mismanaged” discussed how the medical, fitness and food industry mismanaged the obesity epidemic in the US. This public health crisis affects approximately 65% of adults and 17% of young people in this country. We are familiar with coronary heart disease and metabolic syndrome related to the disease, but we have heard little about the mental health issues suffered by those who are overweight or obese. Americans who are overweight or obese are two to three times more likely to suffer serious mental illness. Obesity increases stigma and social isolations and diminishes self-esteem. Mental illnesses adversely affect the quality of life, relationships, employment and integration into community life, all determinants of wellness.
Most mental health providers do not offer obesity prevention or intervention strategies, even though they are a high-risk population. Furthermore, weight gain is a byproduct of many pharmaceutical drugs used to treatment mental health conditions. Unfortunately, too many mental health providers do not believe in the efficacy of offering weight loss information for their clients. This belief is in stark contrast to research, which shows overwhelming benefits.
Mental Health in America
According to a 2012 US News survey, 1 in 5 adults experienced some sort of mental illness in the prior year. The rate was twice a high for young adults between 18 and 25 than among those 50 and older. The survey defined mental illness as having a diagnosable mental, behavioral or emotional disorder. Women reported more episode of mental illness compared to men. This survey revealed that 2 million adolescents between 12 and 17 reported a major depressive episode in the previous year.
Societal stereotypes hinder some older adults from seeking treatment; however, these same adults expressed immediately seeking help for a child or adolescent. The pressures to not complain and grind through are rooted in the American psyche. According to American Public Health Association, adults with a mental illness are 70% more likely to smoke compared to those without an illness.
Body Image and Young Males
JAMA Pediatrics reports that young men and adolescent boys are more likely to abuse drugs and alcohol due to having a negative body image. We live in a culture that promotes lean, thin and muscular as healthy and beautiful, regardless of gender. Compounding this issue is the male macho attitude of “man up” likely prevents young men and adolescent boys from freely discussing their concerns openly.
Having worked in the fitness industry for over 20 years, most of my clients had body image issues. Health clubs are full of members with body image issues. Body image issues can create both mental and physical health problems. Consider the young woman who stops eating because she feels too overweight. The young male who believes that using a steroidal agent to add muscle will help him socially. Many of the mental health problems concerning body image go undetected by families, coworkers and society. I am talking about the functional depression.
Suffering in Silence Depression
Depression is a persistent mood disorder that causes some to feel down and lose their interest to engage outside of themselves. Mood disorders affect how we feel, think and behave and can lead to a variety of emotional and physical problems. Those experiencing functional depression appear to move about their daily lives without concern. However, once outside the public view they shut down and exhibit all classic signs and symptoms of depression. We can idolize a particular body type; dislike our body image because it does not live up to the idol, which leads to harsh judgments of our self because we feel others are judging us just as harshly.
4 Signs of Functional Depression
- Being tough on oneself
- Work becomes a grind
- Substance abuse
- Feeling of wasting time
Mental illness is a health disparity because it is undertreated, underfunded and little discussed. Ethnic minorities and women are affected at higher rates because of societal stigmatisms and access to care and. Ethnic minority’s male suffers in silence because of societal and gender conformities to behave in certain manners. The biggest problem with mental illness is that it intersects with every wellness determinant. For example, a person awareness of self, diet, physical fitness, stress management, family life, job satisfaction, relationships and environmental sensitivity. How can a person be considered healthy, when they suffer from a mental dysfunction.
We receive health and wellness information through the airwaves, online and social media. Mainstream media does a poor job delivering complete and accurate information. Online sources are proving to be just as poor and possibly worst because of the ease of providing false or advertisements that look like a real story. The information varies based on the source, scientific or anecdotal, full story or a highlighted version. Health disparities prevalence continues because of savvy marketers and a consumer base that is not fully informed.
TV News, Social Media and Google Controls Information
There are real health consequences to publicizing incorrect information. For example, obesity is a disease, a fact that went untold for years. The media repeatedly marginalize people who suffered from excess weight gain. Because disinformation is, so prevalent, it is imperative for medical and mental health professionals to remain vigilant in their efforts to provide up-to-date scientific based information. Once bad information is publicized, it may take decades for the correct information to become sufficiently disseminated into society.
The information super highway is an incredible invention, for people around the globe. The internet can provide as much disinformation as it does helpful information. Social media platforms like Facebook, Twitter and the invention of the smartphone are creating a world where not only is information is available 24/7, but we can now tailor our information. Facebook and Google have begun adapting what we see online based on our weighted searches. Regardless if we separate ourselves or become separated by algorithms, we block any conflicting points of view.
American’s Crazy for Entertainment News
We need more scientifically based Information that is, verified and factually correct. Misinformation and disinformation create health disparities; one by not addressing the issues and two because the issues get marginalized then appear smaller and less significant. Health information rarely trends unless there is a major medical discovery or disease scare. Consumption of entertainment news squeezes out news of health disparity. Americans lose because they miss out on beneficial information.
Those of us involved in education must persist to provide information to shine a light where the system fails. We need to share good news and bad with the same enthusiasm. When we make an error or if the research point in another direction at some future date, we need to share that as well. Most of what is claimed as knowledge today about medicine, mental illness and wellness may not withstand time. New research will produce new insights and understanding. We cannot marginalize our failure nor over-emphasize our successes. This is important if we are to garner the public’s trust and become a credible source of information. Disparities persist because of a lack of truth tellers, not a lack of information. To be continued…