Medicine and Health Sciences Commons^™

Unmet Healthcare Need Due To Cost Concerns Among U.S. Transgender And Gender-Expansive Adults: Results From A National Survey, Luisa Kcomt, Kevin M. Gorey, Betty Jo Barrett, Dana S. Levin, Jill Grant, Sean Esteban Mccabe

Social Work Publications

This study examines past-year unmet healthcare need due to cost experienced by transgender and gender-expansive (TGE) adults in the United States in the context of the Patient Protection and Affordable Care Act (ACA). It also aims to estimate the importance of having health insurance among TGE Americans (transgender men, transgender women, nonbinary/genderqueer people, and cross-dressers). Data were from the 2015 U.S. Transgender Survey (N ¼ 19,157 adults, aged 25 to 64 years). Multivariable logistic regression models were used to determine the adjusted odds ratios (AOR) and 95 percent confidence intervals (CI) of TGE individuals’ past-year unmet healthcare need due to …

Healthcare Avoidance Due To Anticipated Discrimination Among Transgender People: A Call To Create Trans-Affirmative Environments, Luisa Kcomt, Kevin M. Gorey, Betty Jo Barrett, Sean Esteban Mccabe

Social Work Publications

Transgender people encounter interpersonal and structural barriers to healthcare access that contribute to their postponement or avoidance of healthcare, which can lead to poor physical and mental health outcomes. Using the 2015 U.S. Transgender Survey, this study examined avoidance of healthcare due to anticipated discrimination among transgender adults aged 25 to 64 (N ¼ 19,157). Multivariable logistic regression analysis was conducted to test whether gender identity/expression, socio-demographic, and transgender-specific factors were associated with healthcare avoidance. Almost one-quarter of the sample (22.8%) avoided healthcare due to anticipated discrimination. Transgender men had increased odds of healthcare avoidance (AOR ¼ 1.32, 95% CI …

Colon Cancer Care Of Hispanic People In California: Paradoxical Barrio Protections Seem Greatest Among Vulnerable Populations, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey, Isaac N. Luginaah, Sindu M. Kanjeekal, Frances C. Wright

Social Work Publications

Background: We examined paradoxical and barrio advantaging effects on cancer care among socioeconomically vulnerable Hispanic people in California. Methods: We secondarily analyzed a colon cancer cohort of 3,877 non-Hispanic white (NHW) and 735 Hispanic people treated between 1995 and 2005. A third of the cohort was selected from high poverty neighborhoods. Hispanic enclaves and Mexican American (MA) barrios were neighborhoods where 40% or more of the residents were Hispanic or MA. Key analyses were restricted to high poverty neighborhoods. Results: Hispanic people were more likely to receive chemotherapy (RR=1.18), especially men in Hispanic enclaves (RR=1.33) who were also advantaged on …

Multiplicative Advantages Of Hispanic Men Living In Hispanic Enclaves: Intersectionality In Colon Cancer Care: A Research Note, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey

Social Work Publications

We examined Hispanic enclave paradoxical effects on cancer care among socioeconomically vulnerable people in pre-Obamacare California. We conducted a secondary analysis of a historical cohort of 511 Hispanic and 1,753 non-Hispanic white people with colon cancer. Hispanic enclaves were neighborhoods where 40% or more of the residents were Hispanic, mostly first-generation Mexican American immigrants. An interaction of ethnicity, gender, and Hispanic enclave status was observed such that the protective effects of living in a Hispanic enclave were larger for Hispanic men, particularly married Hispanic men, than women. Risks were also exposed among other study groups: the poor, the inadequately insured, …

Profound Barriers To Basic Cancer Care Most Notably Experienced By Uninsured Women: Historical Note On The Present Policy Considerations, Amy M. Alberton, Kevin M. Gorey

Social Work Publications

America is considering the replacement of Obamacare with Trumpcare. This historical cohort revisited pre-Obamacare colon cancer care among people living in poverty in California (N = 5,776). It affirmed a gender by health insurance hypothesis on nonreceipt of surgery such that uninsured women were at greater risk than uninsured men. Uninsured women were three times as likely as insured women to be denied access to such basic care. Similar men were two times as likely. America is bound to repeat such profound health care inequities if Obamacare is repealed. Instead, Obamacare ought to be retained and strengthened in all states, …

Eliminating Gender-, Racial- And Age-Biases In Medical Diagnostic Reasoning (Paper), Brian Macpherson Dr.

OSSA Conference Archive

Much attention has been paid in the literature to the deleterious effects of errors in diagnostic reasoning due to underlying cognitive biases. This is an important topic since people’s lives and well-being are at stake. Empirical studies cited by Chapman et al. (2013) corroborate the view that gender, racial, or age biases exist in a significant number of clinicians, thereby limiting objective diagnosis. Croskerry (2003, 2013) endorses a so-called metacognitive (or cognitive ‘forcing’) approach to achieve de-biasing in clinicians, a key component of which is critical self-reflection on one’s own diagnostic reasoning (Croskerry, 2003). However, the first empirical study of …

Commentary On “Eliminating Gender-, Racial- And Age-Biases In Medical Diagnostic Reasoning”, Steve Oswald

OSSA Conference Archive

No abstract provided.

The Normative Significance Of Deep Disagreement, Tim Dare

OSSA Conference Archive

Some normative problems are difficult because of the number and complexity of the issues they involve. Rational resolution might be hard but it seems at least possible. Other problems are not merely complex and multi-faceted but ‘deep’. They have a logical structure that precludes rational resolution. Treatments of deep disagreement often hint at sinister implications. If doubt is cast on our 'final vocabulary', writes Richard Rorty, we are left with "no noncircular argumentative recourse .... [B]eyond them there is only helpless passivity or a resort to force.” I will argue that some normative problems are deep, but that we need …

The Place Of Health In The Liberal Theory Of Justice, Paul Tubig

Critical Reflections

Author Information:

Paul Tubig

PhD Philosophy Student, University of Washington - Seattle

ptubig@uw.edu

Submission Title:

The Place of Health in the Liberal Theory of Justice

Abstract:

The purpose of this paper is to articulate the relationship between health and justice. Ethical claims, such as the World Health Organization’s assertion that health is a fundamental human right or that global health inequalities are normative inequities, require a conceptual analysis of the meaning and value of health within a particular framework of justice. Working from the liberal conception of justice as developed by John Rawls, I will argue that the political significance …