Healthcare across LA Neighborhoods
We haven't gotten to talking about this in class yet, but I'm interested in examining the quality of hospitals and healthcare across neighborhoods in Los Angeles.
In 2004, the LA Times published an investigative series of articles called "The Troubles at King/Drew," which exposed malpractice at the Martin Luther King Jr./Drew Medical Center, a public hospital in Willowbrook, just south of Watts. King/Drew reportedly "had a long history of harming, or even killing, those it was meant to serve." The series' early articles discuss hospital staff members' errors and neglect on a case by case basis, while later reports question LA and the nation's public health system as a whole.
Here's a poignant excerpt: "'You know damn well the county knows what we need,' said 'Sweet Alice' Harris, long revered for her charitable efforts in South Los Angeles' black and Latino neighborhoods. 'My problem is: Why is it that they don't love the poor people and want to help them? We're the first to be cut and the last to be rewarded.'"
I've never questioned the competence of my doctors or my local hospital (Huntington) but many Angelenos have to. I'm wondering, how are resources allocated to hospitals across the city or county? Are inequalities a matter of lack of funding or discrimination based on neighborhood demographics of income or race? In LA, how does the quality of a neighborhood's hospital(s) impact the way that neighborhood is perceived at large from a public health standpoint, if at all? What is your local hospital/healthcare center like? How can the city ensure quality, equitable healthcare for all patients?
So so so many questions.
Link to LA Times piece (I'm pretty sure it won a Pulitzer): https://www.latimes.com/nation/la-kingdrewpulitzer-sg-storygallery.html
In terms of what you said about Huntington, I’ve had a similarly positive experience with my local hospital (Kaiser Permanente), which is part of a stretch of hospitals and medical complexes covering several blocks in Los Feliz. Though my own family has always gone to Kaiser or the Children’s Hospital, I know people in my extended family or friends’ families who sought out medical care at places they saw as more exclusive, like Cedars Sinai on the west side, because they thought it was higher quality and more reliable. Places like Cedars Sinai have more name-brand recognition and a perceived air of celebrity surrounding them, and the disparity between services, technology, and resources available there and at county or regional hospitals is striking. Interestingly, when I tried to research Los Angeles hospital quality and disparity in care across the city, the first study/survey I found was a review of prices for different procedures at four LA hospitals: Cedars-Sinai, USC-Keck, UCLA Children’s Hospital, and Kaiser Permanent, all of which are relatively well-financed and ranked in the top 25 hospitals in California. So, I think it’s notable that statistical attention is being paid to hospitals that are already providing relatively high-quality care and are affiliated with major universities and corporations, which local or county hospitals may be ignored. More broadly, when I looked at the most expensive hospitals in California as analyzed by Amino, a healthcare financing company, five other hospitals topped the list: Olympia Medical Center (safety grade F), Palmdale Regional Medical Center (safety grade C), Valley Presbyterian Hospital (safety grade D), Methodist Hospital of Southern California (safety grade B), and St. Vincent Medical Center (safety grade C). According to the Institute for Health & Socio-Economic Policy, Los Angeles’ Olympia Medical Center reportedly charges as much as 1034% of its operating costs.
ReplyDeletePersonally my experiences in hospitals have been fine. I go to Children's hospital quite a bit to get scans and to me everything the doctors have been perfectly nice and attentive. I also volunteered at Huntington Hospital on weekends for about a year, which gave me a closer look into the inner workings of hospitals. Obviously, Huntington Hospital is in the very wealthy neighborhood of Pasadena. To be honest, I don't know how/in what ways that traces to better patient care. After reading one of the articles, I was really struck by the piece titled "How Whole Departments Fail A Hospital's Patients," which discussed the story of a 28 year old man named Mario who had AIDS and died of pneumonia. His nurse that was supposed to monitor him, never did and didn't notice his vitals slipping over the previous couple days. I would be interested in learning/talking about how certain neighborhoods recruit certain doctors. Why are the better hospitals in more wealthy areas when that's not necessarily where they are most efficiently placed?
ReplyDeleteYour post prompted me to do some more research on how healthcare discrepancies affect people in LA/California, and I found the following article to be particularly interesting and in tune with all that you said: https://www.courthousenews.com/new-medical-study-finds-racial-disparities-in-opioid-crisis/. The article describes the opioid crisis in California in particular and how overdose rates in lower-income areas are significantly higher than that of wealthier ones, further showing the lack of healthcare present for those areas.
ReplyDeleteI think it would be incredibly interesting to see data on the correlation between neighborhood average income and resources present in that region’s hospital, and I wouldn’t be surprised if they went hand-in-hand. I don’t think that a lack of funding and prejudice towards neighborhoods of differing income/race have to be mutually exclusive and rather that such lack of funding stems from discrimination initially. While I don’t know of any actual numbers, I believe that the city must provide the same level of healthcare to all of its residents and not just have the proper resources pooled in places like the Huntington Hospital, etc….
I think that the massive disparities in hospitals in LA really lay bare the massive issues that exist in our health care system as a whole in this country. Many of the well-financed hospitals raise tons of money, and I wonder if this system of philanthropy sustaining medical care leads to disparities because hospitals in wealthier areas might receive more donations from the nearby patients.
ReplyDeleteI'm not really sure about how we can ensure that the quality of hospitals across the county are equitable, but it seems like we also need to think about how we make health more equitable as a whole. Obviously people who are sick deserve quality hospital care no matter their zip code or insurance if they get actually sick, but I think resources also need to be invested in communities at the preventative level so that people hopefully don't end up in the hospital in the first place.
I meant to bring up these lyrics sooner but here is an excerpt from Kanye West's song "Roses" off of Late Registration:
ReplyDeleteYou know the best medicine go to people that's paid
If Magic Johnson got a cure for AIDS
And all the broke motherfuckers passed away
You telling me if my grandma was in the NBA
Right now she'd be okay?
I was always intrigued by this verse. He has a point about "who has access"
The wealthy obviously have more recourses to not only cure a disease/illness but also get to the root of the problem before it becomes severe. There are some stigmas that revolve around any given disease that suggests that only people of lower socioeconomic status can/will obtain that disease. I think people should keep in mind that even the wealthy obtain/contract/are diagnosed with various diseases and illnesses. What we should also keep in mind is that THEY can most likely do something about it to improve their health. Cedars-Sinai Medical Center is kind of known for their nice facilities and is typically catered to wealthier patients and families. Instantly, Cedars-Sinai Medical Center creates boundaries between those who can afford and those who cannot.
For me, my experience with hospitals have been very good. Although I have not personally been to one, my grandpa and mother have, and the doctors treated them very well and were able to help them recover. However, I do know people who have had been experiences with a hospital, whether it be struggling to pay such a large bill or just getting bad service.
ReplyDeleteI agree with Emma that although it seems hard, we need to make health more equitable as a whole. We should allow people to visit any hospital they want where they would be treated equally, and charged a fair amount.
I believe there are numerous discrepancies in healthcare and hospitals across Los Angeles County. Good hospitals are usually located in wealthier cities due to more donation money, higher pay, and better doctors. I remember the first time I went to the Huntington Hospital to give blood and after going through the front entrance I couldn't help but notice how grandiose it was. The hospital was definitely not what I was used to because there were not very many people and the people that worked there seemed very cheery which was unusual to me because I am used to kind of more serious/unpleasant people who work at the front desk of a hospital. I started to think about how different it was from the other hospitals I have been to like Verdugo Hills Hospital and LA County Hospital.
ReplyDeleteI as well as other members of my family do not have very good experiences with hospitals. I have had to stay overnight in a hospital before and there was a complete lack of care for the person who I shared the room with and they were extremely sick throughout the entire night. My cousin went to Henry Mayo Hospital in Valencia when she was little because she broke her leg and after the doctor had put her cast on she was in terrible pain; my cousin and her parents then went back because my cousin was in severe pain and they had to wait for five hours to be seen by a doctor who wouldn't take her cast off. After several hours the doctor took off her cast to reveal a very bad infection from the screws in her leg which caused permanent damage which was caused by the negligence of the staff.
Like Lux, I decided to do some more research on healthcare across LA neighborhoods, more specifically the article I found focused on parolees’ health care needs and access in LA county. The article brought up valid questions like what are the health care needs of prisoners upon their release? What is the geographic distribution of state prisoners who return to local communities in California? And what types of health care, mental health, and substance abuse services are available in the communities, as well as what is their availability?
ReplyDeleteThe article provides a table that shows that more than half of the parolees reside in areas with either the lowest or mid-lowest levels of accessibility to hospitals. Something that I found particularly interesting was that 44% of parolees in Los Angeles county have access to alcohol and drug treatment providers. However, a very limited number have access to mental health providers. The article moves on to point out that even though there are community clinics available, if California decides to reduce correctional costs by releasing more parolees without actual conditions of parole, they too will receive less funding.
I used to volunteer at Huntington Hospital every week, so I really got to know the inner-workings of the hospital. That being said, I did do a lot of discharges so I got to talk to the patients a lot and hear their feedback on their experience. One time I was walking with a mental health patient to the cafeteria to eat some lunch, and I remember him talking about the stigma behind mental illness and how it was even present in the hospital. It made me realize that even in a place as nice as Huntington, people can still be really condescending and insulting, whether it be other patients or even staff members.
ReplyDeleteI have a lot of thoughts:
I've been thinking about this a lot recently actually, especially with our Fit to Be Citizens readings and the way the reading describes how racism, segregation, income inequality and discrimination influenced public health policy and practices in LA. And I actually also talk about this with my family a lot because for my whole life I've also gone to Kaiser ( @harper okaayyyyyy) and most of my childhood friends/family also go to Kaiser but I found that when I came to Poly I was the only one of my friends (that I knew) that went to Kaiser. Maybe it's just a weird coincidence (but also I kinda doubt that). I wonder what healthcare inequities there are even among poly students?
Also I've been noticing an interesting thing recently when I'm driving or just out and about I'll see various health care centers in neighborhoods that are very catered towards that neighborhood's demographics. For example, the other day I was in like sorta the Pico-Union area and I was at a red light next to a building called the "Asian Pacific Health Care Venture" which, after I looked it up is just a pretty basic medical center that obviously works for any race/ethnicity, but it has a very specific name. And I think there's a lot of stuff to unpack there. And there are sooooo many other examples of that. So I'm wondering about that.
Also, I've been thinking about language and how that impacts healthcare. At my doctors office, there are a lot of Spanish speaking doctors and nurses, but I haven't heard many other languages, which is interesting because it's in a very language-rich area and serves a ton of people all the time. Along with that, in terms of payment I'm wondering a lot about the idea of a "sliding scale" in terms of payment, and how accurate that phrase is to reality?
As many others noted, I've only been going to one hospital for the majority of my life, so I don't think I'm really in a position to comment on the quality of the service I get because I have nothing to compare it with. That said, I was reading some articles that suggested that hospitals located in wealthier neighborhoods tend to have access to more resources as the patients have better health care. Sadly, I already assumed this, so I was not surprised by my findings. However, what I found particularly interesting was how many instances where patients were treated differently based on their race. There was a case where a black woman was denied pain meds despite that fact there was absolutely no evidence to suggest she had issues with substance abuse. She later tried a new hospital where she was given the medication which only made her question if they made their decision based on the color of her skin. For the roundup, it would be great if we could further look into this piece as I think it does a great job addressing some racial issues that are still plaguing the industry.
ReplyDeletehttps://www.health.harvard.edu/blog/racism-discrimination-health-care-providers-patients-2017011611015
I would hope that the inequalities would be a matter of lack of funding rather than discrimination. I know that doctors usually take an oath along the lines of the Hippocratic Oath, so I assume that the team in various hospitals do their best to attend to every patient. However, I am curious to know what areas have a lack of funding and the reasons behind this motive. The quality of a neighborhood’s hospitals does have an impact on the way that neighborhood is perceived. If a hospital is lacking in facilities, the surrounding neighborhood will probably be perceived as an impoverished and underdeveloped. I found an article elaborating on the lack of equality in the health system: https://www.advancementprojectca.org/in-the-news/press-release-new-report-reveals-ongoing-racial-disparity-in-health-coverage-and-access-for-californians
ReplyDeleteI have a some thoughts and they r sort of all over the place my b:
ReplyDeleteI remember freshman year when I was sick, it had been many months and my parents were taking me to a lot of different doctors but nothing seemed to really click with us, so eventually my dad drove me out to Cedars Sinai because he thought that would give us this miracle cure that no other local doctor could give us. If you’ve ever been to Cedars Sinai you know that that when you get within a three block radius(ish) you begin to feel as though you’ve stepped into an alternate universe, one that is made up entirely of extremely high-end boutiques and hand-bag and sunglass stores. It was odd and somewhat disconcerting learning that my dad brought me out there simply to get a “better” opinion (is what he called it), like being 10x more expensive and extremely bougie would automatically make that health provider better than any other one. And the saddest part was that the Cedars Sinai doctor told us the exact same thing that every other doctor had already told us. So ya I think that’s interesting to look into.
Also - I was reading an article about discrimination based on race, gender, religion, sexual orientation, etc. and how that affects what happens after that patient’s time at the hospital - often times, when a patient feels they’ve been untreated fairly because of who/what they identify as, they tend to neglect any further treatment (like taking medicine or getting any subsequent procedures following the initial ones), or neglect to go back to that medical provider, in turn hurting that patient more. - so with the Hippocratic oath that all doctors are supposed to take that says “first, do no harm,” it’s odd because it’s clear that discrimination against a patient based on their race/gender/religion/sexual orientation etc is clearly doing harm.
I have heard stories about doctors amputating the wrong leg causing their patients to have both legs amputated and other example of medical malpractice that make me feel grateful for having doctors that I trust in addition to my dad who is a doctor. I mostly have learned about situations where doctors feel pressured to make a decision for patients who do not believe in blood transfusions or other medical procedures that could save someone's life. As a doctor I would hope that ideas of race, class, or gender do not interfere with the treatment of patients.
ReplyDeleteFor Luke: Socioeconomic status is arguably the most significant factor that contributes to the unequal access to quality healthcare. Both the poor that occupy rural America as well as those that live in impoverished areas of our nation’s cities are subjected to a healthcare system that doles out a standard of care that is reflective of our attitude toward the poor and minority groups. As the only industrialized country that does not have some form of universal healthcare, we treat access to medicine as a privilege rather than a right. A glance at the statistics that describe the amount of money industrialized countries spend on universal healthcare and its impact on life expectancy, vs the astronomical costs of our healthcare system in the United States, finds that we spend far more for a significantly inferior outcome. Those individuals from the other developed countries in the world are able to participate in a system that encourages primary care in the form of regular check-ups and tests that enable doctors to identify and treat illnesses before they advance. This is both less expensive to treat and promotes a better quality of life for its citizens. In America, on the other hand, the poor and minority suffer from a disparity of care in the form of unequal access to hospitals, quality professionals, specialized procedures, medications, and the compassion and that characterizes those that are valued members of our society. Rather than spend money that they do not have on a doctor visit, those that have no coverage or inadequate coverage, choose to put off issues pertaining to their health until it becomes unbearable and are forced to seek treatment in hospital emergency rooms. African Americans have a significantly lower life expectancy than that of whites and that gap is widening rather than narrowing according to statistics taken over the last century. From conception, Blacks are already disadvantaged. Issues such as lack of prenatal care that leads to a much higher infant mortality rate than that of their white counterpart, a higher incidence of death during childbirth for Black mothers, and a host of diseases throughout their considerably shorter lives are all threats that are disproportionately suffered. Attacks on the Affordable Care Act, better known as Obamacare, reaffirms our country’s hostility toward the least of us, and all but guarantees that this trend will continue.
ReplyDelete