Should I only see Chinese doctors? and other thoughts on ethnicity and healthcare
The other day, I came across an article on Medium recounting a man’s experience with his Korean wife’s pregnancy complications and eventual diagnosis of stomach cancer. The cancer went undiagnosed until it had metastasized and progressed into the most advanced form of the disease. In Korea, cancers of the liver, lung, and stomach are most prevalent and thus are screened for during annual checkups. In America, breast cancer is checked for yearly since it is one of the two most commonly diagnosed cancers among American women. This contrast left me with questions… what health disparities exist by race and ethnicity? What roles do they play, if any, in individualizing health care?
I grew up exposed to a blend of western and eastern medicine. Sometimes I took pills to alleviate symptoms, and sometimes I held my nose while gulping down a bitter concoction of Chinese herbs. However, when we consulted doctors trained in western medicine, he or she was always Chinese. Growing up, I thought my parents chose Chinese doctors out of convenience, so they wouldn’t have to face a language barrier in communicating their symptoms, asking questions about the suggested treatment, and understanding what our health insurance would cover. These days, I wonder if there are other merits to going to doctors with a similar ethnic background beyond ease of communication. For one, I speculate that a doctor of a particular ethnic background may be more organically aware of diseases prevalent within their own ethnicity via their own family health history. I also wonder if a doctor who patients of a particular ethnicity seek to avoid language barrier issues naturally accrues more experience identifying and treating diseases/conditions prevalent within that ethnicity. It wouldn’t surprise me if a career of treating Chinese patients made a physician more proficient at identifying and treating diseases/conditions that are more frequent within the Chinese population than they are within the general population.
As your typical software engineer, I started fantasizing about a sick visualization (maybe my chance to learn a bit about D3?) that could showcase a breakdown of the most prevalent diseases among different ethnic backgrounds. Maybe alongside that I could include a reference to the diseases that are screened for yearly, for contrast. But, the data comes first. As it turns out, there has been research on the ethnic and racial disparities in health conditions! This fact sheet is pretty cool, and it spurred a lot of thoughts and speculations I wanted to explore further:
- Asthma is very prevalent among African American children. Anxiety can exacerbate asthma. I recently read an article that suggests that the stress and trauma associated with racial discrimination can be detrimental to health and manifest in very physical ways. More on this article later. But, could there be some correlation?
- 1 in 5 Latinos don’t go to the doctor due to language barriers. What can we do about this? There are two approaches I can think of: make existing doctors able to serve a larger range of backgrounds, or have doctors specialize in particular backgrounds. What are the tradeoffs of both?
- Southeast Asian refugees who immigrated to America have high risk of post-traumatic stress disorder due to experiences while immigrating. How does having PTSD affect how healthcare should be delivered, and what conditions are patients with PTSD more likely to develop?
Before I go further, I want to do a deeper dive into the existing research and find if there are any cool API’s I can use to finesse such a visualization. Next time, I’ll report understandings of existing research, results of my API hunt, and thoughts of the article that spurred the first bullet above.