Exercise for All

The stigma on obese individuals seems to be growing right along with the percentage of people in this country that are overweight or obese. Many of these individuals face gigantic disparities. A couple examples are receiving inadequate treatment from doctors and feeling extremely uncomfortable working out in gyms. Even though there are many contributing factors that influence whether a person will be overweight/obese or not, the act of exercising is a definite step in improving this populations health, both physically and mentally.

A company named LivingXL is one that has been supplying the larger crowd with important, every day living essentials: scales that hold more weight, bigger towels, camping gear, and so forth. The owner of this company has found that there are many other essentials this part of the population need; one of those being exercise equipment designed to hold more weight.

Since LivingXL did not have such equipment, they set out to find places which carried this type of gear. A company in NY was found called Worksman Cycles. This company creates bicycles that hold up to 500lbs and also stationary bikes which can hold up to 550lbs. This equipment is not cheap though. The prices range from $550 to $5,000. There is also a company, Star Trac's, which has other types of cardio exercise equipment holding up to 350lbs.

The cost of having equipment like this in a gym would be very costly, but one of the people commenting on the article said gyms would get their money back fairly quickly. Why? Because obese individuals would not have to worry about trying to use a machine, feel more welcomed, and be able to increase their self efficacy.

I am glad to see exercise equipment is being produced for people who are obese, but I have a hard time believing these individuals would be quick to go and sign up at a gym just because of this equipment. Since high school, I have lost 90lbs so I have great empathy for the people who are obese. It is not easy to just get up, get a gym membership, and push ones self to workout a few times a week. The stigma that is put on this population is incredibly debilitating sometimes, and a lot of these people need more than just suitable equipment to exercise. They need motivation and support which could come from a personal trainer, friend, or family member. If gyms are going to add machines for bigger people, I think gyms should also include some kind of personal training package to get the ball rolling. This was my experience. Had it not been for having a trainer for the first couple months of my journey, I don't think I would be the exercise freak that I am today. Going about it alone is really hard to do, especially if one has been discriminated against and ignored in different situations. Another thing gyms could do is let the person test out the facility for a week; test out the machines, make sure they work for the person.

So yes, I love seeing that companies are producing this equipment, but the equipment does not talk, or force, someone to get on it and work out. Getting individuals who are obese to exercise is going to take more than that. One must consider all aspects of the person; their physical, mental, and social constructs as well as habits he/she may carry with them. Going back to the equipment though. It would be great to see some kind of policy where every gym has to have equipment that caters to every shape and size. Maybe when the economy gets better (crossing my fingers), funds could be given to workout facilities to go towards giving obese people the option of having a personal trainer for a month or so as well.

Doctors Have Degrees, Patients Do Not.

I will begin by a statement I overheard in a waiting room not too long ago. It went a little something like this:

"Doctors go to school to learn this stuff; they get a degree. Patients just do not have the knowledge of a doctor."

If I were younger and more naive I would probably agree with the above notion, but I only agree 100% with the first part; doctors holding a degree. I know I am not speaking for every patient, but I know that I am quite knowledgeable when it comes to the signs/symptoms of illnesses. I also have an idea about what kind of treatments are out there and the benefits and risks of the different approaches. Many other patients take it upon themselves to research health issues online and may even take classes on such topics. Heck, maybe they are a college student studying public health or biology (not referring to anyone, *insert sarcasm* haha.) Now, with that being said, I am sure there are those out there who depend on their doctor's expertise to get them by in life, and do not know much in regards to the health field. An article I found from USA Today titled, "Doctors often take the decider role, to patients' detriment" went along with this whole idea.

In a study of over 3,000 adults, over the age of 40, it was found that doctors initiated the conversation with their patient 93% of the time. This included topics ranging from surgical options, to taking medications for high blood pressure, to treatments for cancer. Doctors were more likely to mention the pros of a treatment for example and much less likely to mention any of the risks or cons. Another finding from the study concluded that almost every doctor gives their opinion (of course), but does not always ask the patient for his/her view on the topic being discussed.

To reflect on the conclusions made by this study I will first say I believe it is important for doctors to give their opinions. They DID go to school for quite awhile to learn about different methods of treatment, and telling patients about the benefits of such a treatment "reflects good medical judgment" as expressed by a researcher in the article. A patient has the right to refuse treatment or simply the right to just ask questions, but many doctors are crunched for time and hold off on letting patients express their opinions.

Ways in which to improve these findings can start at the medical school level. I am not sure what the curriculum is, but more time should be spent on the approach future doctors take on interacting with their patients. For example, ways in which allow the patient to express their feelings on treatment, concerns they may have, and so forth. Another problem that needs to be fixed is the amount of time doctors spend with their patients. I know the demand is very high on doctors, and many are swamped with patients left and right, but that may be part of the solution. Maybe doctors need to have a set number of patients they can see in a day which ensures each patient more than a five minute visit. Cutting back on the number of patients a doctor can see is a double edged sword though. That means some patients may have to go another week before they can be seen, but it lets doctors engage more with their patients and gives patients the time to weigh options, ask questions, and give their own opinions. Patients also need to speak up and let their voices be heard because everyone has the right to say yes or no. If patients do not do this, then there will continue to be a belief that there is a gap between patient/doctor knowledge in various health topics, and that doctors are solely the decision makers. I actually found a program called Speak Up that some hospitals have implemented. It is a program that encourages patients, and family members of patients, to ask questions, learn about treatments, pay attention to care received, and know why certain medications are being taken. I wonder if there is a program called the Power of the Patient ... would be a good name for one if there is not one!

MLK Shot for Color of His Skin - Lawrence King Shot for Sexual Orientation.

The GLSEN (Gay, Lesbian, and Straight Education Network) was started in 1995 and is the leader of the pack when it comes to ensuring safety in schools for every student. It hopes to eliminate bullying and harrassment in schools, and strives for all students to be accepted no matter their sexual orientation or the way he/she chooses to express his/her gender.

In an article from the GLSEN site comes a tragic story of a 15 year old boy (Lawrence King) who was shot to death because of his sexual orientation and expression of. This happened in a California school and research has shown that this state is highly unsafe for those who differ from the "norm." Those that fall into the LGBT population.

A report (Inside California Schools: The Experiences of LGBT Students) which sampled 673 California students, found that these students faced enormous amounts of harassment. Not only did the report find high levels of harassment, but also lower grades/performance in school and a higher rate of skipping class. Some of the statistics produced from this research include:

1. Almost every LGBT student reported hearing sayings/words like, "that's so gay" and "faggot" on a day to day basis.
2. 8 out of 10 LGBT students said they had been verbally harassed, 4 out of 10 had experienced physical harassment, and 2 out of 10 had been physically assaulted.
3. Two thirds of those who had been harassed in some way did not report the abuse.
4. Almost a third of students reported missing class, or a full day of school, due to feeling unsafe in the school setting.
5. LGBT students showed lower grades; a half a grade lower than those who were harassed less often.

This harassment, any kind, definitely can affect LGBT students; no questions about it. The disparities that are seen in the LGBT populations can start at a very early age. Even though middle school/high school students are still developing and discovering who they are, there are those who have accepted, and know, that they are gay, a lesbian, bisexual, and so forth. If a person of one of these "categories" (I don't like using that word, but it will work) comes out early, they risk many different disparities from that age on. It could be something like not being chosen to be on a team in PE class, or something on a bigger scale like having a doctor not treat them because of their sexual orientation. As these students progress through life and become adults, they will face even more disparities. Everything from finding a job, where they are welcomed and where they are not, what kinds of treatment they will receive for medical conditions, and how people will view them if they have children.

GLSEN is a great organization, but more needs to be done to stop this harassment being seen in schools. There is a National School Climate Survey that follows the LGBT middle school/high school students in the United States, but all this survey does is prove that this harassment is happening. What does it do other than that? Yes, students are being bullied because of their sexual orientation/gender identity, but instead of just collecting this data DO something about it.

I know many middle school/high school aged students can have a hard time accepting all types of people. I have been there. When one is younger he/she may judge others more and put people into certain "groups" or "cliches", but that does not mean these perceptions cannot be altered. Maybe there should be a class students must take that focuses on the equality of all people. Maybe those who bully LGBT students should be punished more harshly. Maybe parents need to educate themselves more on what is happening in schools and get more involved. Maybe LGBT support groups need to be formed for the younger folks. There is no single answer to this problem, but it is clear that some different options need to be considered to keep this horrible harassment from happening. It crushes my heart to hear a student could shoot another student solely because he/she was not heterosexual.

I really liked these pictures so I added them.

Doctor: Trained in the Healing Arts and Licensed to Practice

Thank you dictionary.com for providing me with the truest, and simpliest, definition of what exactly a doctor is. A person who is "trained in the healing arts" and holds a license to practice. Brilliant. No where in the definiton do I, or did I, see anything about a doctor being of a certain color of skin or of a specific gender. Bingo!

African Americans who get their medical degrees and become doctors have it pretty rough. According to an article titled, "Confronting the Racial Barriers Between Doctors and Patients" from the New York Times, an African American doctor comments on how many patients think he is the wheelchair boy; not a man holding a medical degree who performs medical procedures just as well as any other doctor. Many people do hold biases against African American doctors and sometimes refuse treatment because the patient does not believe he or she has the knowledge of a doctor who is of the same race. This belief goes back to the thought that African Americans are all of lower SES and lack education. Sure, there are African Americans who fall into these categories, but there are also many who have the same status and education level as a white American, maybe even more!

A lot of the research on racial factors in hospital settings has been focused primarily on patients and the treatments they receive. It's been shown that African Americans go through medical procedures that are very undesireable compared to white Americans. Another finding has shown that many minorities do not get the option of surgery, like white Americans do, when it comes to treatment for some forms of cancer. Ridiculous yes, but it is not surprising since doctors do hold biases when treating different races. A lot of doctors do in fact perform the same procedures on all patients with the same ailments, but this is not always a good way of going about reducing the health disparities in treatment among races. There are indeed variations in genes between different races and one treatment may be great for one race, but not for another. To help with this issue doctors need to take more time in getting to know their patients and taking their medical history into strong consideration. At a greater level, medical schools should take this in their hands and educate future doctors on the health differences in all ethnic groups. An emphasis on getting to know their patients well before going through with any treatment or medical procedure should also be addressed in med school.

Dr. Saha, a researcher on such issues, believes that the first step all doctors must take in reducing racism in healthcare is to know how one's own stereotypes and experiences affect the way they view other groups other than their own. Pauline Chen, the author of this article and a doctor herself, took Saha's advice and tried to acknowledge her biases. She stated that when she has a patient of a different race it is hard to connect with them since there are not many shared experiences between herself and them. To counteract this fact, Chen says she unconsciously uses past experiences to try and connect with her patients of other ethnicities. Once again this issue should be taken into consideration way before a medical degree is issued.

This issue of racism in healthcare settings will not dissipate over night, but if the issue is addressed before doctors are even considered doctors, maybe the levels of racism will dissipate over a few nights. Okay, maybe a few years.

You Drive a BMW: Of Course You Have Health Insurance!

In an article from the New York Times titled, "Caught in the Middle, Without Health Insurance", it is strikingly apparent that the number of health insured citizens of the U S of A is dropping incredibly. No longer is it just the poorest of poor populations suffering; it is also the business men and women whom sport around in their pricey vehicles.

Open Door Family Medical Centers (found in parts of New York) were once dealing with poor people in high need of medical assistance. Now, as I stated above, they are filled to the brim with yes, the poor, but also middle class workers along with students just out of college, who are having a terrible time finding a job in the economy of today. According to the article, 7 percent of the US is out of work and 47 million are unable to afford any sort of health insurance. What scary, ginormous, eye opening statistics those are! That means roughly 7 out of 100 people are jobless, which makes me wonder; are children accounted for in those stats, or is just people of working age? I am going to assume it is based off of the 18+ population. After reading those numbers it makes me even more terrified to graduate from college. I have another year left in my undergraduate career, but I am not too optimistic that the economy will bounce back that quickly.

The middle class are getting hit harder and harder as our economy continues to fade. These people do not make enough money to shell out thousands of dollars for private health insurance, but make too much for Medicaid to be an option. The jobs they hold are having a hard time insuring them, so what other option do they have? One man mentioned in the article had to choose between his hypertension meds and his pills for Diabetes. He could not afford both. Truly saddening.

Another reason more and more people are using such places like Open Door is due to the lack of primary care physicians. Nowadays, medical students are going into a specialty knowing they will make more money pursuing that road. Along with this, is the fact that many primary care doctors are not seeing new patients, or their old patients that have had their health insurance dropped. As one woman said, the doctor would not see her unless she had the money in her hand the day of the appointment.

I knew the economy was horrible. I knew health insurance was a pain in the butt to try and get these days, but I had no idea just HOW bad it has gotten. The fact that people cannot afford all of their medications is troubling. The fact that many Lexus owners are no longer able to afford health insurance is awful. The fact that our nation is drowning in the deep end when it comes to our nation's health, and health coverage, is down right sickening.