This was a fabulous presentation by Dr. Norris. I thought she did a wonderful job explaining the effects of social determinants of health and health equity. I loved her explanation on how equality does not work when it comes to health disparities. With equity, you meet the person where they are at so we have equal footing. When we think about the idea of justice in healthcare ethics, I think it leans towards the idea of providing equitable care rather than equal care. Hopefully this type of outlook on patient care can make the playing field more even for individuals and their health. Dr. Norris brought up the idea that at every appointment focusing on physical health, providers should be asking about mental health as well. As a current medical student, I feel that it’s an easy thing we can do to show our parents that we care for them and start a conversation about mental health. Adding just one question to our history taking can help improve the care of a patient. As Dr. Norris said, there are many people who live in a state of chronic stress and may not even realize that is abnormal. By starting this conversation with patients, we can make them aware of this. From there, we can think about how we can support our patient to help decrease this stress. I love that Dr. Norris brought up the weathering hypothesis. I first heard about this concept in the book, How Neighborhoods Make Us Sick: Restoring Health and Wellness to Our Communities, by Breanna Lathrop and Veronica Squires. For some people, the storm continues to come throughout life. Each stressor can add on top of each other. When this stress is chronic and continues to happen, it tears away at you. Both your physical and mental health. By talking to our patients about their mental health, we can do a better job at supporting our patients through their storm. In the book by Lathrop and Squires, they talk about the impact of a neighborhood in Atlanta, GA. At the clinic they work at, they provide support outside of just classic healthcare in order to address social determinants of health. This is another way we can help support our patients who need it. By talking to our patients, asking about mental health, and finding community resources we can refer patients to, we can help promote distributive justice. Overall, this also follows the ethical principle of beneficence to do good. By taking these actions to support our patients, it helps promote health equity in the community we serve.

This was very informative, however why can’t we see the slides?

Thank you so much for talking about this topic, very informative for everybody. Cheers from the mountain of Italy.

This talk by Dr. Norris is fantastic on so many levels, and I want to thank her for her thoughtful approach to health equity and her proposed solutions to fixing the problems therein. Her talk made me think of the book The Body Keeps the Score by Dr. Bessel van der Kolk. In his book, Dr. van der Kolk demonstrates the ways in which trauma is passed on from one generation to the next, largely because trauma often inflicts physical damage on our bodies, and typically in ways we can’t see. It’s this idea of generational trauma that I think is at the heart of Dr. Norris’ proposed method of addressing health inequities, and it makes a lot of sense. The trauma being inflicted upon people doesn’t have to be something as overt as say, an assault or other inciting event, although that could be the case as well. It can be, as she is arguing, more of a slow burn type of trauma that is inflicted by constant levels of stress and anxiety. This constant barrage of stress will take its toll on a person’s body, leading to chronic health issues and poor mental health. It follows then that this is the place to start when addressing health inequity. The ethical concept of justice provides a framework for why health equity is so important. The aim of this concept is to ensure the maximum benefit to both patients and society while striving for fairness and equality. Healthcare providers emphasize the four pillars of ethics, including justice, as a way to guide patient care and attain good health outcomes in all areas. This of course includes mental health, but mental health is very often ignored or minimized by many clinicians for a variety of reasons. These can be time constraints, insurance coverage, or a lack of available mental health clinicians. These are chronic issues within our healthcare system that must be addressed as well in order for there to be a chance that health equity could be attained through Dr. Norris’ proposed approach. As a future physician, I am hopeful that it is possible to reform the way we address mental health as well as health inequities. While there are barriers, it does not have to be complicated by the systems in which we are currently working, and change can come through hard work and concerted effort on the part of providers as well as the communities they are working in. We need to be addressing our patients’ needs and health at all levels-mind, body, and spirit. We can start by doing as Dr. Norris suggested-meeting people where they are in order to have the same viewpoint and be on equal footing. We can then treat the whole patient, mentally and physically. Over time, their bodies and minds will carry less and less trauma and not bear these constant burdens, which will ultimately provide ethical justice for them as individuals and as part of a community.

What a great discussion!! I have seen this over and over during my twenty-one year career as a pediatric nurse. Thank you

It was so informative .a different prospective

I wish we could see the picture she is referencing!

It was an eye openerto learn that the trauma felt in the womb can effext health outcomea throughout all stages of life.

Yup.

Address obesity .

ill admit im a guy and will more then likely never fully understand a woman and how life and day to day stress effects them....but i would agree with a lot of what she says .... and this is where the how ever comes in.....i would suggest that much could be avoided and dealt with prior to they become a problem....she touched on in a bit when she talked about how as children are growing much is determined in this group prior to adulthood... but i would say what and how parents raise their children... society has enabled victimhood... which has encouraged stress related or induced health and mental issues... this has been a HUGE problem for so long that this is not going to be a quick fix....parents of today were raised by parents that were raised with this... it is time that being a victim is no longer the correct way to make things happen.... being some one with the strength of character to be " productive " in either personal or professional aspects of their life and to be a " POSITIVE " role model can go a long ways in fixing much of what ails us