Current Remedies & Considerations for the Future
As described in the Vox article by Eliza Barclay and Dylan Scott, the immediacy of the coronavirus in the U.S. demands action on the part of all age groups and populations within the nation. The current goal of targeting the pandemic is “flattening the curve,” as Barclay and Scott state. They are able to deliver a convincing argument for the logistics of social distancing through many purposeful techniques, including referencing countries that had been hard-hit before the U.S., studies by the Center for Disease Control, and professional opinions by acclaimed professors. Moreover, the authors’ use of graphics such as “Flattening the Curve” diagram put into immediate effect the potential power of social distancing—inherently, a visual that draws the reader to seriously consider how the benefits of giving up time in social gatherings for the time being is much more personal and powerful than may seem.
An important aspect the article fails to mention, however, is that the uncertainty surrounding the current coronavirus outbreak raises many viable questions concerning the future of our nation well beyond the time frame of “months” or “years”. The article does address certain issues within the structure of U.S. medical care, including “the U.S. system’s capacity to handle a severe outbreak” like having only a “maximum number of ventilators… [of about] 160,000” and “45,000 beds in their intensive care units” (Barclay & Scott). Although the current remedy of social distancing is a potential solution to addressing the outbreak at this time, these issues in health care beg the question of “What about the next time?” It is important to address the current situation, but at the same time, we must not fail in analyzing our shortcomings and preparing for an outbreak that will likely happen in the future for the health of our nation as a whole. America must move from a mindset of “for now” towards a critical perspective of “for now and for the betterment of our nation’s future.”
- Promoting a More Comprehensive Way of Understanding “Structural Competency”
Through intertwining personal narrative and facts/figures, Villarosa is able to incorporate several aspects of structural competency using a pertinent issue in American social infrastructure. One way in which Villarosa does this is through addressing the second core competency—what Metzl and Hansen call “developing an extra-clinical language of structure” (129). Villarosa focuses on how illness is impacted by communal infrastructure by mentioning that “For black women in America, an inescapable atmosphere of societal and systemic racism can create a kind of toxic physiological stress, resulting…directly to higher rates of infant and maternal death.” She purposefully chooses to direct the reader’s attention to societally-embedded factors as roots to individual healthcare problems like those of Landrum. This complements Metzl and Hansen’s advocacy of employing epigenetics to connect the realms of healthcare and societal structures—an area they believe is growing in understanding “the impact of social environments on metabolisms or genetics [whereas] concepts of actual social structures and social forces lag behind” (129). In this case, Villarosa goes beyond analyzing the present tendency of “social environments” and instead traces maternal health issues of black women to both historical and current racial structures that undermine these women. In doing so, Villarosa presents a powerful image of how illness can be explored as a complex interplay with structural and systemic issues.
- Hinderances to Understanding “Structural Competency”
Although using facts/figures in conjunction with a personal narrative provides various advantages to understanding structural competency, there are some drawbacks to this method that hinder it as well. Throughout most of her article “Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis,” Villarosa narrows specifically on Simone Landrum and her encounters with maternal healthcare. Although there are a few references to the population of American black mothers, the focus of the article is mainly on this one individual. This can be seen as a hinderance to understanding structural competency in that Metzl and Hansen promote the use of structural competency to shift clinical perspective “from an exclusive focus on the individual encounter to include the organization of institutions and policies” (127). In several instances throughout the article, Villarosa decides to emphasize Landrum’s own experiences in the context of an individual life, detracting from the main purpose of structural competency as one that places an individual in a bigger context of systematic societal organization.
- Kleinman’s Definition of “Illness”
As Kleinman states, illness refers to “the innately human experience of symptoms and suffering” (3). Examples of illness include the unique way in which an individual may cope after acquiring tinnitus, the family dynamic changes that occur due to a mother’s cancer diagnosis, or an athlete’s experienced impediment to success because of a torn ligament.
- “Sickness,” “Illness,” and “Disease”
It is important to distinguish from “sickness,” “illness,” and “disease” because of the different meanings that each term carries and how they aid in understanding different perspectives of a condition. As Kleinman states, the term “disease” is viewed “only as an alteration in biological structure or functioning” (5). He uses this argument to convey the notion that disease is a “hard” way of viewing a disorder. Meanwhile, illness provides an understanding of a condition that is “always distinctive” (Kleinman 5), one that biological aspects cannot capture. In doing so, Kleinman creates a stark contrast between the coldness of “disease” and the immediateness yet intangibleness of “illness.” Lastly, Kleinman distinguishes “sickness” as understanding “a disorder in its generic sense across a population in relation to macrosocial forces” (Kleinman 6). In this way, Kleinman argues that a more communal and mutual aspect of a disorder is possible. By distinguishing these terms, Kleinman enables us to grasp the far-reaching experiences and implications of disorders—from the strictly detached to the most intimate.
- The Meaning of “Materialist” in the Biological World
Kleinman refers to current medical training and healthcare as being engaged in a “radically materialist pursuit of the biological mechanism of disease” (9). He attempts to capture the “hardness” and narrow-focused view that results from viewing a condition as a “disease” rather than a more personal “illness” or societal “sickness.” Kleinman utilizes this metaphor to compare treating a disorder to achieving or gaining a “material,” ultimately leaving providers to fail at recognizing that rather than chasing more of an “item” (in this case a cure or explanation) they should seek to explore “the meanings of illness” (9) that transcend temporary success.