When Values and Experiences Shape Choices

Introduction

I’m quite conflicted. From multiple angles, I am seeing both national and African American communities being ravaged by COVID-19. I am also seeing both gripped by multiple considerations that prevent achievable progress, and admittedly in both examples, these considerations seem out of the control of those affected. My observations aren’t meant to judge but to enlighten. I believe in a fault in your right to decide how you live and die.

Freedoms and Oppression

Americans fiercely guard freedom, individualism and choice. For many, these are values that define life, liberty and the pursuit of happiness. In the midst of a pandemic, that too often means a willingness to prioritize actions not in the national or (one would think) self-interest. However, the point of health self-empowerment is people do get to be educated consumers, appreciating that choices have consequences. Unfortunately, that level of selfishness can create downstream havoc on the most vulnerable citizens. The African American community has legitimate concerns related to institutional racism at the hands of the medical establishment. This has ranged from lack of access, unequal quality of care, and higher costs than the general population to outright victimization as the subjects of medical experimentation. There is no fair way to criticize any African American who is hesitant about engaging the medical establishment. This trepidation has translated into a willingness to rely on herbal medicines and home remedies instead of physician prescribed regimens. It means lower rates of vaccine usage and a willingness to roll the dice on surviving known threats when clinically demonstrable options exist. You may not want to hear it or believe it, but these experiences reflect parallels than converge in the production of suboptimal outcomes. The performance of the US on the world stage is shockingly bad, as we lead the world in cases and deaths. African Americans again suffer disproportionately from COVID-19. Again: both external and self-imposed decisions contribute to these health care disparities.

The Way Forward

Sadly, the way out in both examples is clear, but the implementation of best practice strategies is a challenge that seems more elusive that our hands are able to grab. As the months roll by and deaths accrue, it will be interesting to see when and if the lightbulbs finally go off and our communities stop being governed by fear (legitimate and not) and priorities other than health. The ongoing question is when will we start taking charge of the conditions that cause that fear and relegation of health to a secondary consideration in our lives? I hope it’s soon across the board. Lives are in the balance.

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