Discussion: inital draft of equity concerns (work in progress)

content/50.discussion.md

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 ### Concerns about Equity in Healthcare
 
-Scientific and medical research broadly is shaped by a number of biases.
-Some concerns include how clinical trials recruit and operate.
+The objective of the paper is to compile and synthesis literature on the disease COVID-19.
+To accurately and completely discuss this pandemic, health disparities and bias need to be addressed, so that the information is applicable to all.
+Bias in medicine can be characterized as when a physician and/or patient “others” an individual in a healthcare setting, oftentimes this occurs when a person looks or acts differently.
+By being self-aware of our own implicit biases, one can work towards equality.
 
-<!--Risk of comorbid health conditions associated with more severe outcomes may be influenced by long-term damage caused by chronic stress related to traumatic social experiences [@doi:10.1007/s12170-013-0338-5], perhaps mediated by cardiovascular risk factors [@doi:10.1101/2020.05.10.20097253], although the effects of chronic stress have not yet been researched in the specific case of COVID-19 disparities.-->
+The population of the inhabitants or humans on Earth is approximately 7.8 billion people.
+The myriad of cultures, languages, and environments differentiate the population into subpopulations with varying beliefs, values, and point of views.
+However, the preponderance of the academic discourse made public is produced by western, educated, industrialized, rich and democratic, or WIERD, individuals, which comprise 12 percent of world occupants.
+While there is not much empirical data on the representativeness of WEIRD individuals within mankind, this blatant disparity brings forth the notion of bias in science, for researchers generalize their discoveries to the entire human population.
+The purpose of acknowledging the implicit biases within academia is to provide an appropriate lens for readers to interpret the information.
+
+Humans, more specifically researchers and scientists, ought to examine their ability to distinguish between evolutionary aspects of psychology and cultural aspects of psychology.
+Evolutionary theory suggests that all human psychology behaves in a similar manner.
+Thus, researchers extrapolate the idea that diversity (race, gender, and etc.) lacks importance in how they conduct their studies.
+For instance, many psychology studies utilize university college students enrolled in a psychology course for their surveys or as subjects.
+These biased results from these studies portray a false representation of global human behavior.
+An individual's environment and culture are paramount to their principles and perception, which gravely affect behavior and, consequently, scientific data.
+
+The role of bias in information and its implications goes beyond psychological studies as it is applicable to medicine: how diseases and illnesses are diagnosed, the varying degrees of treatment, and who are in clinical trials.
+The racism within medicine is critical to understanding how practitioners and researchers’ bias negatively affects health outcomes.
+There is a misconception that African-American individuals have thicker skin and exorbitant pain tolerance in comparison to other demographics.
+As a result, African-Americans can be misdiagnosed and be given incorrect prescriptions.
+The glomerular filtration rate (GFR) is a tool used to measure a specific protein in the blood, which is an indicator of kidney function.
+This sophisicalted equation inputs data, such as, weight, age, sex, serum levels of creatinine, and race, to obtain a result.
+Black individuals have a higher racial adjustment factor than that of other races.
+Thus, with similar factors as a white person, for instance, a Black person would have greater kidney function, leading to more kidney complications to reach the threshold of kidney disease.
+In addition to misdiagnosis, participation in clinical trials by African-Americans is disproportionately lower than that of caucasians, even in diseases which [African-Americans] are more susceptible.When there is equal opportunity to participate in clinical trials, there is an insignificant difference between racial groups.
+
+Why are certain racial groups disproportionately being infected with Covid-19.
+Studies suggest that discussions between doctors and patients impact whether or not a physician offers joining a clinical trial.
+The results of the studies convey that physicians’ visits with African-Americans were shorter and provided less information about clinical trials than that of whites.
+Some of the reasons for this disparity are lack of awareness and education, mistrust in healthcare professionals, and lack of health insurance because otherwise there should be no disparity.
+These studies show that both physicians and patients have a bias or misinformation that can affect health outcomes.
+
+There is little to no data on the ongoing clinical trials for COVID-19, however, one can presume that African-Americans and other racial minorities are not obtaining equitable access to clinical trials for a disease that research has shown disproportionately affects them.
+While much of the research on health disparities and bias are inconclusive, humans, specifically scientists in medicine, need to make an effort to think more global and be more inclusive with their clinical trials to aid the health outcomes of all demographics.
+
+<!--From #460: Risk of comorbid health conditions associated with more severe outcomes may be influenced by long-term damage caused by chronic stress related to traumatic social experiences [@doi:10.1007/s12170-013-0338-5], perhaps mediated by cardiovascular risk factors [@doi:10.1101/2020.05.10.20097253], although the effects of chronic stress have not yet been researched in the specific case of COVID-19 disparities.-->