Medicalization’s Role in ADHD Prescriptions for Children

The Medicalization Debate

The healthcare field has been one of the fasted growing industries across the globe in recent decades as researchers and medical professionals continue to search for new and improved forms of care. Advancements in new technology, drugs, and our understanding of various health-related conditions are constantly being made and shaping our perception of the world we live in. As Robert Crawford points out in his publication Health as a Meaningful Social Practice, medical policies, forms of treatment, and the way in which we understand different medical conditions influences how we perceive ourselves within the social sphere of society (Crawford, 2006). This relationship between healthcare and social practices becomes especially important when discussing the concept of medicalization. Medicalization refers to the process in which non-medical problems become redefined within the scope of medicine and are treated as such, according to Peter Conrad from Brandeis University (Conrad, 1992). Medicalization has become a point of focus recently as improper identification of an issue as being medical-related could have harmful effects on both patients and society as a whole. Researcher Erik Parens points out that medicalization itself is not necessarily a bad thing, but rather it becomes an issue when the medicine oversteps its limitations (Parens, 2013).

Emilia Kaczmarek describes four major risks that may arise in the case of over-medicalization. First, over-medicalization may have a negative impact on patient health as it promotes excessive treatment that could lead to undesirable side effects. Next, over-medicalization has an effect on the economy as it can promote the misplacement of both public and private funds. Third, over-medicalization can have important psychological implications by stigmatizing certain individuals or their “condition” as being sick and restrict personal freedom through pressures to alter one’s behavior to the standards of society. Finally, over-medicalization overlooks the different social, political, and interpersonal relationships that may play a role in the problem a person is facing (Kaczmarek, 2018). Excessive medicalization can be seen in a number of different examples, such as ADHD, women and childbirth, menopause, erectile dysfunction, sleep disorders, and much more. In each of these cases, the condition is viewed through a biological lens that causes other contributing factors to be overlooked and an emphasis to be placed on medications and other medical treatments. This reading will be focusing on the influence medicalization has had on ADHD specifically and the impact this has had on the most vulnerable patient population: children.


A Snapshot of ADHD in the U.S.

The Center for Disease Control and Prevention describes ADHD as a neurodevelopmental disorder that is commonly diagnosed during childhood and persists through adulthood (Center for Disease Control and Prevention [CDC], 2022). The condition is typically associated with an inability to pay attention, difficulty controlling impulsive behaviors, and being excessively active. In the U.S., it is estimated that around 6 million children are currently diagnosed with ADHD with over 265,000 of these diagnoses occurring in children between the ages of three and five (CDC, 2022). Of this patient population, 62% were consistently taking ADHD medication while 47% were receiving behavioral treatment for a combined 77% of children with ADHD taking some form of treatment. Behavioral treatment for ADHD does not have an impact on the core symptoms experienced by these patients, but rather it involves teaching children various coping strategies in order to control their symptoms. Behavioral therapy is comprised of two main components in order to help children manage the various symptoms of ADHD. The first is what is known as “parent training” that focuses on teaching children how to control their impulsive behavior. This portion of therapy involves both the children and their parents and provides parents with different strategies in dealing with their child’s behavior. The second form of behavioral therapy deals with what is known as “executive functions.” These executive functions are a set of skills that enable a child with ADHD to better manage their time, stay organized, and plan different tasks (Miller, 2022).

Although, nearly half of all diagnosed children are involved in ADHD behavioral therapy, treatment in the form of medication is much more common and also more relevant to the topic of medicalization. ADHD medication primarily involves stimulants such as methylphenidate or amphetamine. These stimulants, which include well-known brand-name drugs like Adderall and Concerta, are the most commonly used ADHD medications and are often varied by dosage depending on the patient’s needs. In general, long-term use of stimulants can have adverse health effects, primarily on the cardiovascular system, as it can lead to chronic high blood pressure, increased heart rate, and heart failure (Losch, 2023). As a result, concern has grown regarding prescribing ADHD medication to children, especially since some may begin taking these drugs as young as three years old.

Only a small fraction of children with ADHD have outwardly hyperactive symptoms.

ADDitude Magazine

The Medicalization of ADHD and the Risks it Poses to Children

With nearly 1 in 11 children in the U.S. currently having an ADHD diagnosis and this rate of instance steadily increasing since 1997, it calls into question the reason for this growing prevalence (Lanham, 2023; CDC, 2022). Are more people in the U.S. being affected by ADHD, is improved testing allowing for more accurate detection of ADHD, or is our understanding and perceptions of ADHD changing and causing a greater number of people to fall under what society categorizes as ADHD? This is where the topic of medicalization becomes relevant. The over-medicalization of ADHD has the potential to increase the rate of diagnosis in children and, as a result, increase the number of children receiving medicated treatment. It is possible that more people are not actually suffering from ADHD, but rather societal pressures, expectations, and norms are shaping how we view the condition. The structure of the U.S. education system requires students to sit at their desk for prolonged periods of time and often does not involve a lot of physical movement. When a kid fails to adhere to expectations that they remain attentive and non-disruptive for these prolonged periods of time, the first assumption may be that they are suffering from ADHD since an inability to focus and control impulsive behavior is associated with this condition. In today’s world, there is a much greater public awareness of ADHD that has caused it to become de-stigmatized, which could explain the growing numbers of cases. The inability of children to focus in a classroom setting may have previously been thought to be related more to the energetic nature of children, but increased public awareness has created an over-emphasis on the correlation between ADHD and hyperactivity in children, leading to far more diagnoses.

The reason that the changing perception of ADHD in society, leading to more supposed cases, is important again comes down to the emphasis on using of ADHD medication to treat the disorder. The nature of stimulants, like ADHD medications, can create a number of different side effects in those taking them. ADHD medications have been known to cause sleep problems, decreased appetite, delayed growth, frequent headaches and stomachaches, irritability as the drug wears off, tics, and changes in mood (Boorady, 2022). This has caused great concern in prescribing children these medications as they are undergoing significant neurological, hormonal, and physical development and the long-term impact these effects can have on this development are mostly unknown as most studies often involve non-human subjects due to the many ethical concerns of experimenting on humans (Volkow, 2008). The fact that the experience and severity of ADHD often varies among individuals can lead to an increase in the number of patients being diagnosed with and receiving treatment for ADHD as well. According to a study published in the National Library of Medicine, there is not a single pathophysiological entity that causes ADHD, but rather multiple risk factors work together to promote the condition we know as ADHD (Curatolo, 2010). This creates the potential for a number of different neurological conditions and features to be classified as having ADHD implications when they may not necessarily cause ADHD themselves and, therefore, more children may qualify for an ADHD diagnosis. This prevents the development of a biologically based test for diagnosing children and instead diagnosis relies on the clinician’s perception of the child’s behavior and parent description.

Image from HubPages


The over-medicalization of various disorders and conditions has major implications on patient health and overall quality of life. Viewing these disorders with an emphasis on their biological and medical applications opposed to a more comprehensive understanding of the different factors that may contribute to them may negatively affect the patients living with these problems. This becomes more relevant for disorders that are typically diagnosed in children as there could be many long-term effects that have the potential to adversely affect the patient later in life. ADHD is one of these conditions that generates a great deal of concern, especially since the main form of treatment for ADHD in children is prescription drugs. The over-medicalization of ADHD has the potential to increase incidence of diagnoses, and result in a greater number of children taking these prescriptions. ADHD, like many other overly medicalized conditions, lacks a strong biological basis where biological markers can be used to make a diagnosis. Instead, clinicians rely on observed behavior of the patient and descriptions from parents to make the decision of whether or not the child should be treated with a strong chemical compound. Understanding the role that medicalization has on our perception of conditions like ADHD and how this can influence our decisions is key in being able to prevent excessive treatment in vulnerable patients that may not necessarily require treatment.

Works Cited

Behavioral treatments for kids with ADHD. Child Mind Institute. (2023, January 25). Retrieved March 28, 2023, from

Carpiano, R. M. (2001). Passive medicalization: The case of Viagra and erectile dysfunction. Sociological Spectrum, 21(3), 441–450.

Centers for Disease Control and Prevention. (2022, August 9). ADHD throughout the years. Centers for Disease Control and Prevention. Retrieved March 28, 2023, from

Centers for Disease Control and Prevention. (2022, August 9). Data and statistics about ADHD. Centers for Disease Control and Prevention. Retrieved March 28, 2023, from

Centers for Disease Control and Prevention. (2022, August 9). What is ADHD? Centers for Disease Control and Prevention. Retrieved March 28, 2023, from,)%2C%20or%20be%20overly%20active.

Conrad, P. (1992). Medicalization and Social Control. Annual Review of Sociology, 18(1), 209–232.

Crawford, R. (2006). Health as a meaningful social practice. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 10(4), 401–420.

Curatolo, P., D’Agati, E., & Moavero, R. (2010). The neurobiological basis of ADHD. Italian Journal of Pediatrics, 36(1), 79.

General prevalence of ADHD. CHADD. (2022, October 20). Retrieved March 28, 2023, from,%E2%80%9317%20(1%20in%2010)

Is there an increase in ADHD? CHADD. (2019, July 11). Retrieved March 28, 2023, from,and%20getting%20treatment%20for%20children.

Kaczmarek, E. (2018). How to distinguish medicalization from over-medicalization? Medicine, Health Care and Philosophy, 22(1), 119–128.

Mayo Foundation for Medical Education and Research. (2023, January 25). Adult attention-deficit/hyperactivity disorder (ADHD). Mayo Clinic. Retrieved March 28, 2023, from,Treatment,they%20don’t%20cure%20it.

PARENS, E. R. I. K. (2011). On good and bad forms of medicalization. Bioethics, 27(1), 28–35.

Side effects of ADHD medication. Child Mind Institute. (2023, January 25). Retrieved March 28, 2023, from

Staff, P. R. C. (2022, June 7). The long-term consequences of stimulant use. Pinelands Recovery Center of Medford. Retrieved March 28, 2023, from

Volkow, N. D., & Swanson, J. M. (2008). Does childhood treatment of ADHD with stimulant medication affect substance abuse in adulthood? American Journal of Psychiatry, 165(5), 553–555.

The Stigmatization of Mental Illness in College Campuses

For college students struggling with mental health, the weight of stigma and shame can feel heavier than the textbooks in their backpacks. Mental health conditions are among the most prevalent health issues affecting college students today. According to the American College Health Association, 63% of college students experienced overwhelming anxiety in the past year, while 40% reported symptoms of depression (Greenfield, B., & Gracey, E. 2010). However, despite the prevalence of these conditions, mental health stigma remains a major issue on college campuses. The stigmatization of mental illness can cause students to feel ashamed and embarrassed about their conditions, leading them to avoid seeking help and exacerbating feelings of isolation and social exclusion (Eisenberg, et al 2012).

Understanding the intersections of mental health and other types of marginalization is critical for effectively addressing mental health stigma on college campuses. This necessitates a consideration of how other kinds of oppression, such as ableism, racism, sexism, and homophobia, compound mental health stigma, and how these intersecting identities influence students’ experiences with mental health stigma.

In addition, decreasing mental health stigma involves a multi-pronged approach that targets the root causes of stigma, including as ignorance, fear, and misinformation, as well as the institutional and structural barriers that impede students from gaining access to the necessary services and assistance. By examining structural and institutional barriers to accessing care, promoting inclusive and affirming attitudes toward mental health, and addressing the intersectionality of mental health stigma and other forms of marginalization, we can create a higher education system that is more equitable and supportive for all students.

Factors Contributing to Mental Health Stigma in College Campuses

The stigmatization of mental illness in college campuses is deeply rooted in personal and social meanings of mental illness.

“The social organization of illness, including its meanings and symptoms, determines the cultural response to illness and the quality of care that patients receive”

Kleinman Arthur, Illness Narratives, 2017.

The preceding statement by Kleinman reaffirms that the way in which society views mental illness can affect the treatment and assistance provided to those with mental health disorders (Kleinman 2017). The stigmatization of mental illness prevents individuals from seeking care and discussing their experiences for fear of being judged by others. As detailed in Kleinman’s Ilness Narratives, broader societal attitudes and ideas about mental health shape the social meanings of mental illness. Contributing to the stigma around mental illness are media representations of mental disease, misconceptions of people with mental health disorders, and a general lack of knowledge and awareness. In Care Work: Dreaming Disability Justice, Lakshmi Piepzna-Samarasinha examines how cultural and societal notions about disability intersect with mental health stigma (Lakshmi Piepzna-Samarasinha, 2018). She adds that people with disabilities may be perceived as “unwanted” or “broken,” resulting in stigma and prejudice. In addition, mental health issues may be stigmatized due to cultural views about “normalcy” and able-bodiedness, which can result in feelings of shame and humiliation (Lakshmi Piepzna-Samarasinha, 2018).

Furthermore, the interconnectedness of disability and mental health further complicates the problem of mental health stigma on college campuses. According to Piepzna-Samarasinha’s Crip Emotional Intelligence, individuals with impairments are frequently subjected to stigma and discrimination, which may increase their risk of developing mental health issues (Piepzna-Samarasinha, L. 2018). In addition, the lack of accessibility and inclusivity on many college campuses can create further barriers for students with disabilities seeking mental health support.

“The disability community knows firsthand what it’s like to be told that our pain doesn’t matter, that our bodies are wrong, and that we don’t belong”

Piepzna-Samarasinha, Crip Emotional Intelligence

Specific examples of mental health stigma on college campuses illustrate these personal and social connotations of mental illness, as well as the intertwining of disability and mental health (Piepzna-Samarasinha, L 2018). For instance, individuals with mental health disorders are frequently described using negative language and stereotypes, reinforcing detrimental attitudes and beliefs. In addition, kids with mental health disorders may be excluded from social gatherings or treated harshly in the classroom, leading to feelings of isolation and perpetuating the stigma associated with mental illness. On college campuses, the stigma surrounding mental health is pervasive and well-documented (Lu, et al. 2019). Students with mental health disorders may encounter discrimination and negative attitudes from their peers, professors, and even healthcare professionals. Additionally, these students may have difficulty gaining access to necessary mental health resources on campus due to restricted availability, lengthy wait periods, or substandard care. The stigma associated with mental health may also discourage students from seeking assistance or admitting their condition, resulting in feelings of isolation and social exclusion (Piepzna-Samarasinha, L. 2018).

Impacts of Mental Health Stigma on Students and Campus Culture

The impact of mental health stigma on students and campus culture is profound and cannot be overstated. Daniel Eisenberg, of Mental Health on College Campuses: A Review, discovered that stigma and discrimination against students with mental health disorders are pervasive on college campuses, with many students avoiding assistance out of fear of receiving negative labelsand social rejection (Eisenberg et al., 2012). The American College Health Association (2019) reported that 63% of college students experienced overwhelming anxiety in the past year, while 40% reported symptoms of depression. However, only 20% of students with mental health conditions sought help from a mental health professional (Eisenberg et al., 2012). This can lead to detrimental consequences for students, including lower academic performance, decreased quality of life, and higher rates of substance abuse and suicide (American College Health Association, 2019).

The stigma associated with mental health also has a significant effect
on campus culture. Corrigan and Watson, of The Paradox of Self-stigma and Mental Illness, discovered that stigma can create a hostile and unsupportive atmosphere for students with mental health disorders, resulting in social isolation and limited access to resources and support. This can perpetuate the stigma and prejudice cycle,establishing a culture of neglect and apathy toward mental health. (Corrigan, 2004). Furthermore, the lack of money and resources for mental health services, as well as the dearth of skilled mental health practitioners on college campuses, exacerbates the impact of stigma and leaves many students without the care they require. (Eisenberg et al., 2012).

The impact of mental health stigma on students with mental health conditions is also profound. Linton, of The Ableism of Disability Studies, argues that mental health stigma can lead to a form of “internalized ableism,” where students with mental health conditions begin to internalize the negative attitudes and stereotypes associated with their condition and view themselves as inferior or inadequate (Linton, 2018). This can lead to self-doubt, low self-esteem, and a reluctance to seek help or disclose their condition to others (Linton, 2018). Furthermore, students with intersecting marginalized identities, such as those who identify as LGBTQ+ or have disabilities, are at an even higher risk for mental health stigma and its effects, exacerbating the impact of stigma on their mental health and overall well-being (Kaufman et al., 2018).

A comprehensive and evidence-based strategy is required to mitigate the effects of mental health stigma on students and campus culture. Vogel of Mental Health Stigma on Campus: A Review of Literature and Implications for Practice, argue that interventions that focus on developing mental health literacy, encouraging inclusive and affirming attitudes toward mental health, and strengthening access to resources and support can aid in reducing stigma and improving mental health outcomes for students (Vogel et al., 2007). In addition, policies that prioritize the recruitment and retention of diverse mental health professionals, as well as the provision of proper financing and resources for mental health services, can assist in addressing the shortage of resources and promoting a more equitable and inclusive campus culture. (American College Health Association, 2019).

The impact of mental health stigma on campus culture is also significant (Vogel et al 2007). Stigma can create a hostile and unsupportive environment for students with mental health conditions, leading to social isolation and a lack of access to resources and support (Corrigan & Watson, 2002). This can further perpetuate the cycle of stigma and discrimination, creating a culture of neglect and apathy towards mental health (Corrigan, 2004). Furthermore, the lack of resources and financial support for mental health services, as well as a shortage of skilled mental health practitioners on college campuses, exacerbates the impact of stigma and leaves many students without the care they require. (Eisenberg et al., 2012).

Potential Solutions to Address Mental Health Stigma in College Campuses

Mental health stigma is a pressing issue on college campuses, as it can prevent students from seeking help and exacerbate feelings of isolation and social exclusion (Greenfield, B., & Gracey, E. 2010). According to a survey conducted by the National Alliance on Mental Illness (NAMI), 64% of college students with mental health conditions report that stigma has made it difficult for them to succeed academically, and 50% report that stigma has prevented them from seeking help (Nelson, 2011). Additionally, a study by Eisenberg and colleagues (2013) found that only 11% of college students with mental health conditions receive treatment, with stigma being the most common barrier to seeking help (Eisenberg et al., 2012).

Several potential solutions have been proposed in the literature, including destigmatizing language and practices, increasing awareness and education, and involving students with mental health conditions in decision-making. According to Greenfield and Gracefield, of Disability Awareness: A Course for College Students. Journal of Postsecondary Education and Disability, disability awareness courses are one technique to enhance awareness and education (Greenfield, B., & Gracey, E. 2010). These courses allow learners to comprehend the experiences of people with disabilities, specifically those with mental health disorders. In addition, Lu and Feeley of Reducing Mental Health Stigma on College Campuses: Targeting External and Internal Sources of Stigma, argue that external causes of stigma, such as negative media portrayals, can be countered by media campaigns that challenge stigmatizing mental health representations (Lu & Feeley, 2018). Moreover, internal origins of stigma, such as self-stigma and shame, can be addressed through therapy procedures that emphasize the development of self-esteem and self-acceptance (Lu & Feeley, 2018).

However, these prospective solutions are not devoid of obstacles and constraints. Greenfield and Gracey, for instance, remark that disability awareness classes are not yet extensively implemented on college campuses, and there is a need for additional research to evaluate their efficacy (Greenfield, B., & Gracey, E. 2010). In addition, Lu and Feeley (2018) admit that media campaigns can be costly and difficult to continue, and that they may not necessarily alter deeply rooted cultural attitudes around mental health (Reczek et al (2016). Similarly, therapeutic interventions may not be available to all kids, especially those from marginalized backgrounds who may experience significant challenges to care access (Lu & Feeley, 2018).

Despite these challenges, college campuses have begun implementing effective programs and initiatives to combat mental health stigma. For instance, Lakshmi Piepzna-Samarasinha’s Care Work, explores the role of “crip emotional intelligence” and “sick and crazy healer” in creating supportive and inclusive spaces for people with disabilities, including those with mental health conditions (Lakshmi Piepzna-Samarasinha. 2018). Similarly, the National Alliance on Mental Illness (NAMI) has created initiatives like as Ending the Silence and NAMI on Campus to improve awareness, decrease stigma, and give resources and support for students with mental health disorders (Eisenberg, et al 2009).

Going Beyond the Classroom

As a current undergraduate student pursuing pre-health and global affairs at the University of Notre Dame, I am acutely aware of the critical importance of mental health in the college setting. College represents a pivotal time for young adults as they navigate new experiences, opportunities, and challenges that can profoundly shape their personal and professional trajectory. However, mental health conditions such as anxiety, depression, and stress can significantly impact a student’s academic, personal, and social life, making it difficult for students such as myself, to thrive in this dynamic and demanding environment.

The stigma surrounding mental health further exacerbates these challenges, creating significant barriers for students to access care and support, hindering their ability to manage and overcome their conditions effectively. Moreover, given that college graduates are often future leaders and contributors to the building of a more equitable and just society, decreasing mental health stigma on college campuses can have far-reaching effects on society as a whole. By increasing awareness, reducing stigma, and improving access to mental health services and assistance, we can foster a campus environment that is healthier, more resilient, and more conducive to the growth and development of all students.


  1. Crawford, R. (2006). Health as a meaningful social practice. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 10(4), 401-420.
  2. Corrigan, P. W., & Watson, A. C. (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35-53.
  3. Corrigan, P. W. (2004). How stigma interferes with mental health care. American Psychologist, 59(7), 614-625.
  4. Eisenberg, D., Golberstein, E., & Hunt, J. B. (2012). Mental health and academic success in college. The BE Journal of Economic Analysis & Policy, 12(1), 1-37.
  5. Linton, S. (1998). The ableism of disability studies. Disability & Society, 13(5), 665-666.
  6. Piepzna-Samarasinha, L. (2018). Crip emotional intelligence. In Care work: Dreaming disability justice (pp. 23-30). Arsenal Pulp Press.
  7. Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54(1), 40-50.
  8. Vogel, D. L., Bitman, R. L., Hammer, J. H., & Wade, N. G. (2013). Is stigma internalized? The longitudinal impact of public stigma on self-stigma. Journal of Counseling Psychology, 60(2), 311-316.
  9. Vogel, D. L., Wester, S. R., & Larson, L. M. (2007). Avoidance of counseling: Psychological factors that inhibit seeking help. Journal of Counseling & Development, 85(3), 410-422.
  10. Vogel, D. L., Wester, S. R., Wei, M., & Boysen, G. A. (2005). The role of outcome expectations and attitudes on decisions to seek professional help. Journal of Counseling Psychology, 52(4), 459-470.
  11. “Mental Health on College Campuses: A Review” by Eisenberg, Golberstein, and Hunt
  12. “Mental Health Stigma on Campus: A Review of Literature and Implications for Practice” by Vogel et al.
  13. “The Stigma and Shame of Illness” from Care Work by Lakshmi Piepzna-Samarasinha

Youth Caregivers in the United States

Caregiving in the United States has had some improvement in the resources and financial aid allocated to help informal caregivers, but America has still not identified and supported the alarmingly increasing number of youth caregivers.

Image from Unsplash

Care giving in America

According to John Hopkins University, a caregiver is a person who provides direct care for someone who has a short or long-term limitation due to an injury, illness, or some other condition (McQuay) As we learned in class, informal or unpaid caregivers have become a hidden foundation for the long-term care of family members and can impact the carer’s health due to the added stress and responsibility. In the United States, some policies and programs are in place to help caregivers, but all these resources fail to address or aid a hidden group of caregivers, children under the age of eighteen. Children are oftentimes associated as the ones who receive care and support from an adult figure in their life, but according to a 2020 study conducted by AARP on family caregiving in the United States, there are approximately 5.4 million youth caregivers whose roles are reversed as they care and assist their family members  (AARP Family Caregiving, 2020). These youth caregivers are placed in a unique situation as they learn to juggle school and any house and care responsibilities they must bear. Those same stressors and negative health effects we discussed in class that affect adult caregivers are also impacting children carers, having a long-lasting impact on their development and ability to learn.

There are approximately 5.4 million youth caregivers whose roles are reversed as they care and assist their family members

AARP Family Caregiving 2020
Image from iStock

First Experience with a Youth Caregiver

(No names are mentioned in order to respect her privacy and is being included with her permission)

The idea of a child taking over an adult’s responsibilities is not uncommon in the area where I grew up, but I saw just how much the role of a caregiver plays in a student’s life through one of my close friends in high school. There isn’t a specific instance that could fully encompass the emotional toll being a caregiver had on her, but to give you an idea of the physical strain she went through, I will explain what a day in her life looked like. She is the ninth of thirteen children, but because of her interest in medicine along with her determination to stay in school, the responsibility of caring for her mother, younger siblings, nieces, and nephews fell to her. Her morning began around five in the morning as she prepared lunch for her older brothers who went to work before she woke up her younger siblings. Breakfast was prepared for her mother along with her morning medication and helped dress the children who would be staying at home as they were still too young for school. By seven in the morning, she would be heading out to drop off her siblings at their perspective school before rushing to the high school. She would spend the first half of the day in her AP classes before heading out to her job as a server after lunch. Her siblings would ride the bus in the afternoon, and she would finish her shift in time to prepare dinner and help ready her mother for bed before helping her siblings with homework. Once everyone was settled and fed, she would sit down to work on her homework before repeating this stressful schedule the next day. There were some days when she would miss school to take her mother or siblings to an appointment. While most high school students had the opportunity to attend games or hang out with friends, she was spending her weekends cleaning the house and helping care for her siblings and mother. She worked hard throughout high school to be able to attend university, and when she left to study, all the caretaking responsibilities fell on her two younger sisters at the age of 13 and 14. This situation is not an isolated occurrence and is common to see these responsibilities fall to the daughters of families beginning at ages as young as eleven years old.

Image from pexels by Kamaji Ogino

Health Impact on Youth Carers

According to research conducted by Kavanaugh et al, the responsibilities that young carers take on expose them to multiple negative health and education outcomes. Studies have shown that child caregivers are more likely to be anxious and depressed than children who are not caregivers. This, coupled with the fact that a disproportionate amount of youth caregivers in the United States come from lower-income families, means that these kids are also less likely to be able to seek help from the healthcare system  (Kavanaugh, 2016). Learning and development are also impacted by their role as caregivers leading students to have problems focusing during class or causing them to miss school due to their caretaking responsibilities. One study, conducted by the Bill and Melinda Gates Foundation found that 22% of young adults that drop out of school cited caring for a family member as the main reason for their decision  (Gunnerson, 2021). Social development is also affected as youth caregivers are more likely to experience isolation as they are not able to participate in social activities with their peers due to their workload. They could also isolate or become aggressive toward any authoritative figure who could remove them from their home. “Caregiving is not on people’s radar,” said Siskowski, one of the scientists studying the health effects on youth carers. “What they do is behind closed doors, so it’s out of sight, out of mind.” The need for youth carers to keep their situation a secret can increase their anxiety levels and disrupt their sleep What they do is behind closed doors, so it’s out of sight, out of mind (Diaz et al, 2007). This need for secrecy also means that the 5.4 million reported by AARP is probably an underestimate  (Lewis, 2021).

“What they do is behind closed doors, so it’s out of sight, out of mind.”

Connie Siskowski, scientist studying health effects on youth caregivers

Resources for Youth Caregivers

Despite the large number of children impacted by this situation, the current American policies and programs exclude any caregivers under the age of 18 from receiving any aid or access to resources. There are non-profit organizations such as the American Association of Caregiving Youth which was founded in Florida dedicated to supporting children who have the responsibility of being a caregiver and help to provide them with resources to aid the family and work with the school system to help the student succeed in their classes, but there is no centralized system dedicated to identifying and supporting this hidden group of caregivers leaving the responsibility to fall on the individual school systems and more specifically, the teachers and counselors  (Armstrong-Carter et al., 2021). The first step in helping youth caregivers is working to recognize them and their increasing numbers in legislation, helping them by providing them with information and emotional support, and working with schools to accommodate students with these added responsibilities.

Works Cited

AARP Family Caregiving. “Caregiving in the U.S.” (2020) Web. Mar 27, 2023.

Armstrong-Carter, Emma, et al. “The United States should Recognize and Support Caregiving Youth.” Social Policy Report 34.2 (2021): 1-24. Web.

Diaz, Naelys, et al. “Latino Young Caregivers in the United States: Who Are They and What Are the Academic Implications of This Role?” Child & Youth Care Forum, vol. 36, no. 4, 2007, pp. 131–40,

Gunnerson, Tate. “A growing phenomenon, youth caregivers need recognition, support.” Nov 3, 2021. Web. Mar 27, 2023. 03/a-growing-phenomenon-youth-caregivers-need-recognition-support.

Kavanaugh, Melinda S. “Unacknowledged Caregivers: A Scoping Review of Research on Caregiving Youth in the United States | SpringerLink.” Springer Link (2015): 29-49. Web. Mar 27, 2023.

Lewis, Feylyn. “Youth Caregivers: Before, During, and After the Pandemic.” Oct 20, 2021. Web. Mar 27, 2023, youth-caregivers-and-pandemic.

McQuay, Jessica. “What Is A Caregiver? | Johns Hopkins Bayview Medical Center.” Web. Mar 27, 2023,

Considerations in treating HIV/AIDS today with a potential HIV vaccine on the horizon

In watching the film How to Survive a Plague and reading Steven Epstein’s piece on AIDS activism and clinical trial reform, it is clear that the fight to provide care and treatment for those suffering from AIDS has been extremely difficult. Both of these also demonstrate the strong linkage between activism for HIV/AIDS research and treatment is strongly linked to identity, as the 1980s AIDS movement became led by affected individuals that often identified with the gay community. Because AIDS became associated with things like sex and drugs, AIDS became heavily stigmatized and the connection between identity and illness became problematic.   The AIDS movement revealed many systemic issues in the way research is conducted and how those with stigmatized conditions are treated by the medical community and society as a whole (Epstein).  The HIV/AIDS epidemic has been a public health issue for several decades, and though great strides have been made in developing drugs to treat AIDS, there is no cure and an effective vaccine has yet to be developed.   Why has vaccine and drug development for HIV/AIDS been such a long and challenging process? Once available, how will stigmatization and bias toward HIV/AIDS impact vaccination efforts? 

Overview on HIV and AIDS

Since first identified in the US during the 1980s, human immunodeficiency virus (HIV) has remained a public health concern and affects millions of people across the globe.  HIV is a virus that causes flu-like symptoms in the acute stages.  However, if left untreated HIV weakens a person’s immune system such that the infected person develops AIDS (acquired immunodeficiency syndrome).  Once a person progresses to AIDS, they typically only live for a few years, and are at serious risk for contracting opportunistic pathogens that cause fatal infections in a person with AIDS (“Symptoms of HIV and AIDS: What to Look For?”).  HIV is transmitted through contact with bodily fluids and men who have sex with other men, particularly black men, are most affected by HIV, but anyone can contract HIV if exposed (Levine).  

Challenges to Treatment

HIV’s association with and increased incidence in the gay and bisexual communities complicates treatment.  Homophobia has historically played a large role in creating HIV stigma and continues to play a role today. During the AIDS movement of the 1980s many, including government and church officials, judged those with HIV and AIDS, believing that sexual behaviors that contributed to spread the virus were immoral (How to Survive a Plague).  Homophobia prevents many from getting tested for HIV, has caused resistance to pre-exposure prophylaxis, a newer preventative medication for HIV and AIDS, and inhibits safe sex education efforts.  Gay and bisexual men often experience discrimination that causes higher rates of suicide, depression, and drug abuse.  Some lose support from their families after coming out to them which can make them economically disadvantaged, inhibiting their access to healthcare (Halkitis).  Though more people are becoming accepting of the gay and bisexual communities remnants of historic discrimination and homophobia are still evident today and affect these communities’ healthcare especially as a group that remains vulnerable for contracting HIV. 

The difficulty in treating HIV is also due to the biology of this disease.  Unlike other infectious diseases like COVID19 and influenza which are RNA viruses, HIV is a DNA based retrovirus that is less easily targeted by mRNA vaccines.  Specifically, HIV latency phase can prevent HIV from being easily detected.  An HIV positive individual can live for over a decade with latent HIV infection where the virus exists in the body at very low levels (Cure – Science of HIV).  They are still able to transmit HIV with a detectable viral load, but proper medication with antiretroviral therapies (ARTs) can allow a person to have an undetectable viral load that prevents the person from experiencing symptoms or being able to transmit the disease.  However, as a retrovirus, HIV integrates into the infected person’s DNA, so ARTs can prevent replication of HIV, but cannot eradicate HIV DNA from the host.  Thus, those at risk for contracting HIV must be regularly tested and positive individuals must monitor viral loads to understand their risk for developing AIDS and whether they can transmit the virus to others.  With respect to vaccine development, typical antibody neutralization of HIV is challenged by the virus’ ability to evolve and mutate rapidly to evade antibody mediated neutralization.  

As of now, there is no cure for HIV/AIDS.  Antiretroviral therapy (ART) is the most effective strategy to date for HIV management.  Since the start of the HIV/AIDS epidemic, nearly 24 different pharmacological agents have been approved for treating HIV and work by preventing viral replication.  In addition to ART, pre-exposure prophylaxis (PrEP) was approved in 2012 and is highly effective at preventing HIV infection.  Current work is aimed at developing a vaccine for HIV especially as mRNA vaccines have shown great promise for the COVID19 pandemic.  Moderna and the National Institute of Allergy and Infectious Diseases are currently testing mRNA based HIV vaccines in phase 1 trials.  Though initial data from these trials, an additional 5-10 years of trials must be conducted before these vaccines can become widely available (Vesper).   

Enacting an Effective Vaccination Campaign

Beyond overcoming biological challenges in developing an effective vaccine, combating systemic issues and likely opposition to HIV vaccination will be a major concern in disseminating the vaccine to the population.  First, HIV stigma, homophobia, and embarrassment  may prevent people from wanting to get vaccinated.  Many might think vaccination is not necessary for them because it is only common in the gay and bisexual communities, and if they do not identify with those communities they might be reluctant to get vaccinated.  Advocates for improved HIV/AIDS treatment development efforts suggest investing in community engagement and behavioral science to increase reception to vaccination.  With more people receptive to receiving vaccination the social risk a person takes in getting vaccinated decreases.  The COVID19 vaccination effort was wildly successful because public health officials and epidemiologists were able to generate excitement around getting vaccinated and brought millions of vaccines to people in a coordinated effort.  To obtain similar success with HIV vaccination, significant work would need to be done in educating the public about the benefits of vaccination and reducing stigma and perceived social risk surrounding vaccination.  In addition, ensuring that the public has access to vaccination is critical to ensuring success of an HIV vaccination campaign.  This could be accomplished by creating a public vaccination program for an HIV vaccine or by expanding insurance plans to cover an HIV vaccine.  A lack of a federal vaccination program would present challenges in ensuring vaccines reach uninsured people, especially as many at risk for HIV may not have strong health insurance.  A final consideration in bringing vaccination to the public is overcoming vaccine hesitancy.  A significant number of Americans have become wary of vaccines such that the WHO has identified hesitancy to vaccinate as a top ten global health threat.  Even if researchers and vaccine developers can overcome scientific barriers in developing an HIV vaccine, combating systemic issues and societal reluctance to vaccinate will be an equally challenging factor in the vaccine’s success (Bose).  

6 Surprising Things You May Not Know About HIV/AIDS Today | Johnson &  Johnson

Levine, Hallie. “6 Surprising Things You May Not Know About HIV/AIDS Today.” Content Lab U.S., 15 Mar. 2023,


Currently 1.2 million people in the United States have HIV and over 18,000 people died of HIV in 2020 alone (“HIV And AIDS Trends and U.S. Statistics Overview”).  The battle for effective therapies for HIV/AIDS has been ongoing for decades, and without better therapies, people will continue to suffer from this disease especially as climate change will increase opportunistic pathogens that contribute to deaths in the coming years.  As vaccination is one of the most effective ways to prevent death for most diseases, an HIV vaccine would significantly improve the status of HIV positive individuals (Ten Threats to Global Health in 2019).  

However, just developing the vaccine is not enough, and strategizing ways to vaccinate the public will be critical in the vaccine’s success.  With the existence of vaccine hesitancy among Americans, public health officials must properly educate Americans on HIV and the efficacy of the future vaccine.  Additional work must be done to de-stigmatize HIV/AIDS to increase reception to an HIV vaccine and increase the number of vaccinated individuals.  Education is incredibly powerful in helping Americans understand the severity and complexity of this epidemic.  In anticipation of a vaccine, advocates must continue the momentum begun in the 1980s in support of HIV/AIDS treatment and care.  


Arts, Eric J., and Daria J. Hazuda. “HIV-1 Antiretroviral Drug Therapy.” Cold Spring Harbor Perspectives in Medicine, vol. 2, no. 4, Cold Spring Harbor Laboratory Press, Apr. 2012, p. a007161.

Bose, Devi Leena. “Preparing Society for a HIV Vaccine.” Nature India, Nature Portfolio, May 2022,

Casadevall, Arturo. “Climate Change Brings the Specter of New Infectious Diseases.” Journal of Clinical Investigation, vol. 130, no. 2, American Society for Clinical Investigation, Feb. 2020, pp. 553–55.

Cure – Science of HIV.,detected%20by%20the%20immune%20system.

Epstein, Steven. “The Construction of Lay Expertise: AIDS Activism and the Forging of Credibility in the Reform of Clinical Trials.” Science, Technology, & Human Values, vol. 20, no. 4, 1993.

Halkitis, Perry N. “Discrimination and Homophobia Fuel the HIV Epidemic in Gay and Bisexual Men.”,

“HIV And AIDS Trends and U.S. Statistics Overview.”,

How to Survive a Plague. Directed by David France, Public Square Films, 2009.

Levine, Hallie. “6 Surprising Things You May Not Know About HIV/AIDS Today.” Content Lab U.S., 15 Mar. 2023,

“Symptoms of HIV and AIDS: What to Look For?”,

Ten Threats to Global Health in 2019.

Vesper, Inga. “Cautious Optimism for Trials of mRNA-based HIV Vaccine.” SciDev.Net, 30 Mar. 2022,

Stigma and Power Hierarchies in College Medical Care


For many college students, they are away from home for an extended period for the first time in their lives. Used to having their medical problems taken care of by their parents, this complicates seeking care for sicknesses at school. Many schools offer some form of a clinic on-campus, but these are commonly reported to be insufficient to take proper care of what students need. For many female students, especially those seeking reproductive care, it is difficult to seek care for an issue commonly characterized as taboo. As reported in class, women are more likely to see medical care, especially regarding to reproductive issues. At Notre Dame, issues like these become even more complicated as certain medical procedures are restricted due to the dominant Catholic views of the school. Seeking medical care alone as a young woman exposes patients to stigma and shame, allows women to feel ignored in their own experiences with their bodies, and reveals the impact that illness can have on overall lifestyle.

A typical college lecture hall filled with students. Sourced from Unsplash.

Personal Encounter with UHS

Note: I have changed the name of my friend who agreed to let me use this story for class to preserve her privacy.

My friend, Janie, experienced chronic urinary tract infections (UTIs) while at school at Notre Dame from an unknown cause. When she visited University Health Services (UHS) and her gynecologist at home, she experienced extreme judgement and stigma. The first thing her gynecologist asked her was whether she had a boyfriend (not her number of sexual partners, but whether she had a boyfriend) and when she said yes, they noted that in her chart as a piece of medical information. At her follow up appointments, her gynecologist asked about her boyfriend specifically, inquiring whether he was from home or school, how long they had been together, and other personal pieces of information.

Her gynecologist and UHS were ultimately unable to identify the root causes of what they diagnosed as chronic UTIs. Janie suffered four UTIs in four months as doctors from her hometown and Notre Dame refused to acknowledge that a bigger issue might be at play. They accused her of sleeping around and STDs contributing to her pain while refusing to give her antibiotics that would alleviate her pain or evaluate her for a more serious, long-lasting condition.

They made me feel as though my pain was not worthy of serious consideration, that I must be making it up for attention.

Janie on her experiences with medical professionals at University Health Services in Notre Dame

The condition became drawn out over four months, and it greatly impacted Janie’s quality of life. She was in extreme pain and often had to leave class during lecture due to pain. It eventually got to the point that she was unable to walk back from a class building to her dorm (a 15 minute walk). When she called UHS desperately requesting an appointment and reporting symptoms of kidney stones, the nurse told her that there was nothing she could do to get her an appointment in the next week and remarked, “if you were my daughter and in this much pain, I would send you to the ER.” With no car and nobody to take her to the ER, Janie took 3 Advils and tried to take a nap. She woke up to find herself in some relief (after months of agony) and her gynecologist from home later confirmed that she must have passed the kidney stones unaided by medicine.

Stock photo of a patient holding unmarked pills. Sourced from Pexels.

Reading Janie’s story alongside the texts from the course reveals three themes from this module. She experiences stigma and judgement about her character from her medical condition, encounters the power dynamics which dictate access to medicine for a college-aged girl by herself, and is confronted with the reality of illness and how it affects life outside of the medical realm.

Stigma in the Medical Sphere

Janie experienced stigma and shame from medical professionals because she was a college-aged woman seeking healthcare by herself for a UTI. There is a medical link between UTIs and sex, as anything that allows bacteria to enter the urinary tract can increase the risk of UTIs. Janie faced extreme judgement for her condition because medical professionals who were supposed to be caring for her often assumed that it was her fault that she was experiencing pain, and she deserved it because of her promiscuity. As discussed in Chapter 10 of Kleinman’s Illness Narratives, stigma often has religious ties, and “the afflicted person is viewed as sinful or evil…or [can be associated with] a moral connotation of weakness and dishonor” (Kleinman, 2020). It’s very likely that Notre Dame’s status as a Catholic University influenced the training that UHS employees get and affects the way that they interact with patients for conditions that may be related to premarital sex. When Janie experienced the medical professionals’ reaction to her health condition, she felt silenced and judged, just as patients in Kleinman’s book reported feeling.

Power Hierarchies Affecting Care

When Janie called and requested an appointment after reporting severe symptoms, UHS repeatedly told her that they were unable to fit her in. One nurse even told her that she would tell her own daughter to “just go to the ER.” And when Janie reported to the UHS nurse on the phone that she was experiencing extreme pain (7-8 out of 10), the nurse seemed skeptical, asking “really? There’s no way.” When she told the professionals that she thought she may have a kidney stone, reporting typical symptoms like proteinuria and radiating pain from her back down her hip, she was shut down and told that it was probably just another UTI. Similarly, Nelson writes that the communities served by the Black Panthers’ free clinics often described experiences where when “the resident…comes in to check up on [you, he]…talks to you as though you weren’t there” (Nelson, 2013). Because the medical professionals at the top of the power hierarchy did not view those communities as worthy of knowledge, the medical information was weaponized as it was withheld. Janie was also not treated as capable of understanding her own body, denied explanations of why doctors would not treat her for kidney stones and why her symptoms did not qualify. Just as the gay community protesting for AIDS treatments found themselves having to prove themselves credible in order to engage in healthcare discussions over their own care, Janie did not seem intelligent or credible enough as a young woman to be granted agency in her own care (Epstein 2020).

Stock photo showing a doctor explaining something to a patient. Sourced from Pexels.

Impact of Illness on Lifestyle

When Janie was chronically ill for four months, her illness affected more than just her physical health. It impacted her academics, mental health, and relationships with her friends and partner. In Chapter One of Illness Narratives, Kleinman acknowledges the far-reaching impacts of “illness,” defining it as “how the sick person and the members of the…social network perceive, live with, and respond to symptoms and disability” (Kleinman, 2020). Because she was in such severe pain and was denied medication, she had to leave class during lecture for long periods of time and fell behind on schoolwork. She was also unable to exercise, affecting her mental health. Kleinman details the effect of chronic illness on Alice Alcott, who experiences emotional reactions to her medical condition that affect the rest of her life. He explains that the work of the healer is also to deal with emotional consequences that may come from conditions and treatments (Kleinman, 2020). When Janie’s doctor refused to address her feelings of pain or her concern that it may be a more serious cause, she neglected this duty.


Epstein, S. (1995). The construction of lay expertise: AIDS activism and the forging of credibility in the reform of clinical trials. Science, Technology, & Human Values, 20(4), 408–437.

Kleinman, A. (2020). The meaning of symptoms and disorders. In The illness narratives: Suffering, healing, and the human condition (pp. 3–30). essay, Basic Books.

Kleinman, A. (2020). The personal and social meanings of illness. In The illness narratives: Suffering, healing, and the human condition (pp. 31–56). essay, Basic Books.

Kleinman, A. (2020). The Stigma and Shame of Illness. In The illness narratives: Suffering, healing, and the human condition (pp. 169–180). essay, Basic Books.

Nelson, A. (2013). The People’s Free Medical Clinic. In Body and soul: The black panther party and the fight against medical discrimination (pp. 75–114). essay, University of Minnesota Press.

Society’s Meaning of Sickness and its Toll on the Sick

The Cost of Illness

Illness comes with overwhelming amounts of pain, symptoms, trauma, and costs. These emotions consist of negative feelings such as guilt, frustration, apathy, hopelessness, anxiety, loneliness, denial, grief, and disempowerment. Healthcare and treatment costs are at an all time high, leaving behind concerning levels of debt and a lack of affordability for those who need help most. Symptoms and effects of illnesses are not always properly understood; therefore, it is not always known how to treat them. The list of the struggles for the sick person goes on and on. All of these factors shape individuals’ experiences and therefore shape their livelihoods. However, there are other factors that end up placing an additional burden on the sick. Each sick individual’s immediate communities as well as their social environments work hand in hand to affect their personal interpretation of their illnesses through defining them with stigmas, utilizing the ideology of health, and pushing for the creation of controlling health practices. 

First, I will elaborate on how our healthcare system and the society we live in create and place powerful stigmas on the sick, utilize the ideology of health to form systems of beliefs, and misuse their power to control society. Then, I will detail the numerous mental and emotional effects these factors leave on the sick. I will conclude by discussing possible solutions to these issues, specifically focusing on how physicians can better their care of those who are ill.

The Social Meaning of Sickness

Every sick individual has their own unique personal human experience of their symptoms and their suffering. However, both their immediate community as well as their social one adds an additional burden and an additional dimension of suffering they are forced to deal with through stigmas, ideologies, and methods of control.

“Acting like a sponge, illness soaks up personal and social significance from the world of the sick person.”

Kleinman Arthur, Illness Narratives, 2017.

The Power of Stigmas

Stigma is defined by Goffman as discredited attributes that are clearly visible and identifiable, marking patients with disgrace and shame, spoiling their identity, and creating an internalized feeling of being inferior and less than (Goffman 2022). They become defined as straying away from the “normal” status quo as their health is altered in some way, leading to them becoming “disqualified from full social acceptance” (Goffman 2022). My younger cousin is incredibly intelligent, most likely the smartest person I know at the young age of 14. He excels in school, rapidly spits out definitions of complex vocabulary terms, easily explains difficult concepts, and is incredibly quirky with his random comments and daily quotes. His personality and knowledge astounds me everyday. However, he is looked at differently because of his disability. He was diagnosed with autism at a very early age. This has led to him getting degraded and picked on by peers, labeled and placed in a box by educational professionals, and defined by healthcare workers. They all base their understanding of who he is on his differences. “The stigmatized person is defined as an alien other…whose persona…the group regards as opposite to ones it values. In this sense the stigma helps to define the social identity of the group” (Goffman 2022). My cousin is a prime example of an individual who is labeled as “other” by people in society and people in positions of power. 

Ideologies and Their Effects

Ideology is philosophical. It is symbolic and it is practical. It is a system of beliefs shared by a certain group in an effort to shape action, succeeding by covering up patterns of dominance, power, and inequality (Crawford 2006). Ideology becomes acceptable to us. Crawford argues that health itself is an ideology that is powerful and effective as a form of social control as it succeeds in pushing us to participate in certain behaviors and consume certain goods (Crawford 2006). It works to replace the concern for a mutual obligation with a sense of tackling sickness with an individual responsibility for health. In the film “How to Survive a Plague” on the AIDS epidemic, those suffering with AIDS were held to the personal responsibility of fighting for themselves, doing their own research, finding their own drugs and treatment, and using their own voices to protest and stand up against lawmakers and pharmaceutical companies (France 2012). It was clear that those in power were not prioritizing the issue, owning up to their responsibilities of protecting the health of citizens, or assisting those who were suffering incredibly.

AIDS activists protesting for proper treatment, medication, and other rights for victims

Establishment of Control Using Health

In addition to stigmas placed on people and the ideology of health affecting quality of care, the sick person battles differing forms of social and moral control. Medicine and health have become a form of authority that is not often questioned. There is a control over technology and jurisdiction over what is considered to be a good life. There is this idea that there is a rational and objective way to maintain healthy lifestyles and deal with certain illnesses in a way that is deemed “right.” When there is any attempt to step away and do anything in a different way, they are looked down upon and defined as resisting the correct way to heal. This takes an additional step towards labeling people. We become defined as being sick, dysfunctional, or needing medical intervention, leading to healthism where there is no upper limit of health, wellness, and fitness. There is always more you can do to remain healthy or heal. Sick people are pressured to answer two main questions of “why me” and “what can be done.” Without the answer to these questions, they may feel that they have failed, not dealt with their illness in the “correct” way, and deserve to be ill or that it is in some way their fault.

All in all, health practices act as a way to control, hack, and exploit the sick without having to force or coerce them as the effectiveness of social control removes the need for central or government power. A prime example of this is the overwhelming presence of wellness programs from gyms in work offices to the promotion of cycling classes and pilates. These work to create a more productive workforce, reduce liability through providing resources for healthy lifestyles, and attract more employees with the appearance of benefits (Winant 2018). Winant highlights Ehrenreich’s observance of the “fixation on controlling the body encouraged by cynical and self-interested professionals in the name of wellness” and how self care has become “a coercive and exploitative obligation [with] endless medical tests, drugs, wellness practices, and exercise fads that threaten to become the point of life” (Winant 2018).

Moving Forward: Recommendations for Clinicians

So how do we move forward from here? What steps can we take to better treat and care for the sick in a way that respects their dignity and right to fair care and treatment? We must ask ourselves how we can provide the utmost compassion and most effective care and treatment. It starts with those in power and those who interact most closely with the sick. This means physicians must take the first step. In this way, we can work to tackle the many issues that exist and thrive in our societies, hospitals, schools, and even homes.

Kleiman has offered some incredible advice for how we can take steps to achieve this through affirmation, listening, and offering empathy and compassion. He stresses that clinicians should work to affirm both the patients and their family members’ experience with a certain illness as constituted by lay explanatory models (Kleinman 2017). He also highlights the need for empathetic witnessing, which is listening (with care and intention) to what he calls the sick person’s persona myth or the story that they tell in an attempt to make sense of their illness (Kleinman 2017. We must also listen to their and their families fears and the trials and tribulations they face while mirroring these stories back to the patients in order to assist these patients in constructing these narratives (Kleinman 2017. I love these pieces of advice because in my opinion, one of the most important aspects of caring for an individual and bettering their health is forming proper relationships with them, relationships with total and complete care, fair equal dynamics, and dignity for the sick. Compassion and the feeling of being heard and understood is so important as those that are sick often face the experience of not having their voices heard, being constantly invalidated for their pain and emotions, and having their personal experiences be overlooked.


  1. Crawford, Robert. “Health as a Meaningful Social Practice.” Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, vol. 10, no. 4, 2006, pp. 401–420., 
  2. France, David, director. 2012. How to Survive a Plague. Sundance Selects. 109 min.
  3. GOFFMAN, ERVING. Stigma: Notes on the Management of Spoiled Identity. PENGUIN BOOKS, 2022.
  4. Kleinman, Arthur. “The Illness Narratives.” Academic Medicine, vol. 92, no. 10, 2017, p. 1406., 
  5. Winant, Gabriel. “A Radical Critique of Wellness Culture.” The New Republic, 23 May 2018, 

The Toxic Culture of Health & Medicine: The Calvin Ridley Story

Calving Ridley is an All-Pro wide receiver in the NFL. However, his prosperous young career was disrupted this past season when he was banned from the NFL for gambling on his own team, the Atlanta Falcons, to win. He made a mistake and he owns up to it. However, just recently he shared his personal story which provides a lot more insight into what he was going through at the time. In diving deeper into his career and experiences, he highlights a handful of ways in which the culture of health and medicine within the NFL had failed him and led him down an extremely dark path. A team trainer contested and ignored Ridley’s broken foot. Then, Ridley reflects on his personal experience surrounding the passive medicalization of painkillers in the NFL. Finally, we see a more complete picture as Ridley expands upon the social impacts and stigmas around mental health as an athlete.

“Nah, bro, this is different. My shit broke.”

Calvin Ridley on pain in his foot to teammate Julio Jones5

Contesting Broken Bones

Ridley begins his story talking about his early career in the NFL. During his first two years, he played through bone spurs with the help of painkillers. He was performing at an extremely high level despite the pain. Then came the 2020 season, and after a Week 8 game against Carolina, Ridley’s pain level was at an all-time high. Feeling that there was something seriously wrong, he went to the team trainer and got an MRI. The trainer said it was just a bone bruise. Feeling that this was an injury and pain that he could manage, Ridley finished out the season posting career high numbers in receiving yards and touchdowns. However, his team was not performing as well and finished the season 4-12 resulting in a complete staff overhaul. When the new trainer came in, Ridley was sent to a specialist who within the first hour of the examination admitted to Ridley, “Your foot is definitely broken.”5

Broken bones are usually not a contested illness or condition, but in this case it was. While each scenario exemplifies key differences, Calvin Ridley’s injury reflects a lot of similarities to others who deal with contested illnesses. One example of such a condition includes Chronic Fatigue Syndrome. Patients experience incapacitating physical and mental fatigue, but due to the abstract nature and complexity of symptoms and indicators, this condition has historically been highly contested.6 Just like Ridley, these patients know there is something more serious going on even though doctors assure them that they are fine. This often leads to false diagnoses along with excessive, unnecessary, and often ineffective treatments. 

“I’m a football player. I know what we get paid for, you feel me?”

Calvin Ridley on taking Toreador shots every Sunday5

Passive Medicalization of Toradol in the NFL

In Ridley’s case, he was experiencing a ton of pain but persisted on playing through his “bone bruise.” In order to accomplish this goal, he took Toradol every Sunday to ensure that he could play with minimal pain and continue to perform at a high level. Now, Toradol is a drug, often injected, used for quick-acting pain relief. However, it is not supposed to be taken frequently due to high risk of side effects.3 Nevertheless, it was allowed and normalized because of the culture of the NFL and the expectations of its athletes. 

There are several parallels between the use of Toradol and the passive medicalization of Viagra. Similar to the societal expectations we place on athletes, the culture norms of masculinity contribute to the negative feelings that emanate from erectile dysfunction.1 Social factors such as insecurity stigmas around men’s health explain the high demand of Viagra. Men will often opt to take the pill for the quick fix rather than feeling the embarrassment of actually addressing the root causes of their ED. Thus, Viagra users eliminate the possibility of seeking counseling or any other solutions that would more effectively help and potentially solve their condition long term.

“My daughter don’t care. She’s two years old, and she’s running straight up to me, “Dadddyyyyyy!!!” She’s wanting to bake some cookies in the Fisher-Price oven, you know? But I’m coming home broken. I can’t even do anything but lie around in a dark room.”

Calvin Ridley on mental health issues off the field5

Social Impacts and Stigma around Mental Health as an Athlete

As Arthur Kleinman highlights, it is often not until detailed context of a lengthy case is revealed that we can come to fully understand and experience the social meaning and impact of illness.2 As Ridley continued with his struggles with injury, he explains that “after practice, once that painkiller wears off, you still have to come home and be a husband and a father.”5 The social structure of a patient’s life is an integral part of their inner experience and is an aspect of healthcare that is important and necessary but is often ignored. In Ridley’s case, he had a daughter, a wife, teammates, coaches, and even a whole city that were counting on him in one way or another, and the last thing he wanted to do was let anybody down. 

However, the pressure of these expectations compounded with his injury struggles is where the anxiety began. Ridley knew something was off but could not let anybody down, so he just stuck to pills, shots, and gritting it out. This really speaks to the stigma around men’s health, specifically the male athlete.4 There is often a feeling of expectation that men should deal with their problems on their own, and athletes especially are taught to just tough it out. Eventually, Ridley realized that his mental health issues were getting to be too much, and he decided to step away from football to seek help. Even then, there were people in the building that were supportive, Ridley recalls other people looking at him like, “You good, bro.”

Official Statement by the Atlanta Falcons after Calvin Ridley’s suspension4

Depression, Shame, and Recovery

Ridley recalls his time away from the game as major low in his life. He was extremely depressed, did not know what to do or where to go, and was just trying to get through each day. He hit rock bottom when the gambling scandal became public.

“Whenever people ask, ‘What were you thinking?’ The only answer I can give is, ‘I wasn’t.'” 

Calvin Ridley on responding to criticism relating to his gambling scandal5

Ridley eventually sought real help and contacted a therapist. He finally was able to learn more about what he was going through as well as how to cope with the emotions he was feeling. Throughout his story he recognizes and owns his mistakes but also reveals more of the background on what led him to that moment. It is not all his fault and much of what occurred can be attributed to a broken system that has much room to grow in how physical and mental health is handled. 


1Carpiano, Richard M. “Passive Medicalization: The Case of Viagra and Erectile Dysfunction.” Sociological Spectrum, vol. 21, no. 3, 2001, pp. 441–450., 

2Kleinman, Arthur. “The Illness Narratives: Suffering, Healing, and the Human Condition.” Academic Medicine, vol. 92, no. 10, 2017, p. 1406., 

3Murdock, Joshua. “Toradol (Ketorolac): Pros and Cons of This NSAID Pain Reliever – Goodrx.” GoodRx Health, 7 Oct. 2021, 

4“Official Website of the Atlanta Falcons Football Club.” Falcons Home, 

5Ridley, Calvin. “A Letter to the Game: By Calvin Ridley.” The Players’ Tribune, The Players’ Tribune, 8 Mar. 2023, 

6Walker, Jacob. “Researching Contested Illnesses: The Case of Chronic Fatigue Syndrome (CFS).” In-Training, 28 Feb. 2016, 

Family Caregivers and What They Tell Us About the American Healthcare System

According to Vox, nearly 48 million Americans provide some form of informal care to an adult with either physical or mental health needs. My mother happens to be one of these people. She takes care of her mother–my grandmother–who has Alzheimer’s, and who is also physically unable to take care of herself. Family caregivers, like my mother, play a critical role in providing care and support to individuals who are unable to take care of themselves due to age, illness, or physical or mental disability. A challenge that many family caregivers have faced since the Covid-19 pandemic is the inability to take off work to be able to care for their loved ones, which puts caregivers in an unfair situation–to either provide less care or lose their job. Because of the time and extensive care that many older patients require, the commitment for family caregivers is immense. Fortunately enough, my mother happens to be one of the lucky ones.

Source: National Alliance for Caregiving (NAC)

According to the KFF reading, many family caregiving responsibilities (both before and after the pandemic) largely fall on women. More than one in ten women report they were caring for a family member who needed special assistance prior to the pandemic, and over one in ten women also report that they have new caregiving responsibilities as a result of the pandemic. As I think about my parents, my mother happens to have an older mother than my dad’s mother (she’s 84), so it makes sense that she is the one that has caregiving responsibilities. Thankfully, my dad’s mother is only 63 and father only 67 (both in very good physical shape), so I don’t foresee my dad having to take on the role of caregiver anytime soon. However, the findings about gender differences in caregiving was striking to me nonetheless. 

Source: Unsplash

Since 2020, my mother has worked from home and our family relocated cities from New York City to Milwaukee, WI. Now, my mother is a short drive from the facility that my grandmother currently lives in. She is able to see her everyday and is constantly checking in on her, bringing her meals, and taking her to doctor’s appointments. However, she is not paid or compensated for the time, money, and care that she pours into my grandmother. My mother would do what she does whether she was paid or not, however it does significantly affect her everyday life. This kind of constant care can take a significant toll on caregivers’ physical, emotional, and mental health. Specifically, as my grandmother’s Alzheimer’s has progressed, my mom has experienced increased feelings of sadness, anxiety, and hopelessness when she visits my grandmother.

Source: MDPI

These kinds of feelings are common among caregivers and exposes the flaws in the American healthcare system that do not provide family caregivers with the proper help, resources, or money that they need to not only take care of their loved ones, but to take care of themselves in the process too. The lack of proper healthcare services and resources in the United States places a significant burden on family caregivers, who may struggle to provide the care that their loved ones need while also maintaining their own physical and mental health and well-being. Addressing these issues will require a comprehensive approach that addresses the systemic economic, social, and cultural barriers to accessing proper healthcare services and resources.

Source: Atlas

A topic that we did not discuss too much in depth in class, but directly relates to the healthcare system, unpaid family caregivers, and the inequalities that are exacerbated, is long-term care insurance. Privatized long-term care insurance is something that my grandmother was afforded after being a public school teacher in Wisconsin for nearly fifty years. In the 1960s, my grandmother and other teachers like her were not paid well, however in return she was provided with great health insurance, life insurance, and dental insurance. Even though the insurance at the time was great, because healthcare costs for the elderly in the United States have skyrocketed tremendously, her insurance only covers about half of her facility bill, which is $7,000 a month for a single room. My grandmother has recently moved into a shared room with another woman, with the cost being $3,000 less, so the insurance covers the entirety of the bill now. However, the cost for the facility that my grandmother lives in is still too steep for most Americans to pay, leaving them no option but to place their elderly loved ones into nursing homes–instead of homes with more comprehensive, tailored care such as assisted living or memory care facilities.

Source: McKnights Senior Living

The American healthcare system does not prioritize or protect its elderly population. One of the main issues is the high cost of healthcare, which is often unaffordable for those aged 65 and older that are living off of fixed incomes. Many elderly patients also struggle to access quality care because of their inability to be mobile. There is a significant lack of attention on preventative care for seniors, which can lead to more serious health issues down the line, as well as frequent instances of medical errors and misdiagnoses that can have devastating consequences for elderly patients. Reforms are needed in the American healthcare system to protect our elderly population. This could include policies that expand access to affordable care for seniors, provide more comprehensive coverage for preventative care, and implement stronger safeguards to prevent medical errors. Protecting the elderly is so important because they are a vulnerable group at higher risks for health issue, financial insecurity, and social isolation. They have contributed to the inner workings of society for decades, and deserve to be treated care. Their health and well-being is crucial for the overall functioning of society.


Alzheimer’s Association. (2022). What is Alzheimer’s Disease? Retrieved March 27, 2023, from


Breijyeah, Z and Karaman, R. (2020). Comprehensive Review on Alzheimer’s Disease: Causes and Treatment. DMPI. Retrieved March 27, 2023, from

CAP. (2014). Reforms to Help Meet the Growing Demand for Long-Term Care Services. CAP. Retrieved March 27,2023, from

Courage, H. (2021, August 4). America isn’t taking care of caregivers. Vox. Retrieved March 27, 2023, from

Meadowmere and Mitchell Manor Oak Creek. (2023). Memory Care in Oak Creek, WI. Retrieved March 27, 2023, from

NAC. (2020). Caregiving in the U.S. NAC. Retrieved March 27, 2023, from

Ranji, U. et al. (2021). Women, Work, and Family During COVID-19: Findings from the KFF Women’s Health Survey. KFF. Retrieved March 27, 2023, from

Rothschild, P. (2021). Supporting unpaid caregivers in crisis: A talk with Alexandra Drane. Mckinsey. Retrieved March 27, 2023, from


Medicalization of Childbirth: Where We Stand and How We Can Improve

When I ask my mom about my birth story, she immediately winces and says it was the “happiest day of her life.” I always thought it was because as a young mom, birth is a foreign and frightening experience, but as I get older, the more I realize that birth should actually be one of the best days of one’s life and not frightening at all.

Childbirth is one of the most miraculous and profound moments in a woman’s life. It can be a beautiful and challenging experience for the mother and her family, especially when considering its implications for physical and psychological well-being. But, what has transformed this unique event into a terrifying experience, where doctors, hospitals, and medical intervention predominate? This question has led to the development of the medicalization of childbirth, which entails using medical interventions in a process that was initially natural.

Medicalization of childbirth refers to the medical approach to the labor process, from prenatal care to delivery. This practice focuses on the use of medical interventions and techniques aimed at reducing the time of delivery while making it more efficient and safe. While medical interventions have become useful in preventing maternal and infant mortality in the developed world, there are concerns that this approach has led to overmedicalization, where unnecessary and invasive procedures are carried out, and women become passive in the decision-making process.

How did we get here?

Medical Interventions

Medicalization of childbirth is responsible for introducing various medical interventions that aim to make the process more efficient and safer. A significant number of women receive interventions such as induction, epidurals, and c-sections, even when they didn’t want or need them.  While these techniques have been helpful in reducing maternal and infant mortality rates, their overuse has led to the introduction of unnecessary procedures that can cause harm to the mother and the child. For instance, cesarean sections, which involve surgical delivery, are associated with higher risks of bleeding, infection, and other complications.

32.1% of births in the United States are vis c-sections, while the c-section rate recommended by the World Health Organization (WHO) states that “rates higher than 10% are not associated with reductions in maternal and newborn mortality rates.

Besides, high rates of cesarean sections have been associated with reduced successful vaginal birth after cesarean (VBAC) birth, which can lead to more medical interventions during childbirth.

There is a common misconception that once a mother undergoes a c-section, their following births will also be via c-section, however, 60%- 80% of women who had a c-section have had a successful subsequent vaginal birth.


When I asked my mom if there was any reason why she chose the hospital she did, she said it was because this was the “safest” option. Childbirth has become a largely institutional affair, with hospitals and other medical facilities playing a dominant role.

“The achievement of well-being was rapidly becoming a private matter, won by individual effort, professional advice, and consumer products rather than participation in social life.”

“Health as a Meaningful Practice”

Given that they provide medical equipment and expertise, these facilities are seen as safer and more efficient than home births. While hospitalization has reduced mortality rates during childbirth, it has contributed to increased use of medical interventions, leading to more perineal and episiotomy surgeries, induction of labor, and interventions such as forceps, among others. These interventions can be unnecessary, and they may reduce the natural potential of the birthing process.

“It’s an accepted way of having a baby, but it’s not the way that your body is built to have a baby. So all of a sudden there are knives and there’s pulling and you feel like this shaking and it’s sort of a weird, surreal experience.”

“I felt like I was left on my own”: A mixed-methods analysis of maternal experiences of cesarean birth and mental distress in the United States
Image Source: Getty Images
Loss of autonomy

Medicalization of childbirth has led to the loss of autonomy for women in determining their birth plans. Owing to institutionalization, childbirth has become more medicalized, which means women have limited options and are more likely to follow the recommended medical interventions. This is particularly true for first-time mothers who might not be informed about their birthing alternatives. Mothers should have the right to choose their birth plan, including the type of medical intervention to be used, or if they undergo a Caesarean section. They also should be informed about the potential risks and benefits of each choice. Even when mothers raise concerns about their own bodies, there is still suspicion as medical training practitioners have been trained to draw suspicion of patients’ narratives .

“They said, ‘You can either leave against AMA [Against Medical Advice],’ or whatever, ‘or you can get a c-section,’ and so that was really traumatic for me.”

“I felt like I was left on my own”: A mixed-methods analysis of maternal experiences of cesarean birth and mental distress in the United States

Where do we go from here?

Medical advancements have led to the development of methods that improve the safety and efficiency of childbirth. However, it is clear that overmedicalization has led to unnecessary procedures and interventions, which can increase complications and side effects. Medicalization of childbirth has contributed to the overuse of interventions, institutionalization of childbirth, and reduced autonomy for mothers. Rights such as choice of birth plan and not losing the wisdom and traditional methods of midwifery should be respected to maintain that natural balance that birth should be.  Therefore, we should consider interventions and institutionalization as an aid, not the central approach to childbirth. We must consider medicine’s relationship with social control—where medicalization is one of the key strategies employed by medical institutions to control social norms, behavior, and the functioning of society. By finding a balance between the medicalized and non-medicalized approaches, we can ensure that childbirth remains an empowering experience for women. Babies are best brought in with love and support, and a medicalized process should not compromise their natural moment.

Source: Getty Images

Works Cited

  • Crawford, R. (2006). Health as a meaningful social practice. Health:, 10(4), 401-420.
  • Kleinman, A. (2020). The Meaning of Symptoms and Disorders. In The Illness Narratives: Suffering, Healing, And The Human Condition (pp. 3-30). Basic Books.
  • FastStats – Births – Method of Delivery. (n.d.). CDC. Retrieved March 27, 2023, from
  • Infographic: The Overmedicalization of Childbirth. (2018, September 12). California Health Care Foundation. Retrieved March 27, 2023, from
  • Maternal Mortality in the United States: A Primer. (2020, December 16). Commonwealth Fund. Retrieved March 27, 2023, from
  • Scott, J. R. (n.d.). Vaginal birth after cesarean delivery: a common-sense approach. PubMed. Retrieved March 27, 2023, from
  • Sega, A., Cozart, A., Cruz, A. O., & Reyes‐Foster, B. (2021). “I felt like I was left on my own”: A mixed‐methods analysis of maternal experiences of cesarean birth and mental distress in the United States. Birth, 48(3), 319-327.
  • Vaginal Birth After Cesarean (VBAC): Facts, Safety & Risks. (2021, August 23). Cleveland Clinic. Retrieved March 27, 2023, from
  • WHO Statement on Caesarean Section Rates. (n.d.). World Health Organization (WHO). Retrieved March 27, 2023, from
  • Zola, I. K. (1972). Medicine as an institution of social control. The sociological review, 20(4), 487-504.

HIV/AIDS: A Highly Stigmatized Illness With the Capacity to Define a Person

In a society where being healthy is a high standard that people strive to attain, it can be very detrimental to a person when they are diagnosed with an illness that has no cure. The society we live in today has always been very individualistic in the sense that people are expected to become healthy and return to doing what they have been doing before they became sick. There is an idea that people who become sick could have avoided it by changing their lifestyle and habits. In this society, having any illness would make one feel like a burden, feel guilty, or have a sense of uselessness. Sadly, we live in a society where people with these illnesses are not treated with respect. As someone with a great family friend that was diagnosed with HIV, it can be heartbreaking to see the many ways that this diagnosis interferes with their self-image and life. As someone who also has hopes of going to medical school and becoming a doctor, the way that shame and disease can impact people is something that I want to keep in mind to provide patients with the best care. I hope to talk about the background of HIV/AIDS, the negative experience of people with illnesses and diseases, the impact of stigma and shame, and disparities in this disease that causes people with it to be an easy target for discrimination along with ways that physicians can slightly improve the experience. 

HIV/AIDS Background

HIV (human immunodeficiency virus) is a virus that attacks cells that help with fighting infections in the human body (“What Are..”). HIV can be contracted by having contact with bodily fluids such as sharing injection drug equipment along with unprotected sex. Leaving HIV untreated leads to AIDS which is acquired immunodeficiency syndrome (“What Are..”). Although there is no final cure for HIV, people can take antiretroviral medications that are used to treat it, helping people live longer lives (“HIV and..”). Although there are many ways to contract HIV/AIDS, with the most common being drug equipment and unprotected sex, casually interacting with people does not put you at risk which is what makes the discrimination people with HIV/AIDS face very disconcerting 


Experience of Illness: Stigma and Shame

My family friend with HIV/AIDS has mentioned to me many times that his friends would stop reaching out to him once they found out he had it and would describe how doctors would keep their distance from him. Illness can be defined by the human experience of having to live with the symptoms of pain and suffering. The definition of illness and disease is summed up well in Illness Narratives. Since illness is an experience one has to go through, people can become demoralized, lose hope, or feel as if they are a burden to the people that are taking care of them (Kleinman, 1988, Chapter 1). Disease refers to the problem from the physician’s perspective meaning the experience of one who lives with the illness is not taken into account. There is great danger in not considering the lived experience of a person with a disease and the many obstacles they encounter. HIV/AIDS is viewed as a major threat to the major values of American society. In today’s society, people with AIDS are blamed for their “promiscuous sexual practices” (Kleinman, 1988, Chapter 1). AIDS in a way brands the person with the idea that they deserved it for the way that they were acting (Kleinman, 1988, Chapter 1). 

In the case of Horacio Grippa, he not only had to deal with the symptoms that HIV/AIDS had on his body but also the way that he was treated because of it. His illness defined him in a way that got him kicked out of his apartment and made him lose his job as a teacher. He also mentioned how his nurses seemed scared to come close to him and how the doctors he would encounter would wear masks and gloves (Kleinman, 1988, Chapter 10). As a person who wants to become a doctor someday and knows someone with HIV/AIDS, reading this was emotionally taxing. For a patient, seeing a doctor should be a relief and someone that they can count on. The fact that some patients are still discriminated against because of having HIV/AIDS is truly concerning. When I become a doctor, I would hope to treat everyone with respect and make them feel safe and welcome because they already come to see you in a very vulnerable position. 

Disparities with HIV/AIDS that Lead to Easy Targets of Shame Along With Ways of Improving as a Medical Provider 

In the early stages of HIV/AIDS, the predominantly affected were homosexual and bisexual men since they made up 63% of AIDS-reported cases (Bosh et. al). In 1986, the CDC began to report the disproportionate effect that HIV/AIDS was having on African Americans and Latinos (“A Timeline”). The prevalence rate of HIV for African Americans is nearly eight times greater than for white people and three times higher than for Latinos (Geary). These statistics show that HIV/AIDS is common in minority communities that are already great targets for discrimination and shame. This can also make it easier to categorize a group of people and make them feel responsible for the high prevalence rates of HIV/AIDS.

Source: CDC Fact Sheet  Today’s HIV/AIDS Epidemic, 2016

There are many ways of improving the experience that patients encounter, especially when it relates to stigma and shame. As people that work in a clinic or are doctors, one can be understanding of the challenges that patients have such as obstacles that could cause them to need more time to make it to appointments in the example of using a wheelchair. Doctors must overcome certain biases that they are taught and always listen to their patients by not disregarding the symptoms that they are having. There must also be a reconceptualization of medical care where the physician shows empathy and takes the patient seriously. Although this will not solve all the problems and biases experienced by the patient, it would be the first major step in making them feel heard and important (Kleinman, 1988, Chapter 2).


“A Timeline of HIV and AIDS.”,  

Bosh, KA, Hall, HI, Eastham, L, Daskalakis, D.C., Mermin, J.H. Estimated Annual Number of HIV Infections–United States, 1981-2019. MMWR Morb Wkly Rep. 2021 Jun 4;70(22):801-806. Doi 10.15585/mmwr.mm702a1. PMID: 34081686; PMCID: PMC8174674.

​​“CDC Fact Sheet: Today’s HIV/AIDS Epidemic.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Aug. 2016,

Geary, Adam A. Antiblack Racism and the AIDS Epidemic State Intimacies. Palgrave Macmillan, 2014. Accessed October 8 2022.

“HIV and AIDS: The Basics.” National Institutes of Health, U.S. Department of Health and Human Services,

Kleinman, Arthur. The illness narratives: Suffering, healing, and the human condition. Basic Books, 2020.

“What Are HIV and AIDS?”,