Abstract
Marginalized communities are at an inherent disadvantage in the American healthcare system, as language and cultural barriers decrease accessibility and diseases affecting these populations are historically understudied. Therefore, this research portfolio aims to promote equity and inclusion in healthcare by improving treatment options for marginalized communities. Specifically, the technical project aims to characterize the relationship between the enhanced susceptibility to toxoplasmosis, a common parasitic infection, and Inflammatory Bowel Disease. The STS component investigates the effect of the language barrier in the prehospital setting, and then later proposes a multifaceted solution to overcome the problem. While completely eradicating healthcare disparities is out of the scope of this portfolio, the solutions proposed by the tightly coupled STS and technical topics demonstrate viable mechanisms to increase accessibility, inclusion, and equity in healthcare.
The technical component provides a framework to better understand the relationship between Inflammatory Bowel Disease and toxoplasmosis to potentially elucidate more effective treatment options. It is currently unknown whether the unusual shape of the gut outer cells causes the enhanced susceptibility to toxoplasmosis, or whether toxoplasmosis alters the shape of the cells. A poor understanding of this causal relationship has resulted in ineffective treatment options for these patients, thus further contributing to the disparities in healthcare. However, before research could be conducted on this puzzling relationship, a more accurate laboratory setup was required.
The current laboratory setup for experimentation consisted of an environmental chamber filled with holes and haphazardly patched with duct tape. It was impossible for experiments to accurately replicate the physiological conditions in the body, and thus the validity of the results was questionable. Therefore, we designed an updated environmental chamber that was fabricated via a combination of laser cutting and 3D printing in order to more accurately replicate physiological conditions. Furthermore, after the School of Medicine granted us permission to access the lab spaces, we conducted preliminary experimentation to investigate how cells respond to the motions in the gut.
The STS research aimed to investigate ways to increase equity in healthcare through a different lens - by devising ways to overcome the language barrier in the prehospital setting. The language barrier can have devastating effects on low English proficiency patients, resulting in premature deaths, unnecessary and harmful procedures, and contributions to the existing lack of trust between marginalized groups and physicians. In order to better understand the relevant groups affected by the issue, Pinch and Bijker’s Social Construction of Technology framework was applied. This analysis revealed that a technological fix was insufficient to solve the issue, and that such a complex problem required an interdisciplinary solution.
The aforementioned solution encompasses a mobile application with video interpretation and access to professional interpreters, outreach to low English proficiency populations, and culturally specific education for prehospital providers. A more rigorous analysis of the problem definition also revealed the need for special considerations for disabled and neuroatypical members of LEP communities, and thus prompted the inclusion of sign language capabilities, increased magnification, and captions.
Therefore, this portfolio proposed two different solutions to improve treatment options for marginalized communities: through the development of accurate laboratory tools to research understudied diseases, and through the creation of a solution to increase accessibility to Emergency Medical Services. Taken together, the results of the tightly coupled technical and STS topics achieve the overall aim of increasing equity and inclusion in healthcare through both technical design and an analysis of the relevant social factors.
