50% of New Aids Cases In America Are In The South

[B5SnowDog]

Yeah, that was not the best description I have ever given. Let me try this again. As a woman from the northeast who has talked to other women from the northeast about this, I get a weird vibe out of a lot of southern women. Educated, working, big power in how the family is run, but...............there is what looks to ME, based on what I'm used to, as a default setting a lot of southern women take in public. They are overly nice, and quite frankly, sometimes play dumb so as not to hurt what they perceive as the man's fragile ego. Now I'm sure a lot of southern women consider me overly rude and lacking in finesse when dealing with the opposite sex. Point taken. I never saw a woman in San Antonio who would act dimmer than I know she was in order to get along. I have seen this many times in Alabama and South Carolina. These women are calling the shots and carrying the team, I don't understand why they insist on keeping sweet about it.

Like I said, my perception, and not at all meant to imply that southern women patterned their lives after Michelle Duggar. But there is a big difference region to region.

What you describe fits my relatives from Henderson. You certainly would be far less likely to run into it in cities like Houston or San Antonio but in smaller towns in east Texas, the vibe is definitely that of the rural south. I've seen my female relatives surreptitiously hand money to their husbands to pay for dinner while eating out so that the server thinks the man is the one who had the money. Their accent is closer to southern drawl than Texas twang. Heh, they've told me I talk funny.

[Glass Cowcatcher]

I live here, but was not raised here but the south is hardly made up of people who were elitists on the plantation. The African Americans, well that goes without saying and the Caucasians, well plantation live was still the minority.

And while I am not a southern apologist by any means, reconstruction really impacted a lot of white families.

I think the different history affects the culture of the two regions differently, though, even if it is a romanticized version of history.

[treemom]

I think the different history affects the culture of the two regions differently, though, even if it is a romanticized version of history.

I agree with you, but part of the romanticized history also involved the idea of Scarlett o'hara vowing to never go hungry again. Most women here would argue that southern toughness is in their blood from that history...just like women in the panhandle would probably feel a sense of toughness from the dust bowl.

I recently read a book called the worst, hard time. It was really good and demonstrated a lot about that eeking out a living that those in Texas and the plains states experienced during the dust bowl.

[treemom]

I wanted to address Glass Cowcatcher's observation that there are now no family planning clinics in South Dakota. I suspect that is a least partially due to the fact that it's hard to recruit doctors to stay in South Dakota. The same thing happens in rural Greece. People like big population centers. So the Greeks actually came up with a solution that works.

Normally, when it comes to services and civil government, people should take a look at what Greece does, and do the exact opposite. :hand: This is an exception. The Greek government pays for all post secondary education in Greece. The exams are brutal and competitve, but once you get into college, you don't have to worry about how your going to come up with tuition money. In exchange for paying for the education of doctors and teachers, both those proffessions are obligated to go wherever the hell the Greek government tells them to for 7 years. That is how isolated or rural schools, hospital, and clinics are staffed. No exceptions.

If the US government paid for medical school, they would be able to direct resources to under served communities. Something to think about.

Edit-riffles

they do to a certain extent by forgiving student loans when doctors serve in under served areas.

[treemom]

What is interesting about our little derailment is growing up in northwest Indiana I always felt like my area was made up of hardy practical women. Farming communities settled by immigrants, many of whom settled in post wwi and WWII.

Much of what I think the south sees as politeness isn't seen that way in the Midwest states. They know exactly what "bless youR heart" means.

[Arete]

they do to a certain extent by forgiving student loans when doctors serve in under served areas.

Holy crap! You can have your loans forgiven and we still worry about staffing under served communities? I guess it's hard for me to imagine why more doctors don't take advantage of this to get out of debt sooner.

[treemom]

Holy crap! You can have your loans forgiven and we still worry about staffing under served communities? I guess it's hard for me to imagine why more doctors don't take advantage of this to get out of debt sooner.

because a lot of people don't want to live in uNder served communities. And you don't get to be too picky about it.

[treemom]

http://nhsc.hrsa.gov/loanrepayment/index.html

There are four areas in Memphis you can serve and a four year full time contract would forgive 120k in student loans. But the actual pay is going to be low and lots of doctors don't want to serve in south east Memphis or Fraser.

But it is there. And the ACA expanded funding for it.

[Arete]

http://nhsc.hrsa.gov/loanrepayment/index.html

There are four areas in Memphis you can serve and a four year full time contract would forgive 120k in student loans. But the actual pay is going to be low and lots of doctors don't want to serve in south east Memphis or Fraser.

But it is there. And the ACA expanded funding for it.

Yeah, I see now that we are never going to be able to guarantee providers in under served areas short of socializing medical school. :(

[treemom]

Yeah, I see now that we are never going to be able to guarantee providers in under served areas short of socializing medical school. :(

Maybe. I will say it is much easier for say Greece to do it than us because of the sheer breadth of undeserved areas. I think a single payer system for health care will go a long way towards improving the under served areas that are major metro areas (like memphis, we have several national centers of excellence here and over 1 million people and yet we still have several key areas of the city that are under served). If you increase the level of care that everyone gets I think doctors will be less likely to shy away.

I have a good friend from new Zealand, and she always likes to remind herself that you can't transfer what new Zealand has done successfully to the us just from a size perspective.

[Arete]

Agree. Size makes a huge difference. I don't think socialized medical school is feasible in this country, but to be honest, I had imagined debt relief would make a signifigant difference. Apparently, not.

[treemom]

Agree. Size makes a huge difference. I don't think socialized medical school is feasible in this country, but to be honest, I had imagined debt relief would make a signifigant difference. Apparently, not.

I don't want to be too hard on doctors because I think a lot of them do it..but even with that it will be hard to maintain. I think most people would be surprised how much of the country is considered under served. And it usually is related to socio economic issues, not terrain or distance like an Alaska.

It is easy for me to feel disdain, but I also understand what some of the doctors would be stepping into in these areas of memphis. Extremely high rates of early teen pregnancies and neo natal death rates. High amount of domestic violence and child abuse. Lots of addiction issues. The problems you often see in marginalized communities that have significant socio-economic issues. I think it is hard to start your career off there..the burn out factor can be high.

And like teach for America it isn't always good for the communities to have revolving door of new doctors through their lives.

I don't know the answer...but I also can understand why new docs don't make that choice.

[Coconut Flan]

There are also programs for teachers in certain areas and specialties and even public service lawyers.

[gimlet]

http://www.nytimes.com/2012/07/29/magaz ... -iran.html

This is a good piece about changes to delivering healthcare in the rural South based off an effective model from Iran that's an upcoming change due to the ACA.

[miffy]

I think this is true. The UK, Australia, NZ & Canada all have well known 'free' healthcare programs & the combined population of all countries is less than the population of the USA.

I'm Australian & I pay 2.5% of my income as a medicare levy. I'm not low income so I don't get free dental or anything 'extra' like that. However I have extras only private health cover which is cheaper than paying upfront at the dentist & optometrist.

Full private health cover is still really popular here. But its mostly taken out when you are trying to get pregnant, earning over $80k (to avoid a surcharge) or getting older. You still get the same level of treatment regardless of how much you earn or the kind of health cover you have. Private cover here just means you get to feel horrible in a nicer hospital. :lol:

[emmiedahl]

http://nhsc.hrsa.gov/loanrepayment/index.html

There are four areas in Memphis you can serve and a four year full time contract would forgive 120k in student loans. But the actual pay is going to be low and lots of doctors don't want to serve in south east Memphis or Fraser.

But it is there. And the ACA expanded funding for it.

That's part of the problem--$120K is a lot, but it might be half or a third of what a new doctor is carrying in loans from school. And that doctor can make $30K a year more in a more desirable area, so they break even by not going to the underserved area.

The best forgiveness programs I have seen forgive half of your loans for five years of work. Again, it might not be financially worth it to many young doctors considering they can make enough money to pay their loans themselves in, say, Seattle and have a better lifestyle.

Another issue is the lack of primary care doctors and I am not sure how to deal with that outside of making med school free, possibly offering financial incentives. I know someone who intended to go into primary care, but with the amount of loans he had and also his weariness of being poor after more than ten years of living on ramen, he specialized and makes 3 times as much as a primary care, with a better schedule to boot.

Unless your state has a school and you get accepted to it, you are looking at $40-50,000 a year in tuition for medical school. Plus living expenses, plus whatever loans you have from undergrad. And then there is a residency before you begin making even minimum wage.

[debrand]

because a lot of people don't want to live in uNder served communities. And you don't get to be too picky about it.

I think that the US military does something similar but the person has to serve so many years in the military.

The government could pay just for general practioners because they are needed in rural areas. The student would have to agree to serve a certain amount of time in areas that the government chooses. The doctor still pays taxes on their income sp the government will eventually recoup some of its funds.

[Arete]

I think that the US military does something similar but the person has to serve so many years in the military.

The government could pay just for general practioners because they are needed in rural areas. The student would have to agree to serve a certain amount of time in areas that the government chooses. The doctor still pays taxes on their income sp the government will eventually recoup some of its funds.

It's is true about the military. A good friend paid for medical school this way. They will pick up 100% of the tab for you to go to medical school. In exchange, you are part of the reserves during medical school, and after you graduate you owe them 12 years of active duty. You do go in as a officer.

Not everyone's cup of tea and not everyone can pass the physical or has the temperament to be in the military, but at least it's an option.

[Knight of Ni]

This reminds me of a video I saw of that woman politician who made headlines a few years ago. She was the one who was in the anti-masturbation club when she was a teen. I think her last name was O'Donnell. In this video she was talking to a news host about her views on healthcare spending. She said that she thinks too much money is being spent on HIV/AIDS research and care. According to here it is a completely "preventable" disease. I got the feeling that she was implying that those who had HIV/AIDS were at fault and didn't deserve care. Basically they acquired it through their "sin". The host replied with "Thankfully it's not you making those spending decisions."

I can't believe that people believe this. It also shows a fundamental lack of knowledge about the disease. She probably doesn't even know that HIV/AIDS can be passed to children.

[shesinsane]

This reminds me of a video I saw of that woman politician who made headlines a few years ago. She was the one who was in the anti-masturbation club when she was a teen. I think her last name was O'Donnell. In this video she was talking to a news host about her views on healthcare spending. She said that she thinks too much money is being spent on HIV/AIDS research and care. According to here it is a completely "preventable" disease. I got the feeling that she was implying that those who had HIV/AIDS were at fault and didn't deserve care. Basically they acquired it through their "sin". The host replied with "Thankfully it's not you making those spending decisions."

I can't believe that people believe this. It also shows a fundamental lack of knowledge about the disease. She probably doesn't even know that HIV/AIDS can be passed to children.

Probably Christine O'Donnell, one of the dumber things to come out of Delaware. At least the state was smart enough not to send her to Congress.

[JesusFightClub]

It's is true about the military. A good friend paid for medical school this way. They will pick up 100% of the tab for you to go to medical school. In exchange, you are part of the reserves during medical school, and after you graduate you owe them 12 years of active duty. You do go in as a officer.

Not everyone's cup of tea and not everyone can pass the physical or has the temperament to be in the military, but at least it's an option.

*nods* We have something a bit like this here as I understand it. I had friends who left high school to join a sort of program where you became a military nurse or medical person. The tests you went through were very rigorous but if you passed them, you weren't paying for anything in further education or medical school. That's over 10 years ago so I don't know now.

Also the same - you owe the military in service. Maybe not a "bargain" it's wise to take.

[Sumeri]

I think that the US military does something similar but the person has to serve so many years in the military.

The government could pay just for general practioners because they are needed in rural areas. The student would have to agree to serve a certain amount of time in areas that the government chooses. The doctor still pays taxes on their income sp the government will eventually recoup some of its funds.

My own personal opinion is that there are no family planning clinics in South Dakota because of the anti-abortion laws in South Dakota. I live here, and we do have very well trained doctors in every other specialty. I don't see us as having difficulty securing medical professionals - no more so than other rural areas.

There are clinics here, for example, you go to a regular GP for your paps and such. And sliding scale clinics, too - but nothing is branded as a "family planning" clinic because (imo) of the hostility towards all things that might be perceived as pro-choice. Remember, we are NOT well known for reproductive rights. Of course that trickles down to all things sex related. Backwardass country fucks.

[FlorenceHamilton]

I was an HPSP Air Force Scholar. My entire med school tuition and supplies were paid by the USAF. I also got a monthly stipend (I did need some loans to cover living expenses). 45 days each year were active duty. I spent 6 weeks in military training for the first two years and then military medical train for the second two years. Residency training can be either military or civilian and incurs no additional time debt. The pay back is a year for each year of the scholarship. So basciall, yyou owe 4 years after your training is complete. If you do military medical training, you may end up with over 10 years in which kind of makes it worth your while to give the 20 years and qualify for a pension.

I only had to serve as an Air Force doctor for 4 years after I finished school. I did have a total debt of about 40K in loans as well. I jusr looked on the website. The deal has not changed.

[Arete]

My friend was Army. His program demanded 12 years after he finished med school, and he did struggle with remaining a few years more for the pension, but in the end decided he was done and wanted his family settled in one place. He owed nothing when he got out.

[dawn9476]

http://articles.latimes.com/2012/jul/26/opinion/la-oe-biagiotti-aids-in-the-south-20120726

This is just sad.

I've got to work on a paper but I accidentally stumbled on this information and needed to share it with you guys. Instead of analyzing the article-which is very good-I'll just put up some quotes for those who don't want to read the entire article.

A lot of those adolescents living with HIV are probably teen moms who are passing the virus onto to their kids. We all know that the south has a huge teen pregnancy epidemic.