A medical professional’s role is to suggest and discuss treatment plans when their patients face disease or injury. The willingness of patients to follow medical suggestions can vary, and there is often a disconnect between healthcare providers explaining treatment plans and patients actually following them. My interest lies in closing this gap, developing a more effective culture of treatment in healthcare. The Southern Oral History Program’s interview database—specifically a collection titled “Stories to Save Lives: Health, Illness, and Medical Care in the South”—enabled me to explore what factors influence this variability in patients’ agreement to their prescription. I focused on the narratives of two women with different systems of social support to understand the connection between social support and prescribed medical treatment. I found that there is a positive correlation between the social support one receives and their loyalty to a suggested medical treatment.
The discussion of familial support throughout medical care was a recurring theme in many of the oral histories. Sabra Hammond, a Physician’s Assistant at CommWell, discusses her work in Asheville, North Carolina with patients that have low health literacy. She says that her work made her realize that her family was very medically literate, explaining that:
“We went to a doctor for care and we had insurance most of the time, and if something was wrong, it was expected to be taken care of. There was a consciousness about the cost of medical bills and medicines, but it was considered to be the thing, and the important thing. And my mother used to joke that she’d gotten her medical degree from Reader’s Digest [laughs], and so she was always going around diagnosing and discussing things, medical and whatever. So health was like good food and culture. It was a thing that was known and talked about and considered to be a baseline part of who we were” (16:11.3-17:05.9).
Hammond’s unique upbringing offered her a strong support network that ensured she put her health first. This motivated Hammond to make sure her patients had this same unwavering adherence to their prescribed medical treatment, whether that be a prescription drug or a referral to alternative care. The way a patient is raised has enormous influence in forming their relationship with prescribed treatment. Individuals like Hammond, who were taught to prioritize their health during their upbringing and had a supportive social network, are able to reap the benefits of these lessons by continuing to prioritize their health as adults. They have this continued support and mentality that putting health above all is not only okay, but necessary.
I felt that another oral history, that of Lata Chatterjee, highlighted the other end of the spectrum, showcasing the negative experience of someone who lacked a strong support network to ensure that they followed their prescribed treatment. Chatterjee was raised in India and moved to the United States, where she taught as a professor for many years. She contrasts her healthcare experience in India and the United States, discussing insurance, traditions, specific treatments, and having to leave behind your established community when immigrating.
She explains that “people think immigrants come here and it’s easy. It’s very difficult being an immigrant, leaving your culture, leaving your society, all because you want to do something with yourself which is more than you could have in your home place. For some, it’s bringing up their children. For some, it’s being more useful to society. Whatever it is, it’s not easy, whether you come in as me with a Ph.D behind you or you come and work in the gardens digging dirt. It’s all hard, very hard” (28:50.3-31:07.5).
Chatterjee did not have an established community, such as her family, to lean on when she sought treatment in the university medical centers as a student. She found that immigrant stereotypes took control of her diagnoses and prescriptions. When she came down with a common virus, the medical professionals tested her for diseases such as tuberculosis repeatedly, only to find she did not have it. She was so frustrated with her care that she considered moving back to India. She lacked a network in the United States to support her and ensure she maintained her social, emotional, and physical health. Thankfully, one of her friends in the United States intervened right before she moved back.
Her friend said, “‘Forget this healthcare system. Just come with me. I’ll take you. We have a country home in Western Pennsylvania near State College, and just sit there. I’ll stock your refrigerator with food. Don’t go out’” (32:36.3-34:26.7).
This friend’s help cured Lata. After taking time at this house, Lata said that “in a month, she came back to collect me, and I was sick and never got sick again” (32:36.3-34:26.7). With the support of her friend, her community, she put her health first and adhered to what was right for making her better. Without this, she would have gone home, possibly getting sicker during travel and giving up on her dreams of teaching in America.
Both Lata and Sabra’s stories show how important social support is in our attitudes towards healthcare, something that sociology researchers have supported. Katharine M. Donato and her co-authors explain that a “greater frequency of contact with friends and neighbors are associated with better self-rated health, and so too is having more close friends and perceived social support, net of other factors” (Katharine M. Donato et al. 10). Support goes a long way in our health care whether it is from the provider, family in Sabra’s case, or a friend in Lata’s situation. According to M. Robin DiMatteo in “Social Support and Patient Adherence to Medical Treatment: A Meta-Analysis,” social support is powerful in driving loyalty to treatment because it encourages “optimism and self-esteem, buffering the stresses of being ill, reducing patient depression, improving sick-role behavior, and giving practical assistance” (DiMatteo et al. 207).
Sabra and Lata’s stories reveal how diverse and consequential a patient’s social support can be. It is important that medical professionals holistically treat patients, taking factors like social connectedness into account. Sometimes, successful treatment rides on just this factor alone. The positive correlation between social support and adherence to medical treatment is a powerful tool that could be the line between health and suffering; both patients and providers deserve to be informed about it to create a more effective and equitable healthcare system.
References
Lata Chaterjee. Interview with Nicholas Allen. 11 December 2018 (Y-0084). Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.
DiMatteo, M. R. (2004). “Social Support and Patient Adherence to Medical Treatment: A Meta-Analysis. Health Psychology,” 23(2), 207–218. https://doi.org/10.1037/0278-6133.23.2.207.
Donato, Katharine M., et al. “Something Old, Something New: When Gender Matters in the Relationship between Social Support and Health.” Journal of Health and Social Behavior, vol. 59, no. 3, 2018, pp. 352–370., https://doi.org/10.1177/0022146518789362.
Sabra Jane Hammond. Interview with Maddy Kameny. 27 June 2018 (Y-0028). Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.