Browsing by Author "Robinson, Peyton"

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    Acknowledging Racial and Ethnic Health Disparities in Mass Incarceration
    (Indiana State Medical Association, 2022-06-06) Brown, Lucy; Clark, Sydney; Nunge, Rebecca A; Fazle, Trilliah; Cooper, Siena; Robinson, Peyton; Darroca, Roberto
    Whereas, the United States incarcerates more people per capita than any country in the world, where the U.S. comprises only 4% of the world’s population, yet is home to nearly 16% of all incarcerated people in the world; and Whereas, in Indiana, the total jail population increased by 526% between 1970 and 2015, while rates of pretrial detainees have increased by 72% in the state’s 48 rural counties, 43% in the state’s 21 small/medium counties, 40% in the state’s 22 suburban counties, and 268% in Marion County alone since 2000; and Whereas, in 2015 in Indiana, when including jail, prison, immigration detention, and juvenile facilities, the incarceration rate was 765 per 100,000 people, well above the rate of the United States as a whole, which was 665 per 100,000 people; and Whereas, Black residents make up 10% of Indiana’s population, but represent 24% of people in jail and 34% of people in prison; additionally, pretrial populations, disproportionately Black and Hispanic, more than doubled from 2002 to 2017; and Whereas, in 2019, Native people made up 2.1% of all federally incarcerated people, larger than their share of the total U.S. population, which was less than one percent; additionally, Native women are particularly overrepresented in the incarcerated population, making up 2.5% of women in prisons and jails and only 0.7% of the total U.S. female population; and Whereas, populations of color are more impacted by the use of money bail, where Black defendants often receive higher bail amounts, even when controlling for legal factors such as offense severity; and Whereas, Black and brown defendants are 10-25% more likely to be detained pretrial or to receive financial conditions of release; and Whereas, significant racial and ethnic disparities exist among policing, arrests, and incarceration rates, which further exacerbate disparate health outcomes for Black communities, including, but not limited to, Black individuals disproportionately being stopped by the police, experiencing use of force and repeated arrests, serving sentences of life and life without parole, being sent to solitary confinement, and receiving convictions that place them on death row; and Whereas, nearly one in three Black men will ever be imprisoned, and nearly half of Black women currently have a family member or extended family member who is in prison; and Whereas, ISMA (RESOLUTION 15-31) advocates for improved health care of incarcerated individuals; however, ISMA has no policy acknowledging the inequitable burden of incarceration and policing on minoritized individuals and communities of color; and Whereas, the AMA (H-65.954) recognizes police brutality as a manifestation of structural racism which disproportionately impacts Black, Indigenous, and other people of color; therefore, be it RESOLVED, that ISMA recognize that unjust and disproportionate racial and ethnic disparities exist in policing, sentencing, and mass incarceration among Black, indigenous, and other people of color (BIPOC) and have devastating impacts on BIPOC communities; and be it further, RESOLVED, that ISMA refer to the Committee on Diversity, Equity and Inclusion for study on what policies would be germane for ISMA to act on regarding racial and ethnic disparities in mass incarceration.
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    Improving Conditions for Incarcerated Individuals
    (2022-06-06) Clark, Sydney; Cooper, Siena; Brown, Lucy; Nunge, Rebecca A; Fazle, Trilliah; Robinson, Peyton; Darroca, Roberto
    Whereas, in 2019, the United States’ incarceration rate was estimated to be 629 per 100,000 people, which is the highest rate globally and over 8% higher than the closest country; and Whereas, in Indiana, the total jail population has increased 526% from 1970 to 2015 and the total prison population has increased 224% from 1983 to 2018, with our incarceration rates being fourth highest nationally; and Whereas, in 2015, Indiana had the second highest rate of pretrial detainees in the nation at a rate of 272 per 100,000 people; and Whereas, since 2000, the rate of pretrial detainees has increased 72% among Indiana’s 48 rural counties, 43% in 21 small/medium counties, 40% in 22 suburban counties, and 268% in Marion county alone; and Whereas, in the United States, the rate of recidivism is 70% within 5 years of release with few resources to assist reentering individuals find housing, gain employment, or access social services; and Whereas, when connected with employment opportunities, financial planning services, stable housing, and physical and mental health services, rates of recidivism decrease significantly, over 60% amongst those who complete programs, among reentering individuals; and Whereas, incarcerated individuals have higher rates of mental illness than the general population, with approximately 14.5% of men and 31% of women in jails having at least one mental illness as compared to 3.2% and 4.9% respectively amongst the general population; and Whereas, nationally, the number of suicides has increased by 85% in state prisons, 61% in federal prisons, and 13% in local jails from 2001 to 2019, with suicide being the leading cause of death in jails; and Whereas, the risk of suicide in recently released individuals is nearly 6.8 times higher than that of the general population, with most occurring within 28 days of release; and Whereas, in a study of 80 jails by Scheyett et al., 68 reported having no mental health staff who provided care within the jail, 15 reported taking, on average, 5 days or longer to retrieve inmates’ medications and none were utilizing evidence-based screenings to assess for serious mental illnesses, highlighting a concerning disconnect between jail staff and mental health providers; and Whereas, re-entering individuals are unlikely to connect with primary care upon release and very rarely seek mental health services in the months following release; and Whereas, inarcerated individuals are often restricted from accessing rehabilitative social services such as the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), and Medicaid either through a lack of meeting eligibility requirements or personally held beliefs by incarcerated individuals surrounding eligibility and accessing resources; and Whereas, when provided assistance and access to expedited Medicaid enrollment, reentering individuals were more likely to access health services and receive prescriptions; and 263 Whereas, ISMA (RESOLUTION 15-31) advocates for improved health care of incarcerated individuals; therefore, be it RESOLVED, that ISMA support legislation that improves access to comprehensive physical and behavioral health care services for juveniles and adults throughout the incarceration process from intake to re-entry into the community; and be it further RESOLVED, that ISMA support legislation that removes barriers and increases access to social services and benefits apropos to the respective situations of incarcerated individuals and re-entering individuals, such as: (a) food subsidies; (b) healthcare, including Medicare and/or Medicaid; and (c) housing; and be it further RESOLVED, that ISMA work with relevant stakeholders to create discharge planning and programs that connect reentering individuals with primary care providers and medical homes within the community.
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    Is ChatGPT 3.5 smarter than Otolaryngology trainees? A comparison study of board style exam questions
    (Public Library of Science, 2024-09-26) Patel, Jaimin; Robinson, Peyton; Illing, Elisa; Anthony, Benjamin; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objectives: This study compares the performance of the artificial intelligence (AI) platform Chat Generative Pre-Trained Transformer (ChatGPT) to Otolaryngology trainees on board-style exam questions. Methods: We administered a set of 30 Otolaryngology board-style questions to medical students (MS) and Otolaryngology residents (OR). 31 MSs and 17 ORs completed the questionnaire. The same test was administered to ChatGPT version 3.5, five times. Comparisons of performance were achieved using a one-way ANOVA with Tukey Post Hoc test, along with a regression analysis to explore the relationship between education level and performance. Results: The average scores increased each year from MS1 to PGY5. A one-way ANOVA revealed that ChatGPT outperformed trainee years MS1, MS2, and MS3 (p = <0.001, 0.003, and 0.019, respectively). PGY4 and PGY5 otolaryngology residents outperformed ChatGPT (p = 0.033 and 0.002, respectively). For years MS4, PGY1, PGY2, and PGY3 there was no statistical difference between trainee scores and ChatGPT (p = .104, .996, and 1.000, respectively). Conclusion: ChatGPT can outperform lower-level medical trainees on Otolaryngology board-style exam but still lacks the ability to outperform higher-level trainees. These questions primarily test rote memorization of medical facts; in contrast, the art of practicing medicine is predicated on the synthesis of complex presentations of disease and multilayered application of knowledge of the healing process. Given that upper-level trainees outperform ChatGPT, it is unlikely that ChatGPT, in its current form will provide significant clinical utility over an Otolaryngologist.