#health disparities for minorities

[reasoningdaily]

GREENWOOD Dist.–With data from the state’s own health department showing Black mothers are nearly twice as likely to die from childbirth as White mothers, a grassroots coalition is stepping up to fill in the gap in solutions.

A Tulsa-based coalition of Black reproductive health advocates, dubbed “The Persevere Cohort,” is hosting an event to update the community on their efforts over the last year and their plan for what comes next on Saturday, May 6 from 10:30 a.m. to 12 p.m. at OSU-Tulsa inside the B.S. Roberts room.

According to the Centers for Disease Control, despite Republican Gov. Stitt repeatedly voicing efforts to make Oklahoma a top 10 state, Oklahoma consistently ranks in the bottom 10 of U.S. states for some of the worst rates of pregnancy-related deaths. The Governor’s Office did not immediately respond to a request for comment.

Oklahoma’s annual report, “Oklahoma Maternal Health, Morbidity and Mortality,” shows that Black women account for 40.8 maternal deaths per 100,000 live births, compared to 25.4 for White women, 24.9 for Native American women, and just 4.4 for Hispanic women. The overall maternal mortality rate for Oklahoma women was 23.5, according to the report. Rates for Native Hawaiian and Asian/Pacific Islander women were not available.

In recent years, local organizations such as Tulsa Birth Equity Initiative have also stepped up to address the crisis. The organization has trained 71 community duolas and supported 119 births since 2019.

Oklahoma maternal mortality in bottom 10 as abortion access banned

Advocates for reproductive choice have warned that banning access to abortion would disproportionately impact Black women. Even so, Oklahoma has become one of strictest anti-abortion states after Governor Kevin Stitt signed into law a bill that bans abortion at fertilization. According to the CDC, Oklahoma is 40th in the nation for overall maternal mortality rates.

National rates of maternal mortality are already three times higher for Black women and have been climbing each year, a fact The Persevere Cohort is determined to address at the local level.

On Saturday, the cohort will discuss the next phase of its plans to advance Black reproductive health through an initiative called “Reproduce U.”

“Beginning summer 2023 Reproduce U. will bring together community members, industry professionals, systems leaders and elected officials to have critical conversations about black reproductive health outcomes and to form research teams that will craft attainable policy solutions,” the cohort announced on Monday.

Reproduce U. will focus on Increasing Humanity in Healthcare and Creating Equity in the Economics of Healthcare over a 10-month span, the group announced.

The May 6th Initiative and The Persevere Cohort are supported by OSU-Tulsa Center For Public Life and Standpipe Hill Strategies in partnership with Hillcrest Medical Center, St.Francis Hospital Tulsa and Ascension St. John Medical Center through funding from The Robert Woods Johnson Foundation.

[alwaysbewoke]

[gpstudios]

Celebrating National Minority Donor Awareness Day: Saving Lives Through Diversity in Donation 🌍💉

Happy National Minority Donor Awareness Day! 🌍💉 Celebrate the importance of minority organ, eye, and tissue donors. Raise awareness, educate, and encourage registration to save lives. #MinorityDonorAwareness #SaveLives

Introduction Happy National Minority Donor Awareness Day! 🌍💉 Celebrated annually on August 1st, this important day is dedicated to raising awareness about the need for minority organ, eye, and tissue donors. It aims to educate and encourage people from diverse backgrounds to consider donation, thereby helping to save and improve lives. Join us as we explore the significance of National Minority…

[suchananewsblog]

The Importance of Access to Treatment

Historically, racial and ethnic minorities in the United States have lived with long-term disparities in both access to health care and the quality of care that they receive. These differences are improving thanks to laws like the Affordable Care Act. Still, some minority groups have higher rates of illness and death from many health conditions than white people. And they’re still more likely to…

[fatliberation]

I totally understand and can empathize with fat activists when it comes to medical fatphobia. But I do think its important to provide nuance to this topic.

A lot of doctors mention weight loss, particularly for elective surgeries, because it makes the recovery process easier (Particularly with keeping sutures in place) and anesthetic safer.

I feel like its still important to mention those things when advocating for fat folks. Safety is important.

What you're talking about is actually a different topic altogether - the previous ask was not about preparing for surgery, it was about dieting being the only treatment option for anon's chronic pain, which was exacerbating their ed symptoms. Diets have been proven over and over again to be unsustainable (and are the leading predictor of eating disorders). So yeah, I felt that it was an inappropriate prescription informed more by bias than actual data.

(And side note: This study on chronic pain and obesity concluded that weight change was not associated with changes of pain intensity.)

If you want to discuss the risk factor for surgery, sure, I think that's an important thing to know - however, most fat people already know this and are informed by their doctors and surgeons of what the risks are beforehand, so I'm not really concerned about people being uninformed about it.

I'm a fat liberation activist, and what I'm concerned about is bias. I'm concerned that there are so many BMI cutoffs in essential surgeries for fat patients, when weight loss is hardly feasible, that creates a barrier to care that disproportionately affects marginalized people with intersecting identities.

It's also important to know that we have very little data around the outcomes of surgery for fat folks that isn't bariatric weight loss surgery.

A new systematic review by researchers in Sydney, Australia, published in the journal Clinical Obesity, suggests that weight loss diets before elective surgery are ineffective in reducing postoperative complications.

CADTH Health Technology Review Body Mass Index as a Measure of Obesity and Cut-Off for Surgical Eligibility made a similar conclusion:

Most studies either found discrepancies between BMI and other measurements or concluded that there was insufficient evidence to support BMI cut-offs for surgical eligibility. The sources explicitly reporting ethical issues related to the use of BMI as a measure of obesity or cut-off for surgical eligibility described concerns around stigma, bias (particularly for racialized peoples), and the potential to create or exacerbate disparities in health care access.

Nicholas Giori MD, PhD Professor of Orthopedic Surgery at Stanford University, a respected leader in TKA and THA shared his thoughts in Elective Surgery in Adult Patients with Excess Weight: Can Preoperative Dietary Interventions Improve Surgical Outcomes? A Systematic Review:

“Obesity is not reversible for most patients. Outpatient weight reduction programs average only 8% body weight loss [1, 10, 29]. Eight percent of patients denied surgery for high BMI eventually reach the BMI cutoff and have total joint arthroplasty [28]. Without a reliable pathway for weight loss, we shouldn’t categorically withhold an operation that improves pain and function for patients in all BMI classes [3, 14, 16] to avoid a risk that is comparable to other risks we routinely accept.

It is not clear that weight reduction prior to surgery reduces risk. Most studies on this topic involve dramatic weight loss from bariatric surgery and have had mixed results [13, 19, 21, 22, 24, 27]. Moderate non-surgical weight loss has thus-far not been shown to affect risk [12]. Though hard BMI cutoffs are well-intended, currently-used BMI cutoffs nearly have the effect of arbitrarily rationing care without medical justification. This is because BMI does not strongly predict complications. It is troubling that the effects are actually not arbitrary, but disproportionately affect minorities, women and patients in low socioeconomic classes. I believe that the decision to proceed with surgery should be based on traditional shared-decision making between the patient and surgeon. Different patients and different surgeons have different tolerances to risk and reward. Giving patients and surgeons freedom to determine the balance that is right for them is, in my opinion, the right way to proceed.”

I agree with Dr. Giori on this. And I absolutely do not judge anyone who chooses to lose weight prior to a surgery. It's upsetting that it is the only option right now for things like safe anesthesia. Unfortunately, patients with a history of disordered eating (which is a significant percentage of fat people!) are left out of the conversation. There is certainly risk involved in either option and it sucks. I am always open to nuanced discussion, and the one thing I remain firm in is that weight loss is not the answer long-term. We should be looking for other solutions in treating fat patients and studying how to make surgery safer. A lot of this could be solved with more comprehensive training and new medical developments instead of continuously trying to make fat people less fat.

[mariacallous]

The nomination of Vice President Kamala Harris as the Democratic presidential candidate has shaken up the race in ways that have yet to fully play out. However, given the fact that she could become the first woman U.S. president, it is surely worthwhile to consider the role of the women’s vote in November’s election.

One need only look back to the 2022 midterm election, where the women’s vote was arguably instrumental in rebuffing a predicted “red wave,” leading Democrats to exceed electoral expectations. That election occurred less than five months after the Supreme Court’s Dobbs decision that overturned Roe v. Wade, allowing states to greatly restrict access to abortion. This led to a greater-than-expected Democratic vote among women, especially young women, for House of Representatives and other state candidates.

Now, just weeks after most polls had President Joe Biden trailing his Republican rival Donald Trump, the emergence of Vice President Harris as the Democratic candidate has already injected enthusiasm among many Democrats, especially women. As my Brookings colleague Elaine Kamarck has argued, women’s health, abortion, and reproductive freedom—issues Harris has championed—will once again be leading issues for this election. Harris has also voiced support for issues important to women including paid parental leave, child care, and the economy, as well as other policies that have the support of many younger and minority women. Indeed, the broader support of women’s groups for Harris’s candidacy has already been evident in funding and outreach.

With Harris’s nomination, will new enthusiasm and a voting surge among women be enough to power her to victory in November? To address this question, this analysis first reviews the role of women’s votes in recent presidential elections and which women’s demographic groups were most favorable to Democratic candidates. It next shows how gender differences in voter turnout have provided women with a numerical electoral advantage over men. The analysis proceeds to look at changes in the demographic make-up of women voters, from 2012 through the present, showing the rise of Democratic-favorable groups within their ranks. It concludes with a voter simulation of 2024 election results showing what recent polls imply, if we assume that the new enthusiasm for Harris translates into higher voter turnout and increased Democratic support among women, both dynamics that could help increase her chances for victory in November.

Women have a history of backing Democratic candidates in presidential elections

Examining gender differences in presidential voting preferences shows that women have voted for Democrats over Republicans in every presidential election since 1984.1

This is evident for recent elections, as seen in Figure 1, which shows the D-R (Democratic minus Republican) vote margins by gender for presidential elections between 2000 and 2020. In each case, the D-R margins are positive for women and generally (though not always) negative for men, and women voted more strongly Democratic than men, regardless of whether a Democrat or Republican ultimately won the presidency.

Election year 2020 showed sharp gender disparities for the seven battleground states, displayed in Figure 2. In each of these states, only one of which (North Carolina) Trump carried, women registered positive D-R margins compared with negative margins for men. The widest gender disparities were in the three “blue wall” states of Wisconsin, Pennsylvania, and Michigan, as well the southern state of Georgia.

Gender differences also pervaded demographic groups in the 2020 presidential election (see figure 3), as was the case in earlier elections. D-R margins are higher for women than for men in groups where women voted strongly Democratic: Black voters, Hispanic voters, and voters aged 18 to 29. Even for non-college white women voters—who favored Republicans—the negative D-R margins are not as large as those of men. Only among Asian American voters were men’s D-R margins higher than women’s.

Women’s turnout rates are higher

Perhaps even more important than partisan preferences, turnout rates—the share of eligible voters who vote—will help dictate women’s influence in the coming election. Turnout rates for women have exceeded those for men in presidential elections dating back to 1980. Figure 4 depicts gender differences in turnout for presidential elections since 2000. The 2020 election showed the highest overall turnout rates in decades. Because of their higher turnout rates, and the fact that women live longer than men, the 2020 election had 9.7 million more female than male voters.

Largely because of their higher turnout rates, women comprised more than half of all voters (53%) in 2020. Yet their shares vary across demographic groups (see Figure 5).  Women comprised 58% of all Black voters, 55% of Asian voters and 54% of Hispanic voters. Fifty-four percent (54%) of voters aged 65 and older were also women. And among white non-college graduate voters, a group that tends to vote Republican, women still comprised a majority (52%).

The female electorate is becoming more diverse and highly educated

As the size of the female electorate increases, its demographic makeup is changing. Figure 6 shows the shifts in the profile of eligible women voters between 2012 and 2024 by race and education. Notably, there are gains in women’s groups that tend to vote Democratic—white college graduates and people of color—and a decline in the women’s group that tends to vote Republican—white non-college graduates. For the first time in a presidential election, the latter group will make up less than 40% of the women’s electorate.

The seven battleground states, shown in Figure 7, also display similar shifts in the demographic profiles of their female electorates. In each, there is a decline in the share of white non-college graduate women, and an increase in the share of women of color. This is occurring in the “whiter” states of Wisconsin, Pennsylvania, and Michigan, as well as the more diverse states of Arizona, Nevada, Georgia, and North Carolina. In Nevada, for example, the share of women who identify as white non-college graduates declined from 48% in 2012 to 35% in 2024, while at the same time the share of women who identify as Black, Hispanic, Asian or other nonwhite races rose from 36% in 2012 to 47% in 2024. Thus, with respect to demographic attributes, the female electorates in each state have become more Democratic-leaning in their voter profiles.

Simulating the 2024 election after Harris announcement

Polls taken both before and after the shift from Biden to Harris as the likely Democratic nominee offer crude indications of what the 2024 election might hold. Three polls of likely voters conducted by the New York Times/Siena College on June 26, July 3, and July 25—after Biden bowed out of the race and endorsed Harris—reveal the changes that took place in men’s and women’s D-R voting margins (see Figure 8).

The D-R margins for women–at 14% for Harris vs. Trump on July 25, were especially high, though countered by a still-high negative D-R margin of 17% for men.

Still, the high women’s D-R margin favoring Harris greatly reduced the overall D-R margin compared with the earlier two Biden vs. Trump margins shown in Table 1. That is, in the two polls taken while Biden was still the assumed Democratic nominee, the negative D-R margins of -4% and -6% (44%  Biden vs. 48% Trump on June 26; and 43% Biden vs. 49% Trump on July 3) strongly favored Trump. Yet, the July 25 poll for Harris vs. Trump reduced the D-R margin to just -0.6% (47.5 for Harris vs. 48.1 for Trump) when we applied this to a simulation model discussed below.

Of course, the July 25 poll was taken just after Biden withdrew and endorsed Harris as the likely Democratic nominee. Clearly, Harris’s campaign had not yet fully begun and the immediate support from many women’s groups suggests that both female turnout and voting preference could increase on Harris’s behalf in the weeks and months ahead. To estimate these likely effects, we conducted simulations of national D-R margins—a base simulation—and two additional simulations based on assumptions of greater women’s turnout and a stronger voter preference for Harris (see Table 1).

All three simulations begin with the 2024 national female and male eligible voter populations reported in the Census Bureau’s monthly Current Population Survey. The “base” simulation applies the 2020 election female and male voter turnout rates, presented above, and the Harris vs. Trump voter margins from the July 25 poll shown in Figure 8. The second simulation alters the base simulation by increasing women’s turnout rate by 10%, from 68.4% to 75.2%, larger than the 5.1% rise in female turnout which occurred between 2016 and 2020. The third simulation alters the second simulation by also increasing the female D-R voting margin by 5 percentage points.

The results in Table 1 show that while the base simulation yields a small Trump advantage, a 10% rise in women’s turnout would bring a small Harris advantage. Moreover, both increasing women’s turnout by 10% and the women’s D-R vote advantage by 5 percentage points would yield a clear Harris win (49.2% Harris vs. 46.3% Trump). These assumptions, reflecting a rise in women’s enthusiasm for Harris between now and Election Day, could put a popular vote win for her well within reach. It is also possible that the strong Trump voter preference for men, reported in the New York Times/Siena College poll, could shift as more male voters become familiar with her campaign.

The impact of an energized women’s voting base

The simulations conducted here make plain that rising women’s enthusiasm for Kamala Harris’s candidacy could lead to consequential shifts in the 2024 election through increases in voter turnout and voter preference. This is especially notable given the recent history of women’s support of Democratic candidates in national and congressional elections. Beyond looking at polls alone, simulations such as these show how taking into account the eligible voter base and rising voter turnout rates can affect election results.

These simulations should not be viewed as predictions; much will depend on how well Harris can continue to energize an already favorable female voter base. It also depends on her performance in crucial battleground states, which will determine how she fares in the Electoral College. What these simulations do show is how an enthusiastic voting bloc, when translated into voter turnout and voting preferences, could impact the final election result this coming November.

[mayfay-analysis]

Danny's Medical Complications

Or: I had an idea and it won’t leave (and unfortunately I can’t do dialogue to save my life)

It started simple enough, a quick visit to Frostbite for a general checkup. And then it kept going. New machines, techniques, people, and an increasingly worried yeti was starting to freak Danny out a bit. Eventually it all went away and Frostbite set him down for A Talk.

See, Halfas are hella rare for a reason. The conditions needed to form them are really rare yes, but they aren’t the Main problem. No the main issue is the Disparity. Ghosts are beings of emotions, sufficient stress, emotional/mental harm, lack of ecto, and more can all lead to death. And Halfas crank that up to 11. They have a human side to take care of that’s constantly changing and growing, a higher ecto requirement to fuel their higher base strength, and a myriad of other minor complications that haven’t been properly studied cause Halfas are rarely found and usually don’t form ghosts on death

Say what

What do you mean “don’t form a ghost” they’re already half way there!

And there lies the problem, they’re halfway there. Ghosts are pretty static. they might change yes, but it’s usually due to major events or over the course of eons. And how do they decide on what they’re gonna be? By dying of course! Once the body dies its ghost is formed based on the current life situation and they move on. Simple, quick, easy. No complications here no siree!

Enter Halfas

They already died, and while infant ghosts and experience some major changes as they settle it’s nothing to the degree humans do. And as time passes the static ghost half and changing human half can drift, wobbling on that line between life and death. And once it gets to extreme? They fall. If the ghost half starves or dies the human half experiences Major health complications, leading to death shortly after. If the human side dies they try to form a ghost using all the ambient ecto the ghost side has been feeding on, leading to the ghosts death in most cases but if not they’re practically two different beings and fusing them will kill both anyways.

Good news though! With all the combat and rediculously high ecto levels Danny was exposed to to form his other half, his ghost side has stayed pretty adaptable! The other ghosts didn’t realize they were fighting a literal infant thanks to the high ecto levels he had (and the knowledgeable ones that Did had other reasonings the meant a little smack down they totally wouldn’t lose was an acceptable trade off for them). Horrifying, he will spend the next century finding all sorts of animal pelts, boxes, music tracks, etc landing on him in the middle of the night. But it has a silver lining! Thanks to not being allowed to settle Danny can still shape his ghost form to a degree. And Clockwork, brilliant old man that he is, has an Idea on how to fix this.

Great! Lay it on him Clockwork! What’s he gotta do? Get de-aged and die? Ha Ha! You sure know how to make a good joke old man-child, now what’s the real way?

Oh

Oh no

Danny Can form a ghost on death, but it’ll require dying while as mentally and physically similar to how he was when the portal closed. Problem there, he’s changed. He’s changed a Good Bit. Luckily Clockwork can handle the physical aspect but Desiree needs some extra time for her end. See, she Can change brain chemistry and whatnot, but it takes time to become permanent. A quick fix like her usual work is fragile (lies, it’s still stupidly powerful but forming a ghost relies on the persons deepest core, and that takes time to settle in to Desiree’s magic). So they just have to de-age Danny to an appropriate age where once he hits around the age he was when the portal closed Desiree’s magic will have settled, molding his personality/core to as close as they can be.

And then he has to die.

Doesn’t have to be as extreme as the portal incident was (in fact new factors like major doses of ecto would be a Very bad idea, his malleable ghost side is already pushing the limits with the minor variation he’ll already have) but it Does need to be in an area with high levels of ambient ecto, preferably his new hometown to match his current life’s lack of geographic movement.

He’ll also need to have his ghost half locked away to a degree. He’ll still need to be liminal of course, that long term exposure to ecto is needed to fuel a ghosts transformation, but proper ghost powers are getting put away unless Clockwork thinks they’re needed (and if it Does get to that point he’s getting pulled out for a second try anyways).

So where to put him? Well Gotham of course!

Clockwork…. Why are you like this (it’s all for the good of the timeline. And Lady Gotham owes him a favor he prepared just for this)

From there if he ends up in the Bats care (Nasty Burger explosion, Ghost Jazz, or simply not having anyone capable of properly raising him knowing he’ll die at 14) it doesn’t take long for one John Constantine to notice the Heavy Infinite Realms influence on the small child and drag the big bat away for his own Talk (double angst if he’s able to recognize the specific brand of Time Magic indicating a death prophecy). If he ends up under Jazz’s care then it might take a bit longer, but she’ll likely end up tied up in Bat business and from there it wouldn’t take long for a Very stressed Jazz to accidentally reveal something (or a child Danny not realizing “I know when I’m going to Die in excruciating detail!” is Not something you share with strangers, especially not ones as paranoid as the Bats).

Also for loose threads I imagine Ellie is unstable because her ecto is cloned off of Danny, while her human half is its own person. That large disparity usually leads to death (as seen in the other clones) but she’s able to force it off with sheer ecto strength, using the ecto shots as fuel to Force her body to stay together until they reach an inevitable conclusion or potentially meld together like Dan does).

As for Dan he’s not Properly a Halfa. I never watched the show so I don’t have all the details but I understand he’s some kinda mix of future Danny and Vlad gone evil and destroying the world. This mix Might be able to last longer than a regular Halfa would due to the insane amounts of ecto he has in his system. And as time passes the mixed ghost halves Could be unstable enough to sort of meld with his human parts, creating something of a Highly unstable ghost-human hybrid (seperate from Halfas since this is a blending of the two, not a distinct line between two halves).

That wouldn’t work with Danny cause it requires a second ghost mixing with him And the two somehow not destabilizing during the years it takes for the blend to settle. And the Ellie route is out since that requires So Much fine control and vigilance over a Very long period of time to slowly manually shape the ghost half to better fit the human half, rather than the other way around like Danny’s doing.

[mayfay]

Danny’s Medical Complications

Or: I had an idea and it won’t leave (and unfortunately I can’t do dialogue to save my life)

It started simple enough, a quick visit to Frostbite for a general checkup. And then it kept going. New machines, techniques, people, and an increasingly worried yeti was starting to freak Danny out a bit. Eventually it all went away and Frostbite set him down for A Talk.

See, Halfas are hella rare for a reason. The conditions needed to form them are really rare yes, but they aren’t the Main problem. No the main issue is the Disparity. Ghosts are beings of emotions, sufficient stress, emotional/mental harm, lack of ecto, and more can all lead to death. And Halfas crank that up to 11. They have a human side to take care of that’s constantly changing and growing, a higher ecto requirement to fuel their higher base strength, and a myriad of other minor complications that haven’t been properly studied cause Halfas are rarely found and usually don’t form ghosts on death

Say what

What do you mean “don’t form a ghost” they’re already half way there!

And there lies the problem, they’re halfway there. Ghosts are pretty static. they might change yes, but it’s usually due to major events or over the course of eons. And how do they decide on what they’re gonna be? By dying of course! Once the body dies its ghost is formed based on the current life situation and they move on. Simple, quick, easy. No complications here no siree!

Enter Halfas

They already died, and while infant ghosts and experience some major changes as they settle it’s nothing to the degree humans do. And as time passes the static ghost half and changing human half can drift, wobbling on that line between life and death. And once it gets to extreme? They fall. If the ghost half starves or dies the human half experiences Major health complications, leading to death shortly after. If the human side dies they try to form a ghost using all the ambient ecto the ghost side has been feeding on, leading to the ghosts death in most cases but if not they’re practically two different beings and fusing them will kill both anyways.

Good news though! With all the combat and rediculously high ecto levels Danny was exposed to to form his other half, his ghost side has stayed pretty adaptable! The other ghosts didn’t realize they were fighting a literal infant thanks to the high ecto levels he had (and the knowledgeable ones that Did had other reasonings the meant a little smack down they totally wouldn’t lose was an acceptable trade off for them). Horrifying, he will spend the next century finding all sorts of animal pelts, boxes, music tracks, etc landing on him in the middle of the night. But it has a silver lining! Thanks to not being allowed to settle Danny can still shape his ghost form to a degree. And Clockwork, brilliant old man that he is, has an Idea on how to fix this.

Great! Lay it on him Clockwork! What’s he gotta do? Get de-aged and die? Ha Ha! You sure know how to make a good joke old man-child, now what’s the real way?

Oh

Oh no

Danny Can form a ghost on death, but it’ll require dying while as mentally and physically similar to how he was when the portal closed. Problem there, he’s changed. He’s changed a Good Bit. Luckily Clockwork can handle the physical aspect but Desiree needs some extra time for her end. See, she Can change brain chemistry and whatnot, but it takes time to become permanent. A quick fix like her usual work is fragile (lies, it’s still stupidly powerful but forming a ghost relies on the persons deepest core, and that takes time to settle in to Desiree’s magic). So they just have to de-age Danny to an appropriate age where once he hits around the age he was when the portal closed Desiree’s magic will have settled, molding his personality/core to as close as they can be.

And then he has to die.

Doesn’t have to be as extreme as the portal incident was (in fact new factors like major doses of ecto would be a Very bad idea, his malleable ghost side is already pushing the limits with the minor variation he’ll already have) but it Does need to be in an area with high levels of ambient ecto, preferably his new hometown to match his current life’s lack of geographic movement.

He’ll also need to have his ghost half locked away to a degree. He’ll still need to be liminal of course, that long term exposure to ecto is needed to fuel a ghosts transformation, but proper ghost powers are getting put away unless Clockwork thinks they’re needed (and if it Does get to that point he’s getting pulled out for a second try anyways).

So where to put him? Well Gotham of course!

Clockwork…. Why are you like this (it’s all for the good of the timeline. And Lady Gotham owes him a favor he prepared just for this)

From there if he ends up in the Bats care (Nasty Burger explosion, Ghost Jazz, or simply not having anyone capable of properly raising him knowing he’ll die at 14) it doesn’t take long for one John Constantine to notice the Heavy Infinite Realms influence on the small child and drag the big bat away for his own Talk (double angst if he’s able to recognize the specific brand of Time Magic indicating a death prophecy). If he ends up under Jazz’s care then it might take a bit longer, but she’ll likely end up tied up in Bat business and from there it wouldn’t take long for a Very stressed Jazz to accidentally reveal something (or a child Danny not realizing “I know when I’m going to Die in excruciating detail!” is Not something you share with strangers, especially not ones as paranoid as the Bats).

Also for loose threads I imagine Ellie is unstable because her ecto is cloned off of Danny, while her human half is its own person. That large disparity usually leads to death (as seen in the other clones) but she’s able to force it off with sheer ecto strength, using the ecto shots as fuel to Force her body to stay together until they reach an inevitable conclusion or potentially meld together like Dan does).

As for Dan he’s not Properly a Halfa. I never watched the show so I don’t have all the details but I understand he’s some kinda mix of future Danny and Vlad gone evil and destroying the world. This mix Might be able to last longer than a regular Halfa would due to the insane amounts of ecto he has in his system. And as time passes the mixed ghost halves Could be unstable enough to sort of meld with his human parts, creating something of a Highly unstable ghost-human hybrid (seperate from Halfas since this is a blending of the two, not a distinct line between two halves).

That wouldn’t work with Danny cause it requires a second ghost mixing with him And the two somehow not destabilizing during the years it takes for the blend to settle. And the Ellie route is out since that requires So Much fine control and vigilance over a Very long period of time to slowly manually shape the ghost half to better fit the human half, rather than the other way around like Danny’s doing.

[madelynraemunson]

CALL ME WHAT YOU WANT 𓆩♡𓆪

(Book 1 of the Hellfire Gentlemen's Club)

(strip club owner!eddie x fem!exotic dancer!hargrove! reader)

𝐌𝐎𝐃𝐄𝐑𝐍 𝐀𝐔 18+ MINORS DNI

006: The Eddie Special

Rent is paid, food is on the table, and Max finally has a YMCA membership! All because of you. But just when you think you've got your two lives under control, Robin and Vicky show up to Hellfire for date night — and see you dancing center stage.

* = somewhat smut

** = smut

↳ chapters: 001, 002*, 003** , 004**, 005 , 006 , 007* , 008**, 009, 010, 011, 012* , 013**, 014**, 015, 016**, 017, 018, 019, 020*

word count: 5.2k words

warnings — eddie being an asshole again but also very sweet, mutual pining, angst, yearning, profanities, power imbalance, double standards, smoking, alcohol, sexual harassment, health issues/disparities, trauma, pedophilia, incest, name-calling

“A compromise would surely help the situation.”

♡

“Hey, stranger.”

Robin flashes you a “good morning” smile as you’re washing the dishes. Scooting to the side, you continue to scrub as she leans against the sink with her back, munching away at her breakfast sandwich that Vicky had prepped for her the night before.

“Morning,” you grin in return.

“Funny,” she says. “We live under the same roof now but our friendship still feels long distance.”

“Sorry… ” you frown. “Work’s just been a lot.”

So is living a double life. To shake off the guilt that constantly gnawed at you, you dry your hands and proceed to make yourself some coffee. When you scan the fridge, the only creamer you can get your hands on is...

Hazelnut. Just your luck.

There’s a tinge in your chest as you dunk it into your mug. You stir aggressively. Robin notices how tense you are and walks over to you.

“Don’t be so hard on yourself, my guy,” she says as she pats you on the back. “Healthcare is tough. I dated a travel nurse once and that poor woman had back problems for days.”

“Such a physically and emotionally taxing job,” Vicky adds as she emerges from their room. “I don’t know how you do it, Hargrove.”

“Good morning, baby.”

“Good morning, sweetheart.”

Smooch.

You chuckle to yourself as you sip your Eddie-coded coffee.

“Yeah. I don't know how I do it either…”

The wooden stairs creek and crack as a pair of Vans stomp against them. Max is awake. This morning is an exciting one. After many, many overtime shifts at Hellfire, you've accumulated enough tip money to pay for Max's membership for 12 months. On top of that, rent had already been paid so you had a hefty cushion leftover for leisurely expenses.

You can hardly contain yourself. Seeing the surprised look on your sister's face is sure to be the highlight of your morning.

Max stares at you in shock when she sees you in the kitchen.

“Whoa,” she says. “She’s awake.”

You only ever see Max in passing when she comes home from the skate park. And that's right when you leave for work. From what she tells you she hasn't made many friends, but her main priorities right now are her hobbies and preparing herself for college classes in the Fall. Sometimes Max will tag along with Robin and Vicky to run errands, but you can tell she misses spending time with, and seeing, her sister.

“Shocker, right?” you sigh. “Thought I'd catch you before you head out.”

With your hands behind your back, you stride over to Max to give her her well-earned gift.

“What’s this?” she wonders.

“Your ticket to the Y,” you explain. “A band and a quarter, should last you a year.”

"Whoa!" Vicky exclaims.

"Holy shit! Look at that!" Robin cheers.

Max's eyes widen as she takes the money from you. “ $1200?! What bank did you have to rob to get $1200?”

“No bank,” you shake your head as Max counts all of the Benjamins. “Just the pockets of old, retired folk.”

You grin from ear to ear as you watch Max get bombarded with hugs that she is reluctant to accept, but does regardless. Vicky and Robin hoot and holler and squeal and cheer, reaffirming to Max that she deserves it the most.

“You’re really giving the elderly a run for their money,” Max says as the celebration comes to an end.

You watch in amusement as Vicky and Robin take turns counting Max's money.

“Yeah well it’s the least they can do for me,” you sigh. “My body feels like it’s aged 10 years.”

Max excuses herself from your roommates and throws herself onto you this time. You do your best not to cry. You've really missed her hugs.

“Thank you,” she says. “Thank you. Thank you. Thank you.”

Seeing how happy your sister is makes all your struggles worth it. Anything for Maxine.

———— 🔥 ————

“I don’t know who you think I am, but I don’t really give a damn right now.”

The past couple of weeks at Hellfire have been nothing short of awkward.

Eddie only really comes to you when he needs something, which — now that you've taken off those rose-tinted glasses — pretty much fits the bill of who he is as a person.

But he still lingers. For example, when you and Chrissy go on breaks together, there is always something for Eddie to do in close proximity. Table needs wiping? Eddie is there. Aisle needs sweeping? Mike, go help in the back. When you're dancing on customers, Eddie comes out from doing paperwork in his den to greet the regulars. And whenever you would turn to look at what Eddie’s doing, his gaze is already fixed on you and what you’re doing.

Like cat and mouse. But of course, he does it with all his dancers. Right?

A part of you wants to confront Eddie and his behavior, but before you even can he's out the back door to go on a "smoke break" with Argyle after closing, which usually is a short jump to him leaving. So you try to act unbothered by it by staying just a while longer with Henry… just in case he does come back.

But Henry puts you to work when you stay. He typically has you make sure all doors are locked, all chairs are stacked, and that any stray garbage is thrown away. You two play music while you work alongside one another, talking shit about customers and about how every day is starting to look the same.

You’re aware of how you openly contradict yourself, saying the days all bleed into one another and how you miss your bed. Yet you’re still at Hellfire. Way past closing time. Henry for sure has caught on to your odd behavior, but he doesn’t seem to mind because he enjoys your company.

It’s like clockwork now, this ritual-slash-routine.

Today is different for some reason.

"Hey!" Eddie calls out. “Shy Girl!”

You’re alone eating in an isolated part of VECNA’S LAIR when Boss Man makes his way over to you.

You’re frozen in your spot as he approaches you…willingly. Although you could care a lot less about his presence, the gesture still causes you to sit up a little straighter and blot-dry any remnants of your food with your napkin.

Eddie sets down new laminated prints of his menu in front of you. Plop.

"New item on the menu,” he gloats, very amused with himself. “Waffle fries. What do you think?"

Annoyed, you huff.

"Sure."

Two weeks of barely uttering a sentence to one another. Two weeks of avoiding eye contact and possibly one ‘excuse me’. Two weeks of being a background character in Eddie’s life and his icy shoulder making sure you knew it.

Now you’re more than an extra today. Because today Eddie decides you’re something of value, and that just for today your input actually matters. It's pathetic. It all makes Steve and Nancy look like best friends.

Your eyes travel to his firm hands. His silver rings. You hate to admit that you miss how they felt against your skin, especially since your skin seemingly isn't the only one he grazes. I do this with all my dancers. Your hands ball into fists. How can someone be so okay with using someone the way Eddie did with you?

"So we'll do regular waffle fries and the crinkle cuts will be our sweet potato fries from now on,” he explains.

“Mhm.”

“And eventually,” Eddie booms dramatically. “We’ll introduce the concept of different types of fries. Cajun fries, cheese fries, chili cheese fries. Then we'll introduce new cuts like curly fries... wedges..."

Not a word from you.

"Then we’ll do animal style fries like how you Californians do it at In-N-Out. I’ll call it ‘The Eddie Special’. It’ll be amazing!”

"You call the shots, Eddie."

Like he always does.

Eddie finally gets the message. You watch as his shoulders droop as he surrenders.

"Are you okay?" he dares to ask perplexedly.

"Never better!" you exclaim.

You grab your finished meal and dart past him, not even bothering to pardon yourself when your shoulders brush his slightly. You hear Eddie exhale, super displeased as the taps he makes on the table with his fingers render themselves fast and impatient.

“You don’t wanna stay and chat?” your superior demands sharply.

“I have to clock back in,” you answer coldly. “Sorry.”

“K then,” Eddie quietly mutters, returning the energy.

You try to look busy, so you pull out your phone and pretend to check something. Luckily, a text message from Robin pops up for you to reply to.

ROBIN BUCKLEY ☀️🤍

Date night with Vicky tonight. Breakfast/lunch/dinner waiting for you in the fridge when you get home 😁

You smile.

You da bestest 🩷 thank u

Buzz.

ROBIN BUCKLEY ☀️🤍 loved “You da bestest 🩷 thank u”

“Hey, Hargrove?” Eddie calls out to you.

His voice sounds a lot softer and apologetic. With the optimism that your tactic worked, you spin around to face Eddie with eager eyes. Maybe today is the day things go back to normal again.

“Hm?”

“No going on your phone when you’re clocked in, k?”

A blow to the chest. Bitter and agitated, you shove your phone into the back pocket of your booty shorts. Yes sir, you mutter to yourself mentally.

After thanking you, Eddie struts to the kitchen, using his own phone to pull up Dio on Spotify. He and Argyle like to head-bang and fuck around in the kitchen when they’re together. Messing around is only okay if Eddie does it, you assume.

To make matters worse, Eddie then proceeds to use his stupid phone to send someone a text. You scoff at the irony. Fucking prick.

Another trigger of yours? Power imbalance and double standards.

Attempting to be drama-free, you ironically make your way over to Steve and Jonathan, who are posted up at POTIONS.

“Hey Shy Girl,” Jonathan nods.

"Hey Johnny," you greet him.

You turn to the literal love of your life.

“Sup, Steve.”

"Hey, Hargrove," Steve nods. "How'd you do on tips last night?"

"Stellar," you answer. "Fucking love Fridays."

You and Steve are still casually hooking up. But just as you predicted, things aren’t quite the same. The problem this week is that Steve is struggling to finish, and you start to feel discouraged and insecure when he softens up inside of you.

Steve always used to finish. Now when you look up at him his gaze is fixed on something else, his strokes are less enthusiastic, and he mistaked one of your kinks for someone else’s once. But you pretend not to notice. A part of you even feels like you deserve it.

Steve is struggling with the eye contact today. You kick at the floor, trying to find a way to make your presence relevant in this corner of Hellfire. Knowing very well what you’re doing, Steve holds up a French fry from his red picnic tray as a supportive gesture.

"Would you like some?"

You beam at him and open your mouth so he can feed you. Steve obliges.

“Thanks boo,” you say to him as you chew.

He blushes. “Welcome.”

“You guys are cute,” Jonathan smiles as he wipes his hands with a hand towel. “I gotta run to the restroom, you mind watching the bar for a bit, Hargrove?”

“Not at all,” you oblige. “I’ll be here. Eating Steve’s fries.”

“Great,” Jonathan says, excusing himself. Then he halts. “Oh! If you open the register, Eddie has something for you underneath. Code is 0-1-1.”

Eddie has something…for you?

You turn to Steve and he just shrugs. As if it weren’t already obvious, you and Eddie weren’t exactly on friendly terms. What could that man possibly have for you?

It’s a termination notice, you can feel it. Bracing yourself for the absolute worst, you punch the code in.

0 - 1 - 1.

CHA-CHING! The register pops open. You lift the till that housed the cash and coins to unveil a pile of cash joined together by a small paper clip. There is a tiny note that was written onto a ripped piece of paper.

You pick it up. This couldn’t be for you, you think. But the sloppy handwriting with a partially bleeding pen says otherwise.

‘Hargrove: $600 — YMCA MONEY’

----- ❤️‍🩹 -----

“She the devil, she a bad lil bitch, she a rebel.”

Tonight you’re doing private dances with customers and also doing tip rail. But you wish you were just doing tip rail 'cause tonight’s clients were ballsy.

One patron said you look like his daughter. But it’s okay because ‘she’s married and out of the house’. Another said you look like one of his students. But it's totally okay because he teaches at the community college, therefore almost every pupil there is ‘at least 18’. It still doesn’t make it any better. All you could think about is your 18 year old baby sister — someone’s daughter and someone’s someone — someone who will also be walking the halls of Hawkins Community College later this month.

This customer, however, takes the cake. After guiding his hand away multiple times during the lap dance, he always manages to find the straps of your bra again. Upon strike three, you lose all patience.

“Yo, can you not do that?” you hiss, your inner Cali dude coming out to play. “I moved your hand away many times.”

The man is almost appalled. “It’s a strip club, isn’t it?”

“Yeah, but I strip on my terms.”

"I paid for your services," he spat. "So I'm sure I get to do what I want, hoe."

“Don’t call me that!”

“I'll call you what I want,” the customer insists. “It’s what you are anyways if you’re in this job right?”

He takes out another dollar and tucks it into one of your cups. You could only stare in shock. The audacity of this guy.

“Here,” he says degradingly. “Looks like you really need it. Now let me see those tits. Please.”

Anger consumes you. Whatever amount of the Neutral Wolf you had left in you has now melted away. The Big Bad Wolf is taking over now. You give the man a shove, hoisting yourself off his disgusting body.

"What the FUCK is your deal, bruh?" you bark, a piece of Billy coming out of you more than you intended. "You want a piece of me that badly, don't you?"

Your words cause a scene in the surrounding area. Not even phased by it, the patron decides to push you further.

“Easy, easy,” he rolls his eyes. “If it’s that much of an issue I’ll just take my money back.”

He yanks the dollar back from out of your bra. His knuckles just grazed your tits.

“What kinda strip club is this anyways? Theme is janky as fuck. The STRIPPERS don’t even strip. They’re RUDE, and they’re butt ugly. The owner should be ashamed. Oh and by the looks of it, you don’t have much tits to work with after all.”

“Pull up your shirt,” you quip. “I think I found ‘em.”

This poor man. He didn't know you're a Hargrove.

And soon you’re throwing shit. His money. Your shoes. Every curse word in the dictionary, both traditional and urban with the exception of a few. You’re seeing all red now, and you’re pretty sure if no one stopped you, you’d have ripped the guy’s head off.

“If I don’t have tits, why you trying to get at me?” you roar. “You like little boys or something, bitch?!”

“HENRY!” Eddie shouts.

You turn in the direction of Eddie’s voice. He had been watching. Through your furious, free-falling tears, you can see in his dark eyes, closed fists, and flared nostrils that he is angry as well.

“On it, boss!” Henry shouts as he scampers on over. “What the fuck do you think you’re doing, asshole?”

The friendly bouncer swoops you off to the side and asserts himself between you both. Lucky for the guy, no dislocated limbs were in the cards today. All it took was another person with a penis to get this fool to back down. He tries to reason with Henry but it’s far too late. Henry’s already pushing him towards the door.

“I’ll be coming BACK to have my way with you,” the beast growls and spits. “Fucking SKANK!”

“I HOPE THE FUCK YOU DO, MOTHERFUCKER!” you challenge him. "I'll be right here waiting!”

A calloused hand lands on your lower back. Thinking it’s another customer, you turn aggressively, fist winded up. As quickly as you lunge, a large palm catches it mid-air.

It’s Eddie.

Worry washes over your boss’s face when you two lock eyes for the first time. After what seemed like an eternity. He looks at you with the utmost concern. You almost see a tear glistening in his eye. A portion of his hair falls over his face in attempts to conceal it.

"Are you okay?" Eddie asks again, genuinely.

You nod, gulping.

You aren't okay, that's the thing. Not when Eddie looks like that. And not when he's looking at you, like that. Suddenly, Hellfire melts away and you're back in his van, fighting back every urge to fall into him and his musky, pine aroma infused with nicotine, weed, and beer. Just like home. Eddie feels like home.

Papers beat rock. Slowly, Eddie lowers your fist with the palm he had draped over you. The pulsing music and blinding strobe lights trickle back into your system.

"It's okay if you aren't..." Eddie starts. “You know... alright.”

"Eddie," you stop him. "Please. I'm alright."

“That was a lot.”

“But it's nothing new to me.”

He studies you. Doesn’t speak for a while.

“It's true!” you insist, attempting to diffuse Eddie's concern. “It kinda reminded me of the frat parties in San Diego I used to go to. You know what I’m saying?”

You try to laugh. But Eddie doesn’t. Henry and some dancers come to check up on you, especially Chrissy, to ask if you're okay. They even try to start a petition to jump the guy. You repeat the very thing you've been saying since it happened — yes, you are okay — and thank them for their concern. Then it's back to you and Eddie the moment they all disperse.

"Want a break?" he offers.

You shake your head. Dancing it off would help more, actually. And besides, if his offer is just another attempt to get you alone in his car and fire you up only to extinguish it all again in one sitting, you'll pass.

"Wanna go on stage now then? Get a break from individual dances?"

You smile and nod. "I'd love that."

The night can only get better from here. Eddie offers you his hand and helps to hoist you onto the stage. The DJ announces your name, and you’re back in business, putting on your million dollar smile and batting your seductive, little lashes.

Your song comes on and you start to shake your ass. Lost in the trance of the song, you become one with the pole, climbing it and gliding along it, twirling from it, and hovering with it, twerking and spreading your legs whenever you saw fit. The audience revels in it.

It all feels so good. Yes you are being provocative, everybody and your brother's worst nightmare -- but you're the one in control. No one can ever take your body autonomy away from you. Never again. Not anymore.

You do a death drop to the floor and quickly ease into your splits. The crowd goes wild as you roll your hips to the song, allowing yourself to get showered by the dollar bills that were raining down on you like a storm.

To thank everyone for their overwhelming support, you spin yourself around to face the crowd. But your heart nearly stops.

“Oh my god,” you gasp aloud.

Nothing could ever prepare you for what... or who rather... you see in front of you.

“Oh…my god,” Robin repeats, face sheet-white like a ghost.

Vicky is right beside her with the same shock on her face. Of course, your roommates have acknowledged this place before, so it wouldn't be a surprise that they eventually made this place their date night.

Your mind short-fuses and all you can do is crawl away backwards. Luckily, no one in the crowd seems to suspect how thrown off you just became. Your body quickly calls on another dancer as your mind races. And soon Emmy is taking your spot at the tip rail.

You look over at Eddie, who was in the corner leaning against the wall, but now he is standing upright and confused. Throwing on your cloak, you thank everyone for coming out and run out to the back alley.

"Shit, shit, shit, shit, shit, shit, shit," you mutter to yourself, as your heels click against the cold floor. Your cover is blown. What do you do now? "That's what you get for working local, Hargrove."

You find an area in the alley to rest and hit your dab pen ferociously. As you pace back and forth, you start to develop your exit plan. Nothing new, you develop these plans all the time.

Eventually Robin and Vicky find you. Clumsily spilling out the back door comes Thing 1 and Thing 2, assessing your body language and emotional well-being before finding the right words to say. It’s uncomfortable for everybody.

“Well this is quite the nursing home,” Robin remarks.

“Babe!”

“What?!” Robin exclaims. “I’m trying to lighten the mood.”

“Yeah but that can kinda come off as witty and sarcastic.”

“Well I don’t mean for it to.”

“Just because you don’t mean for it to, doesn’t mean it won’t come across that way.”

“Well knowing Hargrove I would hope she knows it’s not meant to come across that way.”

“GUYS!” your overstimulated self shouts.

All is quiet on midwestern front. Vicky and Robin switch between looking at you and back down at the ground while you resume your stress-filled nic break.

Finally, you speak after exhaling.

“So how’s everyone’s niiight?”

Robin gets straight to the point. “Why didn’t you tell us you work here?”

“I was protecting Max.”

“From what?” Robin wonders. “Ass and boobies? Extensions and falsies and freakishly high, high heels?”

“Doesn’t sound like nightmare fuel to us,” Vicky shrugs.

“It is when you consider the women Billy’s brought home.”

“What does Billy have to do with any of this?” asks Vicky.

“A lot, actually,�� you answer.

You shove your pen back into your cloak pocket.

“Look,” you say. “I really needed the money. And I needed it fast. With my server and dancing background, I figured being a stripper was the best way to make it. And I was right. It’s quick money, but it’s sure as hell not easy. It’s draining for the most part, but—”

You stomp at the ground in frustration.

“My sister is fed and she can go to the Y and go to school and she’s away from Billy anditsallthatI’veeverwantedokay? That’s why I did it.”

“Okay, but I don’t see the point in coming up with this elaborate story that you work nights at a nursing home,” Vicky squints in thought. “Come on Hargrove, we are the least judgmental house in the boonies. I mean look at us.”

“Art Hoe Lesbians in a red state,” Robin points out. “I’m sure exotic dancer is a very mild offense.”

They did have a point. And it's not like Max is the type to slut-shame either. But you wanted Max to live as normal of a life as possible. Having a stripper sister also didn’t seem like the best conversation starter in Hawkins.

"I guess I'm just used to living a lie," you admit exhaustedly. "And running away... I also know Max would be worried sick for me."

"You only live lies if you tell 'em," Robin points out. "But as long as you're here with us, you're free to be your true and authentic self."

"Your job right now is to provide," Vicky adds. "And you're doing a wonderful job."

You beam. "Yeah?"

They both nod, yes. Sometimes you forgot what a support system is like. It always used to be everyone for themselves.

"Thanks guys."

"You're welcome," Vicky grins. "For now we'll keep our lips locked. We did not see anything."

"But you are going to have to tell Max eventually," Robin scorns.

"I know," you sigh. "I appreciate the stall."

The three of you hug. That's another thing you've been needing these past few weeks. A warm, authentic hug.

"Nice ass by the way," Robin compliments you.

"And tits," Vicky adds.

"Thanks."

———- ❤️ ———-

“I’ll kindly take you up on that Eddie Special, please,” you mumble.

Eddie had last-called everyone 15 minutes ago, but deep down you hope he had enough room in his heart for you. It’s been a dumpster fire of a shift.

Sure enough Eddie caves, judging by the way he starts up the fryer again after having shut it down right before you got to him.

He grins warmly. “Coming right up.”

As the fryer starts to bubble, Eddie loads in the last of the crinkle cuts. He waits close by with crossed arms.

Eddie’s first to break the silence.

“You seemed to know those customers,” he comments, referring to Vicky and Robin. “Judging by how fast you ran from them. In pumps too.”

“They’re my roommates,” you reply. “My best friend and her partner. They didn’t know I work here.”

He raises the eyebrow at ‘best friend’. “Even they didn’t know you work here?”

“I don’t know what they’d do with this information,” you utter defensively. “I guess it’s just hard for me to trust people.”

“Is it really, Miss Flight Risk?”

He’s referring to moving in with a girl you met online. You shoot him a look. The “I-didn’t-really-have-any-other-choice” look. He quickly digresses.

“I’m kidding,” he surrenders. “Okay? I understand that there are some things you gotta keep secret.” Eddie wriggles the basket full of fries around in the fryer. “…Even from your loved ones.”

Something tells you he speaks from experience. You shrug it off, ensuring he’d elaborate if he wanted to eventually.

Meanwhile you just decide to hit him with some small talk.

"How’s Chef Lucas been doing back here?"

"Fine and dandy," Eddie breathes. "For the most part. He burnt some things a couple of days ago, but that's part of being an apprentice, right?"

"Totally,” you nod. “Mistakes are bound to happen."

"Ohhh yeah," Eddie mutters, almost to himself. "Lots and lots…of mistakes."

"Trial and error, if you will,” you pitch in.

"Yup,” he draws on. “Seeing what works and what doesn’t. Testing the waters..."

Your eyes meet again. Briefly at least.

Eddie struggles to hold his gaze and instead resorts to clumsily playing around with a cloth nearby while whistling a tune. You can feel it getting awkward again so you find a way to keep the conversation going.

“Thank you for being there,” you attempt. “And helping out with my sister’s membership. You didn’t have to.”

“But I wanted to,” Eddie insists. His back is towards you so you can't read his expression. “You’ve been working very hard.”

“That’s why you don’t have to,” you say as-a-matter-of-factly. “It’s already paid off.”

Eddie chuckles. “Okay, then use it to buy yourself something nice. You deserve it.”

A hoot sounds from the opposite end of the hall. It’s Henry making his way over with some keys.

“Alright Babyboy, I’m out,” he announces. “I can lock up if you’d like? Not like I have anything to do.”

“I can take it from here,” Eddie insists. “Sweet dreams, Mr. Creel.”

Henry makes his way over, narrowing his eyes.

“Thought you normally go see Wayne after this.”

“I do,” Eddie replies. “But he had company earlier and I’m sure he already put himself to bed by now. I’ll stop by for breakfast.”

Henry’s eyes shift between you and Eddie. There’s a small smirk but he tries to conceal it. You’re staying late again, huh?

“Your words not mine,” Henry says. “Goodnight you two.”

You both bid Henry goodbye and he sees himself out. Eddie proceeds his periodic check-ins with your taters.

"You've uh, been appointing Henry a lot," you point out.

"Hell yeah, like clockwork," Eddie shrugs. "This industry is predator central. Just hate when dickheads think they can disrespect my girls. I don’t play that way.”

My girls.

“Not his first time doing shit like that,” Eddie adds, referring to the customer. “I regret giving him another chance. I should just get Henry or Jim to print a picture of his face and plaster it all over the walls. DON'T LET THIS ASSHOLE IN.”

You laugh. Eddie laughs at your laugh and then goes to melt the cheese for your dish.

“Yeah,” you say. “You give a man another chance and all he does disappoint you.”

Eddie sighs and nods timidly. “Yeah… Men ain’t shit huh?”

It falls silent for a bit. Eddie slowly stirs the melted cheese concoction he had going on in his pot while eyeing the time. You fiddle around with your cloak out of habit. Eddie speaks first again.

“You know what Shy Girl, I’m gonna do it,” he says. “Gonna broadcast his face and I’ll have you sign off on it.”

“Really?” you say.

“Of course,” Eddie shrugs. “You know how I am. I don’t play when it comes to you.”

The rasp in his voice sounds like melted butter. For a fraction of a second, you start to wonder what you were even mad about earlier.

You really missed talking and bantering with Eddie. Aside from whatever the hell was going on between you both, his companionship was not something you felt was fake.

Eddie begins mixing some sauces, and when he's done he hands you what you assume is your tips that you forgot to collect. You know, when you bolted off the stage.

"Already tipped everyone else out," he explains. "Rest is yours to keep."

You thank him and count all your bills. Now you have $600 of reallocated YMCA money and tips from tonight to pay off your bills and splurge.

You haven't had this much money since your waitressing job. You are forever grateful.

“Is there...anything I owe you Eddie?” you question. “Like at all? You’ve done a lot for me lately.”

“Ehhh you’re in the clear, I guess,” Eddie sheepishly smirks. “Lucky for you I’m a sucker for flattery.”

The fries are now cooked to a golden crisp and Eddie adds the components needed for The Eddie Special. He spends a decent amount of time to perfect the presentation before sitting down in front of you. In true Eddie fashion, he takes a bite of his own creation.

"HOT," he comments, trying to blow on the fry that's already in his mouth. "Hot, hot, hot. Fresh out the fryer."

Judging by his face, however, he approves. You can’t help but giggle over and over again. He gestures for you to try some.

It’s love at first bite.

"Mhm," you coo. "Thank you, Eddie."

"You're welcome," Eddie says. He grabs a washcloth to clean up the area. “Now… when you’re finished, how about I treat you to a real dinner?”

-------

author’s note: school has been taking over my life but i’m so glad i got to crank out this chapter for you guys 🖤 i’m excited to see how y’all are gonna react to shy girl’s orientation dinner…. 👀

tag list: @changemunson , @the-fairy-anon , @ali-r3n , @corrodedcoffincumslut , @bebe07011 , @mmunson86 , @eddiesguitarskills , @chelebelletx , @imonhereforareasonsadly , @eddies-trailer-babe @hideoutside , @motherfckerrr , @jxpsi , @munson-magic , @lindseyj23 , @sidthedollface2 , @manda-panda-monium , @elvendria , @micheledawn1975 , @hereforshmut , @siriuslysmoking , @nymphetkoo , @m-chmcl-rmnc , @holabeans00

[befuddledcinnamonroll]

Spare Me Your Mercy - final thoughts

I was out of town last week, so didn't have a chance to watch the SMYM finale until today. But wow, what an experience this show was. I have a few minor criticisms, but overall, I found this to be such a nuanced and heartfelt watch.

You can tell how deeply those making this series cared about the topic of euthanasia, and creating a venue for discussion. The emphasis on people's autonomy and right to dignity, the callout of class disparity and how it impacts the end of one's life, the inequity in health care and how people with few resources are disproportionately burdened with caring for dying family while still trying to survive day to day. How the trauma and pain of it all grows exponentially, continually leading to further tragedy.

I know there are criticisms of the Kan and Thiu relationship, but honestly, it worked for me. To me, it felt like what was needed for the story. Thiu is clearly a deeply internal character. He may not necessarily hide but he is not remotely forthcoming about his inner world, whether it be his sexuality or his affections or his worries about Kan. Kan is much more open and extroverted, but at the same time, he was willing to lie to Thiu for their entire lives due to his convictions. These are not men who are going to be doing grand romantic gestures for each other; it's a quiet, and honestly, quite realistic form of love. At the same time, it was supposed to feel slightly off, because there was a giant wall between the two of them. There were too many secrets, and too much pain, and none of it was being dealt with in the open. They couldn't be genuinely honest and intimate with each other. Until the very end, when Kan shows he is willing to give up everything in an act of love for Thiu, and Thiu is finally able to say what he feels. It may feel dark, but the wall is down, and I think they will weather what comes next.

What I particularly appreciate about this series is the emphasis on how harmful it is when you cannot talk about a difficult subject. It is likely that many of us fall into slightly different places on the spectrum of what is moral and ethical when it comes to euthanasia, but the vital thing is being able to communicate about it. Thiu's mother wasn't able to tell her son that she was ready to die, so he became mired in his regrets and his grief, rather than understanding it was her choice. Rin wasn't able to talk to her father, to know that he was self-determining his end (and thinking of her), so she was left to wonder and feel rejected. Somsak wasn't willing to listen to his lover's wishes, due to his entrenched beliefs, so missed being there for his final moments. Boss couldn't come to Kan directly, and ended up on a misguided and fatal path. And none of them had an avenue to process their pain. It all needed to be talked about, to be brought into the light of day without fear or shame. We all need to be able to talk about it.

It's really interesting to watch this show as someone who grew up in America when the furor around Kevorkian happened (for the non-Americans, a doctor who went to prison for euthanizing a terminally ill man), and experienced what it's like when euthanasia breaks in as a topic of news cycles and everyday conversation. I am also someone who lives in a state where assisted dying is legal. My parents are elderly, and we have talked about their end of life wishes. Living in a state where they could make their own decisions was paramount to them. It's incredibly challenging, and it hurts to even think about, but it is so very necessary to communicate with those we love.

My heart goes out to everyone who has had to personally grapple with this topic, and had to deal with a lack of legal options for a peaceful end of life. May we come ever closer to a world where we all get full autonomy, and can be open with those we love about what we need, both now, and at the end.

[reasoningdaily]

The Real Disparities of Mental Health Care in 2023 america

The real disparities of mental health care in america between minorities and rich - Reality Ausetkmt 04/13/2023

Mental Health Disparities in America

Mental health is an essential part of overall health and well-being. However, not everyone has equal access to mental health care. In America, there are significant disparities in mental health care between minorities and the rich.

State Mental Health Care Index Score

West Virginia 53.4

Mississippi 54.1

Arkansas 54.5

Oklahoma 54.9

Alabama 55.2

Kentucky 55.4

Missouri 55.7

Tennessee 55.9

Louisiana 56.1

South Carolina 56.3

The Mental Health Care Index is a score that measures the availability and quality of mental health care in each state. The score is based on a number of factors, including the number of mental health providers, the cost of mental health care, and the access to mental health care.

The states with the least mental health care are typically rural states with low incomes. These states often have fewer mental health providers, and the cost of mental health care can be prohibitive. Additionally, people in these states may be less likely to seek mental health care due to stigma or lack of awareness.

There are a number of things that can be done to improve mental health care in these states. One is to increase funding for mental health services. This would allow states to hire more mental health providers and make mental health care more affordable. Additionally, states can work to reduce stigma associated with mental illness and educate the public about the importance of mental health care.

There is a strong correlation between mental health care spending and violence rates. States with lower mental health care spending tend to have higher rates of violence. This is likely due to a number of factors.

First, people with mental health problems are more likely to be victims of violence. They may be more likely to be targeted by criminals, or they may be more likely to engage in risky behaviors that put them at risk of violence.

Second, people with mental health problems are more likely to be perpetrators of violence. They may be more likely to lash out in anger or frustration, or they may be more likely to commit violent crimes.

Third, states with lower mental health care spending tend to have fewer resources for preventing and responding to violence. This means that there are fewer programs and services available to help people who are at risk of violence, and there are fewer resources available to respond to violent incidents when they do occur.

There are a number of things that can be done to address the link between mental health care spending and violence. One is to increase funding for mental health services. This would allow states to hire more mental health providers and make mental health care more affordable. Additionally, states can work to reduce stigma associated with mental illness and educate the public about the importance of mental health care. Finally, states can invest in programs and services that prevent and respond to violence.

there is a correlation between police violence statistics and states with less spending on mental health care.

A 2021 study by the National Bureau of Economic Research found that states with lower mental health care spending had higher rates of police killings of unarmed civilians. The study found that a 10% increase in mental health care spending was associated with a 1.5% decrease in the rate of police killings of unarmed civilians.

The study's authors suggested that the link between mental health care spending and police violence may be due to a number of factors. One possibility is that people with mental health problems are more likely to be involved in interactions with police, and that these interactions are more likely to be violent. Another possibility is that police officers in states with lower mental health care spending may be less well-equipped to deal with people with mental health problems, which may increase the risk of violence.

The study's findings suggest that increasing mental health care spending could be an effective way to reduce police violence. However, it is important to note that the study was observational, and it is not possible to say definitively that the link between mental health care spending and police violence is causal. More research is needed to confirm the findings of this study and to identify the specific mechanisms that may be responsible for the link.

Minorities

Minorities are more likely to experience mental health problems than white people. However, they are also less likely to receive mental health care. In 2017, only 39.2% of black adults with a mental illness received treatment, compared to 54.9% of white adults.

There are a number of factors that contribute to these disparities. One factor is lack of access to care. Minorities are more likely to live in areas with fewer mental health providers. They are also more likely to be uninsured or underinsured.

Another factor is stigma. Minorities are more likely to report feeling stigmatized for seeking mental health care. They are also more likely to believe that mental health problems are a sign of weakness or personal failure.

The Rich

The rich are more likely to have access to mental health care than the poor. In 2017, 67.7% of adults with a household income of $75,000 or more received treatment, compared to 45.7% of adults with a household income of less than $25,000.

There are a number of factors that contribute to these disparities. One factor is cost. Mental health care can be expensive, and the rich are more likely to be able to afford it.

Another factor is access to care. The rich are more likely to have health insurance that covers mental health care. They are also more likely to live in areas with more mental health providers.

The Impact of Disparities

Mental health disparities have a significant impact on individuals, families, and communities. People who do not receive mental health care are more likely to experience symptoms of mental illness, such as depression, anxiety, and substance abuse. They are also more likely to have problems at work, school, and in their relationships.

Mental health disparities also have a financial impact. The cost of untreated mental illness is estimated to be $210 billion each year. This includes the cost of health care, lost productivity, and criminal justice costs.

Addressing Disparities

There are a number of things that can be done to address mental health disparities. One is to increase access to care. This can be done by expanding insurance coverage for mental health care, increasing the number of mental health providers, and making mental health care more affordable.

Another is to reduce stigma. This can be done by educating the public about mental health, promoting positive portrayals of mental illness in the media, and challenging negative stereotypes.

Finally, we need to invest in research on mental health disparities. This research can help us to understand the causes of disparities and develop effective interventions.

Conclusion

Mental health disparities are a serious problem in America. They have a significant impact on individuals, families, and communities. There are a number of things that can be done to address these disparities. By increasing access to care, reducing stigma, and investing in research, we can make mental health care more equitable for all Americans.

[ripplestitchskein]

I think it’s important to note in discussions that a power imbalance on its face is not an issue. I would argue MOST people have relationships with people who hold some level of power over them or an imbalance in some capacity. Stay at home parents or single income households, households with large income disparities all are financially beholden to the money holding partner. I am in such a relationship and have been for 18 years, my partner has been a stay at home parent for 9 of those but I’ve always been the primary income because my skill set leads to better opportunities and increased income potential. People enter into relationships with coworkers, either explicitly boss/employee or supervisor/employee or where they are not direct reports but still hold a higher position in the hierarchy. Since we spend a majority of our time at our workplaces that is a really common way to meet people, especially for those of us who don’t date traditionally. People with medical complexities or mental illness and neurodivergence may be partially or whole reliant on others to give care and may be vulnerable in ways that inherently give the other party more power. People are in relationships with those who possess greater social capital, like media influencers or politicians. People are in relationships with people who have greater physical prowess or jobs that could be potentially problematic from a legal standpoint such as cops, judges, military or government agents. Even non romantic relationships feature power imbalances, letting someone crash on your couch, providing housing or necessities, or providing palliative care etc.

Where it becomes a problem is when it is coercive in nature, when that power is leveraged to harm the other, or threatened, and when consent cannot be given such as in the case of minors or mental/physical incapacity.

Stolas being an employee of IMP at some point in the future is not on its face an issue unless there is coercion, an issue of consent or if power is leveraged by the narrative in a way that would make him feel that he has no choice in entering a relationship with Blitz or will have his position threatened. The implicit threat itself, that of someone working and gaining financial benefit from someone they are in a relationship with is a standard part of society and something we interact with in our own relationships as a matter of course and especially in cases of mental or physical health issues or neurodivergence sometimes unavoidable.

[eternal-echoes]

“In response to the high rate of suicidality among the trans population, advocates of gender theory consider only one possible cause: transphobes. If only people were more accepting, the argument goes, those who identify as trans would not harm themselves with such tragic frequency. This proposal, known as the "social stress" hypothesis, is not without merit. Stigmatization, bullying, and rejection from families and faith communities would certainly contribute to feelings of hopelessness.(19) However, the study that reported the 41 percent suicide risk also noted, "The survey data did not allow us to determine a direct causal relationship between experiencing rejection, discrimination, victimization, or violence, and lifetime suicide attempts."(20)

Doctors Paul McHugh and Lawrence Meyer explain, "Studies show that while social stressors do contribute to the increased risk of poor mental health outcomes for these populations, they likely do not account for the entire disparity."(21) If the problem of suicidality and poor mental health outcomes could be resolved by creating a more culturally friendly environment for individuals who identify as trans, one would expect better results from more tolerant societies. But this is not the case, as can be seen from the dismal results in Sweden and the Netherlands.(22) Similarly, in the United States, Dr. Jay Greene pointed out, "Lowering legal barriers to make it easier for minors to undergo cross-sex medical interventions without parental consent does not reduce suicide rates-in fact, it likely leads to higher rates of suicide among young people in states that adopt these changes."(23)

The problem of poor mental health outcomes and suicide is largely the result of the fact that more than 90 percent of people who commit suicide have a psychiatric diagnosis.(24) Therefore, it is an oversimplification to blame intolerant cultures for the poor results of gender reassignment treatments. The core problem could be that legitimate underlying mental health issues are not being addressed.”

-Jason Evert, Male, Female, or Other: A Catholic Guide to Understanding Gender

—

Work cited:

19) Cf. D. Burgess et al., "Effects of Perceived Discrimination on Mental Health and Mental Health Services Utilization Among Gay, Lesbian, Bisexual and Transgender Persons," Journal of LGBT Health Research 3:4 (2008), 1-14.

20) Haas et al., "Suicide Attempts Among Transgender and Gender Nonconforming Adults: Findings of the National Transgender Discrimination Survey," 13.

21) McHugh and Mayer, "Sexuality and Gender," Part Two.

22) Cf. Dhejne et al., "Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden,", 1-8; H. Asscheman et al., "A Long-Term Follow-Up Study of Mortality in Transsexuals Receiving Treatment with Cross-Sex Hormones," European Journal of Endocrinology 164:4 (April 2011), 635-642; N. Adams et al., "Varied Reports of Adult Transgender Suicidality," Transgender Health 2:1 (2017), 60-75.

23) Jay Greene, "Puberty Blockers, Cross-Sex Hormones, and Youth Suicide," Heritage Foundation, June 13, 2022).

24) J. Bertolote and A. Fleischmann, "Suicide and Psychiatric Diagnosis: A Worldwide Perspective," World Psychiatry 1:3 (2002), 181-185; R. Hirschfeld and J. Russel, "Assessment and Treatment of Suicidal Patients," New England Journal of Medicine 337:13 (September 25, 1997), 910-915.

—

For more recommended resources on gender dysphoria, click here.

[suchananewsblog]

The Importance of Access to Treatment

Historically, racial and ethnic minorities in the United States have lived with long-term disparities in both access to health care and the quality of care that they receive. These differences are improving thanks to laws like the Affordable Care Act. Still, some minority groups have higher rates of illness and death from many health conditions than white people. And they’re still more likely to…

[realjaysumlin]

Milk isn't good for Dark Skin Humans worldwide because it creates the Vitamin D Paradox. Vitamin D deficiency is one of the major causes in many health problems for Dark Skin Humans worldwide due to getting the proper dosage of sunlight.

Skin colors should only be an indicator for human health and not the social construct of race based science that provides a falsehood that skin colors represent race and intelligence which skin colors don't have anything to do with either one of these dumb and ignorant beliefs.

Our sun is a great indicator that all humans evolved from Dark Skin Humans in Africa and populated our planet.

[grison-in-space]

Hey, as someone who works in COVID research. I feel the pain you expressed in your post about being worried about the next administration. We get a lot of grants from the department of health and human services and all it takes is for covid research to become too controversial and a lot of people are going to lose their job.

Not to mention how many people are here because they immigrated or are here on a work visa. People in the lab are scared.

My college roommate is over in y'all's field, so like.... my estimate from well outside that place is that like two thirds of infectious disease research has been diverted to COVID since 2020ish? and the evidence sure looks like y'all are a major target on the chopping block, so. *tired* Good luck to you, strength to your arm, let's all hope we can let the OAR or NIDA or NIMHD set the tone for our responses to a virulently hostile and totally anti-law "takeover" rather than, say, some of the slower agencies that haven't entirely adjusted to the new hostile climate. (NIMHD has a virtual town hall happening tonight, November 15 2024, even! I really encourage clinicians and anyone concerned with minority health disparities to check in.) Federal agencies have weathered hostile administrations before, but I confess I was a little more cheered thinking about how little attention go paid to NIH last time than I really should have been this time. Might go re-read a history book on the early FDA to self-soothe.

I had an illustrative conversation about it a couple of days ago with my boss: I'd mostly talked to folks on NSF or DOE money, neither of whom will be surprised by attempts to make cuts. She was startled by the realism and tactical thinking folks in those networks are applying to their plans for the situation, and I mean... it's because NSF and DOE weather hostile administrations all the time, because those are the agencies that are usually putting up with climate change denialists (and in NSF's case, most of the people who are just ideologically opposed to science for its own sake, like creationists).

NIH isn't used to that, but some of the subagencies are. COVID researchers haven't had an especially unfriendly climate to wrangle en masse, but there sure are infectious diseases folks who have, plus the illustrative experience of the CDC.

I am also glumly hoping the next pandemic--because Trump et al are clearly intending to gut our infectious disease surveillance teams, just as they did last time--gives me personally even a somewhat better time than the last go-round. I am frankly expecting to see one, and fascinated to see how our already burnt-out and overstretched healthcare worker corps reacts to that added little sting of spite when it predictably happens again.

Unless enough people oppose him when he tries, I guess, and unless we all collectively proof against his bullshit enough to stall him until his attention span shifts (unlikely, I suspect). God, I am going to have to do so much fucking marching again, huh. I oughta order a new formal labcoat for protest purposes; I think I got too fat for my last one somewhere in the last couple of years.