India holds the site of one of the world’s most populated countries, with over quadruple the population of the U.S and only 1/3 of its landmass. This contrast made it interesting to learn about the components of healthcare delivery in India, especially how population density affects access and quality of care compared U.S.

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     On our first day of lectures, we heard from Dr. Indira, a gynecologist, at PHRII (Public Health Research Institute of India). Her focus is on women’s, mothers', and children's health, particularly concerning cervical cancer and screenings. In India, there is a lack of general education surrounding health, with a strong correlation to low literacy rates. This results in deficits in vaccination rates, health screenings, and a high burden of disease. Her main priority is to bring awareness to communities, notably rural areas and villages, about hygiene, nutrition, and the importance of seeking medical care. Drawing from her medical background, she shared anecdotes and highlighted differences between the U.S and Indian healthcare systems. This was a relevant lecture, as it laid the foundation to explore contrasts between healthcare systems throughout the program, and properly sensitized us before interacting with members of the community and engaging in activities like the cervical cancer screening camp.

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     One major distinction between the two countries lies in the social philosophy of when to receive care. The U.S emphasizes prevention, where yearly checkups and vaccines are common, resulting in a lower death rate for communicable diseases; the focus is more on managing non-communicable diseases such as diabetes and cancer. In contrast, India's system is more reactive. Due to poverty and limited education, there is a greater burden of communicable diseases, as individuals visit doctors for curative treatments when physical manifestations of diseases interfere with daily life. This cultural approach contributes to a lot of stigmatization and ostracization within communities, as others will assume that an individual is seeking treatment for being ill, discouraging proactive care. As a result, misconceptions surrounding vaccines are common, and many do not go to doctors out of fear of interpersonal judgment. For this reason, the  HPV vaccine rate is less than 1% in the country. This issue is compounded by geography and economics as more than 60% of the population lives in rural areas, where access to healthcare may be less accessible, and travelling would require losing a day's work pay.

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     Another significant distinction lies in healthcare structure. In the U.S,  healthcare is roughly divided between public and private sectors, with an implicit understanding that cost correlates with treatment quality. Despite a high standard of care, steep costs lead to widespread medical debt and delayed treatment.​ In contrast, India offers 70% of its care entirely free through the public sector, ensuring more equitable distribution given the country's poverty and population density. This includes, but is not limited to, services of cancer treatment, surgery, radiation, and ambulance rides, as well as all drugs such as insulin, vaccines, and HIV medication. However, hospitals may be very chaotic to maneuver as they are very crowded on and first-come, first-served basis. It is not uncommon for appointments to go unattended due to demand. This may be especially challenging when accounting for the fact that the majority of ailments presented are communicable diseases, making it easier to spread, especially without proper ventilation or cooling systems.

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     Individuals from my community in the U.S would have likely found this portion of the lecture both appealing and shocking. In a capitalist society, free healthcare is inconceivable; yet many, especially those of low socioeconomic status, would welcome the idea. Like in India, many Americans must miss a day’s work to receive healthcare, so I believe that if there were greater opportunities for free healthcare and the possibility of receiving care without the added economic burden, this would be an attractive option. Still, individuals within my community might differ in acceptance of this structure of healthcare since they are used to a specific standard of quality. I’m unsure if many Americans are willing to accept a system where long waits and a lack of comfort (like air conditioning) are common. Additionally, some Americans struggle with medication adherence, stopping treatment early once they feel better. Under the free healthcare system, there is a big discrepancy between generic and name-brand medication, resulting in longer dosing periods with more side effects. There may be some that would decide against partaking in this type of system as they may be used to more tailored or expensive medications.

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     This lecture prompted me to reflect deeply and raised many questions regarding global health, primarily about how the gap in health disparities can be bridged to provide more equitable and comprehensive healthcare to all members of a population. There were many parallels between the two countries’ healthcare systems, but the most striking comparisons drawn pertained to mental health. Although the U.S. leads in preventative physical care, its approach to mental health often mirrors India’s curative model; interventions typically occur when the problem physically manifests and requires immediate attention. This raised important questions that should be addressed by research: How can we shift global attitudes toward mental health from curative to preventative? What educational strategies might reduce stigma and promote early intervention? And how can we bridge the mental healthcare gap? These questions are especially relevant to my area of interest, Neuropsychology. Disorders like dementia and Alzheimer’s carry significant stigma, making preventative and early treatment paramount in maintaining cognitive processes. Understanding how global health perspectives can evolve is vital in shaping effective outreach and prevention efforts in mental health. 

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     Be that as it may, the stigma towards mental health and receiving treatment is lessening day by day, especially in younger generations. I believe future directions of research should investigate how awareness campaigns, like the healthcare work Dr. Indira, improve willingness to access care. This can determine what types of education are most effective, and how gaps in awareness can be supplemented with other initiatives to increase equity and access to healthcare, especially in mental health.