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A Path to Health Equity: Exploring Healthcare Disparities in Minorities
The critical issue of healthcare disparities among minority populations remains a significant and complex challenge in present-day society. The National Institutes of Health estimated that the total burden of racial and ethnic health disparities was 451 billion dollars in 2018. There's still much to learn about how to measure health disparities, health equities, and social determinants of health. Eliminating healthcare disparities requires a greater effort that combines understanding the root causes along with interventions and advocacy as the two main pillars in the ongoing fight for equity. Through research and evidence-based data, solutions are being created to impact change that will be sustainable. The next steps are determining "How do we identify key strategies and interventions that can make a substantial and meaningful contribution to ongoing efforts to eliminate healthcare disparities among minority populations?" Key strategies include health literacy and buy-in to these health equity issues.
Understanding healthcare disparities is the first step toward reducing them. Healthcare disparities, often referred to as health disparities, are differences in health outcomes, healthcare access, and healthcare quality experience by different groups of people. The CDC defines health disparities as "Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations." (CDC 2008) The result of health disparities is unequal access to healthcare services, variations in the quality of care received, and differing health outcomes with sidelined or vulnerable populations after bearing the brunt of these disparities. Health disparities encompass a wide range of differences in healthcare access and outcomes affecting various aspects of individuals' well-being. These disparities can be observed through statistical data and research findings.
According to the Agency for Healthcare Research and Quality through the US Department of Health and Human Services, there has been a decline in life expectancy for Hispanic and non-Hispanic black groups, than for non-Hispanic white groups, thus widening the healthcare disparity among these groups. Overall, Black, Hispanic, AIAN, and NHOPI people fared worse compared to White people across most examined measures of social determinants of health. These health disparities not only affect the health and well-being of individuals, but also have significant social, economic, and public health implications.
Economic consequences have increased due to health disparities. Healthcare disparities contribute to increased healthcare costs for everyone. In 2018, JAMA found that when analyzing the Medical Expenditure Panel Survey, adults with less than a high school diploma accounted for an uneven share of 2018's burden. Although they only make up 9% of the population, they account for 26% of the cost. (Yancy 2020). Socioeconomic factors play a significant role in health care disparities. The influence of income, education, access to resources, and healthcare disparities is complex.
The cost of medical treatments and medications can pose a significant barrier for low-income individuals. Lack of financial resources can lead to delayed or inadequate treatment, intensifying health conditions. Health literacy and education levels are associated with the outcomes of health care as well. An individual's understanding of health information, adherence to their treatment plans, and the ability to navigate throughout the healthcare system directly affect these outcomes.
Cultural and linguistic barriers in healthcare also present significant challenges that can hinder effective communication, access to quality care, and health outcomes. Patients with limited English proficiency or non-English speaking patients face difficulties when communicating with healthcare providers. Cultural competence is essential for providing patient-centered care that respects the individual's cultural backgrounds and preferences. Without aligning with the needs of the patient a provider's treatments may be less effective. Systemic and institutional factors also play a role in perpetuating healthcare disparities. These are deeply rooted in policies and practices that have long-lasting effects. Inadequate public health funding and policies related to preventive services such as vaccinations can hinder access to vaccinations, leading to outbreaks that put more weight on these health disparities. To address systemic and institutional factors that affect healthcare disparities, it's important for us to advocate for policy change, provide training for providers to reduce bias and discrimination, allocate resources to underserved communities, and promote transparent data collection and analysis.
Studies have also shown that racial and ethnic minorities, particularly Black Americans, may receive different diagnoses and treatments for the same conditions compared to their white counterparts. Discrimination can foster mistrust in the healthcare system, resulting in a reluctance to seek care and adhere to treatment recommendations (Hostetter and Klein 2021)
There are ongoing efforts to address healthcare disparities by addressing barriers to access, quality, and social determinants of health. There are several governmental initiatives and policies implemented to help reduce healthcare disparities and promote health equity. The Affordable Care Act, Medicaid expansion, and Maternal, Infant, and Early Childhood Home Visiting Programs are just a few initiatives already in place (CDC 2008). Community-based programs and interventions targeting minority populations have been instrumental in addressing these disparities. Community-based programs and interventions illustrate the effectiveness of culturally competent, locally embedded approaches to address healthcare disparities (Institute of Medicine 2003). From early detection to faith-based there are a variety of programs out there designed to ensure that every person has the opportunity to live long and healthy lives.
Healthcare organizations and professionals are viewed as the forefront of the mission to address healthcare disparities. Some programs are aimed directly at the professionals who assess, diagnose, and treat patients. Diverse teams can help reduce implicit bias in healthcare. A diverse workforce is more likely to challenge stereotypes and biases. Cultural competence training equips professionals to address disparities more effectively by modifying care to individual patient needs. Health organizations can also advocate for fair policies related to health. Advocacy and activism lie in the ability to mobilize communities, share public opinions, and influence policy change. By having community partnerships and quality improvement initiatives, health organizations will be more likely to have these issues integrated into their mission and practices. Some campaigns, like health literacy and advocacy for policy change, empower patients to advocate for their health and demand fair care as well.
By identifying the evidence-based interventions that have shown promise in reducing disparities along with already successful strategies we take a step closer to the overall goal. A randomized housing study reviewed a program called Moving to Opportunity is an example of a geographic intervention. It followed up with families that were assisted with moving after a decade. The study showed that there was a decrease in mental and physical health issues among the families that had been moved to better geographic environments. When we use evidence-based interventions and strategies to target health outcomes we can continue to implement the same practices because they have already proved successful.
Evaluating the impact of policy changes and their effectiveness in addressing disparities, emphasizes the role of research and data analysis. The Affordable Care Act gave access to millions of people who previously did not have access to coverage. This act requires enhanced collection and reporting of data on multiple populations. Collaborative efforts with community leaders and healthcare professionals to create targeted solutions were more effective than medical-based treatments. When community leaders and family are involved, there is a greater positive response rate to health education (Berge et al 475-488). A flat hierarchy between patients, community leaders, and health professionals helped form better solutions. Now that there's a stakeholder in each space to represent each perspective of the process more insight can be gained.
What is the importance of promoting diversity and inclusivity in healthcare practices? When we implement diverse, culturally safe spaces we drive the burden of health disparities lower and lower. The first step to effective treatment plans is to understand the specific needs and barriers of each patient. Challenges in addressing healthcare disparities range from systemic barriers to social determinants of health, requiring comprehensive, coordinated efforts to achieve equitable healthcare access and outcomes. Representation matters, if a particular group is underrepresented then the data is more likely to be incorrect. "Among more than 230,000 participants in clinical trials registered with ClinicalTrials.gov, Black individuals were significantly underrepresented across various medical conditions, accounting for only 5.4% of the total participants, despite representing 13.4% of the U.S. population (LaVeist et al 231-238) It will address the systemic and institutional barriers that must be overcome to create equitable healthcare systems. Many times, people are faced with systemic barriers such as unfair program criteria, immigration status, complicated processes, and limited accessibility. Adjustments to these barriers and the systems that create the questions, applications, and enrollment criteria are crucial components to lessening these systemic disparities. Recognizing that altering societal attitudes is critical in developing strategies to overcome. Efforts should come with the understanding that changes in public perception and behaviors can contribute to lasting improvements and outcomes.
We need to make sure that we're using effective messaging by developing effective messages and educational campaigns. We can change perceptions and behaviors. It must be sensitive and target specific communities. Historical injustices such as the Tuskegee Syphilis study have led to a fragile relationship between minority populations and health care providers (Williams and Mohammed 1152-1173). The long-term efforts to sustain to address disparities are challenging. It requires unwavering commitment from various stakeholders, including healthcare organizations, policymakers, advocacy groups, and communities. Funding for programs, research, and interventions may be insufficient. Changes in political leadership can lead to policy reversals and might undermine the progress that's already been made.
Addressing healthcare and eliminating healthcare disparities among minority populations is a moral imperative and a critical public health goal. Achieving health equity leads to better health outcomes, reduced healthcare costs, and a stronger, more inclusive society. It is vital to continue to educate, advocate, and work collaboratively, acknowledging the complexities and barriers that exist. Potential for change is grounded in the concerted and collective efforts of individuals, organizations, and policymakers dedicated to health equity. Policy changes at the local, state, and federal levels, empower communities to actively participate.
Advocacy efforts and activism leadership embody the commitment of healthcare organizations to prioritize diversity, inclusion, and representation in underrepresented groups. It's not only important to research the health disparities and what they affect, but also to understand how you can help eradicate disparities through research and identifying root causes. The root causes of the healthcare disparities are often complex and multilayered. Research serves as the primary vehicle for comprehending the extent and nature of the disparities. By collecting and analyzing data, researchers can identify disparities through various aspects. It may help investigate the influence of socioeconomic factors, systemic barriers, implicit bias, and social determinants of health. Identifying the extent of causes through research is essential for crafting solutions.
A call to action serves as a reminder that healthcare disparities and achieving health equity is not the sole responsibility of any group but a collective effort. We can address these issues by individually staying informed about our health, advocating for and being active participants in our healthcare decisions, getting involved in community health initiatives, and supporting policies that promote health equity. Joining community health councils and advocacy groups to voice concerns, help develop solutions, participate in health literacy programs, and encourage the community to be involved. There is still a great deal of work to be done in this space. Health equity is and will be a burden of patients, providers, organizations, and their communities until the stakeholders and resources are aligned.
