Removing Health Care Education Barriers - Research Paper Example

?Barriers to Health Care Education Health education research was not given much importance until recently. This was particularly the case for language barriers present in the communication of health information and their impact on a range of health education programs. In the US, language barriers became acute with the influx of refugees and the rise in immigrants in the country. The diversity of languages spoken by people in the US has increased rapidly over the past few years. Language is also a barrier because translation services requires funding, the levels of which are often not sufficient. People who lack proficiency in the native language are not able to gather much support because they are often minority groups. Moreover the lack of effective implementation of laws reducing language issues is also an impediment in the delivery of health education (Perkins, 1999). The use of an interpreter for removing health care education barriers started to get researched in 2001. Jacobs, Lauderdale, Meltzer, Shorey, Levinson and Thisted (2001) were the first researchers to work on the impact of interpreters in health care education communication. They carried out a retrospective cohort study extending up to two years and took benefit from the allocation of an interpreter service at a health maintenance organization in the US. The aim of the study was if interpreters impacted the delivery and effectiveness of health care education. The study concluded that the use of interpreter services does cause an increment in the delivery of health care to patients who do not speak English. However there were a number of limitations to the study. The study was followed by a surge of other researches carried out to investigate the effects of various modalities in the delivery of health care in overcoming language barriers. It is observed that communication between the doctor and the patient forms the core of clinical practice. A good doctor-patient relationship is characteristic of effective exchange of information. Language is an integral tool for the doctor since it gives him an understanding of the health beliefs of the patient and allows him to know more about the medical history of the patient. Language also aids the doctor in resolving the differences in various health beliefs. Research has also indicated that healthy communication between the patient and the doctor is therapeutic in itself (Woloshin, Bickell, Schwartz, Gany & Welch, 1995). Language disparities arise in groups of people who are not proficient in the language commonly spoken in the region. In one study investigating the language differences in different population of US Hispanics and their subsequent effects, Spanish-speaking Hispanics were seen to be worse off than English-speaking Hispanics. Spanish-speaking Hispanics constituted to be a vulnerable population in the US with lesser access to health care and preventive services use that English-speaking Hispanics. Recommendations included that the health behaviours of the vulnerable population are maintained, physical activity is promoted and access to health care is increased (DuBard & Gizlice, 2008). Language barriers can arise due to a number of reasons such as the age and disease of the patient, emotional status, level of education and the degree of language proficiency. It is the responsibility of the health care provider to come up with the best possible way to meet the language challenge while being gentle and patient with the person (Parvanta, Nelson, Parvanta & Harner 2010). Over the time, a range of services have been launched and researches have been carried out to reduce literacy barriers in the delivery of health care. One such initiative is the Culturally and Linguistically Appropriate Services (CLAS). This compromises of standard practices to be followed by health care bodies throughout the country and a research process that focuses particularly on the results of such endeavours. The standards were formed by the US Department of Health and Human Services Office of Minority Health along with some collaborated efforts by the national advisory committee of people responsible for creating and implementing policy. Best Practice Guidelines for Health Services Delivery for Newcomers are a set of guidelines provided by the Canadian Council for Refugees to health service providers. Amongst other practices, these programs have aimed to provide health services which are compatible to the language proficiencies of the patients (Bischoff, 2006). A number of measures have been used for the promotion of public health on the national level in limited English-proficient (LEP) individuals. These include using “bilingual providers, bilingual/bicultural community health workers, professional and non-professional interpreters, the role of written translations, and new approaches to interpretation that use technological advances” (Riddick, 1998). The health targets the US aims to achieve include improving the rate of suicide mortality to 11 per 100,000 for people ages between 15 and 24 (Tulchinsky & Varavikova, 2009). These health targets are to be achieved by health education and health promotion as well as by community policing and better prevention programs. However another barrier that emerges with respect to health education is generational diversity. Public health educators are faced with the task of relaying information to people with all age groups. For example a public health care worker has the responsibility of advising older people about the risks in heart disease (Tulchinsky & Varavikova, 2009); the same worker is also responsible for educating young children about a better lifestyle in order to reduce the risk of diseases in the future (Stanhope & Lancaster, 2004). However researches into the successful provision of health education and health promotion in a range of age groups have indicated favourable results by employing an expanded Rowe and Kahn model. The study demonstrated the potential to subjugate racial, class and denominational and to promote healthy lifestyles in the aging population and adults (Parker et al., 2002). A number of national initiatives have also addressed public health issues by stressing upon the population disparities. For instance, the Centers for Disease Control and Prevention’s (CDC) Office on Smoking and Health (OSH) have been engaged in the reduction of disparities relating to tobacco use. However it is observed that these initiatives are mostly dependent on reductionist paradigms; therefore they have little success rates. As a result more holistic models are required to promote health education amongst all age groups. The need to subjugate the barriers to equality and diversity is acute, especially in health care education and promotion. These barriers cannot be overcome unless racial discrimination is eliminated and educational goals encompass the need to improve health; media diversity is recognized as potential means. Different public health organizations are working for the promotion of health by making use of media diversity. For instance, The Opportunity Agenda utilizes a range of media sources to advance social justice (2011). A range of Public Health Services and Foundations have collaborated with the mass media and have adopted strategies such as media advocacy and paid advertising to promote health education in the population (Arkin, 1990). Many national and international agents are working for the promotion of health education and care. Another recognized in health education and promotion is community self-assessment of social norms in public health. Promotion of healthy lifestyles and encouraging people to identify and root out the factors that are deleterious to their health is a challenging task. In the US, there are several NGOs working for the promotion of healthy lifestyles in the populations. The Public Health Education and Health Promotion Section is considered as the most extensive public health association in the world. The Utilization Review Accreditation Commission is another NGO working for the promotion of health care quality. Organizations have also focused on the promotion of health at the workplace, such as the Wellness Council of America. Training of public health workers is an integral cog in the machinery of delivery effective health care. If this training is not adequate, it is going to produce a grave barrier in health education and promotion. The Public Health Training Network is a distance learning program for people who are interested in pursuing health education and promotion. The Center for Disease Control supports this initiative and is committed to the promotion of continuing education (PHTN, 2011). The Future of Public Health and the Institute of Medicine have collaborated for the promotion of better quality education to students going into public health practice. However these efforts are still lacking in complete effectiveness and success and there needs to be a better integration of theory with practice. It is suggested that in order to overcome this barrier to public health, academic programs must work together with public health agencies and provide comprehensive education to students (Schlaff & Robbins, 2009). Slides Outline Health education research not given much importance until recently We have identified a range of health education and promotion challenges in the area of Public Health These are: LANGUAGE BARRIER GENERATIONAL DIVERSITY DIVERSITY IN MEDIA COVERAGE GETTING THE COMMUNITY TO QUESTION THEIR SOCIAL NORMS USING VARIOUS TEACHING STRATEGIES THAT WILL FACILITATES LEARNING IN THE COMMUNITY LANGUAGE BARRIER Increase in the diversity of languages spoken by people in the US Rise of immigrants and influx of refugees Barrier because requires funding and lack of effective implementation of laws Interventions: use of an interpreter First researched by Jacobs, Lauderdale, Meltzer, Shorey, Levinson and Thisted (2001) Study concluded that the use of interpreter services does cause an increment in the delivery of health care to patients who do not speak English Spanish-speaking Hispanics were seen to be worse off than English-speaking Hispanics Initiatives: Culturally and Linguistically Appropriate Services Best Practice Guidelines for Health Services Delivery for Newcomers A number of measures have been used for the promotion of public health: Bilingual providers Bilingual/bicultural community health workers Professional and non-professional interpreters Role of written translations New approaches to interpretation that use technological advances GENERATIONAL DIVERSITY Need to address health promotion and education to a range of age groups Research used an expanded Rowe and Kahn model to promote successful aging Centers for Disease Control and Prevention’s (CDC) Office on Smoking and Health (OSH) targeted disparities relating to tobacco use Holistic models are required to promote health education amongst all age groups MEDIA DIVERSITY Different public health organizations are working for the promotion of health by making use of media diversity The Opportunity Agenda Public Health Services and Foundations Media advocacy and paid advertising COMMUNITY SELF-ASSESSMENT OF SOCIAL NORMS Public Health Education and Health Promotion Section Utilization Review Accreditation Commission Wellness Council of America USING VARIOUS TEACHING STRATEGIES THAT WILL FACILITATES LEARNING IN THE COMMUNITY Training of public health workers Public Health Training Network Center for Disease Control The Future of Public Health and the Institute of Medicine Efforts are still lacking Reference List Arkin, E. B. (1990). Opportunities for improving the nation's health through collaboration with the mass media. Public Health Reports, 105(3), 219–223. Bischoff, A. (2006). Caring for migrant and minority patients in European hospitals : a review of effective interventions. London: SFM. DuBard. C. A. & Gizlice, Z. (2008). Language Spoken and Differences in Health Status, Access to Care, and Receipt of Preventive Services Among US Hispanics. American Journal of Public Health, 98(11), 2021-2028. Jacobs, E. A., Lauderdale, D. S., Meltzer, D., Shorey, J. M., Levinson, W., & Thisted, R. A. (2001) Impact of interpreter services on delivery of health care to limited-English-proficient patients. Journal of General Internal Medicine, 16, 468-474. Parker, et al. (2002). A Multidisciplinary Model of Health Promotion Incorporating Spirituality Into a Successful Aging Intervention With African American and White Elderly Groups. The Gerontologist, 42(3), 406-415. Parvanta, C., Nelson, D. E., Parvanta, S. A. & Harner, R. N. (2010). Essentials of Public Health Communication. Massachusetts: Jones & Bartlett Learning. Perkins, J. (1999). Overcoming Language Barriers to Health Care. Popular Government. PHTN (2011). What is PHTN? Retrieved from http://www2.cdc.gov/PHTN/whatis.asp Riddick, S. (1998). Improving Access for Limited English-Speaking Consumers: A Review of Strategies in Health Care Settings. Journal of Health Care for the Poor and Underserved, 9, S40-S61. Schlaff, A. L. & Robbins, A. (2009). Teaching health departments: meeting the challenge of public health education. Journal of Public Health Management and Practice, 15(5), 439-42. Stanhope, M. & Lancaster, J. (2004). Community and public health nursing (6th ed). Missouri: Elsevier Health Sciences. The Opportunity Agenda (2011). Promoting Diversity, Racial Justice, and Educational Opportunity. Retrieved from http://opportunityagenda.org/promoting_diversity_racial_justice_and_educational_opportunity Tulchinsk, T. H. & Varavikova, E. (2009). The new public health. Massachusetts: Academic Press. Woloshin, S., Bickell, N. A., Schwartz, L. M., Gany, F., & Welch, G. (1995). Language Barriers in Medicine in the United States. The Journal of the American Medical Association, 273(9), 724-728. Read More