Healthcare Disparities in Minorities - Research Paper Example

Healthcare disparities in minorities Over the years, healthcare provision to the minority groups has been an issue of concern to policy makers in the industry. There is detailed research that documents the high prevalence of health disorders that are treated within settings of primary care. Ethnic and racial minority populations have a higher likelihood of receiving health care within such care settings. Most of the research is devoted towards studying efficacious treatment interventions for common health disorders. On the other hand, lack of viable studies presenting information on ethnic minority and racial groups is a hindrance to making progressive strides. For example, African Americans are undercounted within the national household surveys and are overrepresented in institutional settings such as foster care, jails, and shelters. Shortage of such studies raises particular concern in terms of ethnic and racial minorities as well as populations that are limited English proficient. The initial contacts with health care providers have a typical outcome within primary care settings while integrating individuals with a higher likelihood of receiving their health care within suitable care settings (Gauld, 2009). The concept of integrated health care presents a comprehensive and multi-disciplinary health care approach. The application compares to alterative interventions to chronic conditions and has proven effective in terms of management and detection of various health disorders. Even though such integrated care concepts vary based on the most appropriate means of attaining the integration, there are essential elements like management of systematic clinical care. Health care systems require inputs from social workers, registration by nurses and other licensed health provider (Papanicolas & Smith, 2013). Modern health care settings require proactive outcome monitoring and follow-up. Systematic approaches often involve the integration of care management with ultimate primary care and psychiatric consultation physician oversight for purposes of gaining proactive treatment of health problems. Efforts of describing and assessing integrated care models and levels of community settings integration are based on the provisions of barriers against the success of such programs. Government agencies on health care quality and research are involved in the production of comprehensive reports regarding different data sources such as literature without traditionally peer-reviewed journals (Brach, & Chevarley, 2008). The findings in the suggestion are reported based on an integrated health care system and personnel’s positive outcomes. On one hand, there are similarities in developing meta-analyses through overcoming difficulties of discerning certain elements for the integrated care systems. Success is based on the improvement of outcomes and overall increased health attention on primary care settings resulting in improved outcomes. Linguistic sensitivity coupled with language accessibility is a critical contributor to treatment of both physical and mental health disorders. Precision in terms of diagnosis, treatment, and screening, is dependent on interview with linguistic accuracy. Having physicians who do not address the language of patients is one of the independent indicators of poor chronic disease control and significant build up on health disparities (Papanicolas & Smith, 2013). The outcomes include lack of satisfaction by patients and low-quality patient education and a poor understanding of respective disorders. Language barriers obstruct ideal communication and result in addition of lack of interest and respect for the patient from the providers. Adult minority among the non-English speaking persons face communication difficulties based on their primary care physicians resulting in hardship to understanding instructions regarding their health status. Low English proficiency is linked to poor quality reports of primary care as well as the absence of care sources. The group also faces reduced access to continuity of care. LEP patients who have physicians that do not share speak their first language have a less likelihood of adequately comprehending medical situations in turn; there is a high likelihood of reporting adverse medication reactions and trouble understanding labels. Shortage of English fluency leads to reduced use of health care (Brach, & Chevarley, 2008). LEP persons have a reduced likelihood of self-identifying needs for health services. The situation predicts a lifetime health care application resulting in longer untreated disorders duration. Lack of an integrated need in terms of treatment, such as among Asian Americans and Latino, relates to various cultural factors. The variables include reliance on family, somatization of stress and social support networks instead of consulting medical providers. Such individuals share low levels of health literacy. Magnitudes of the language barrier contributing to the health care disparities are likely to rise while population grows. The description of ethnic and racial groups in a monolithic population manner functions as a hindrance to the provision of ideal health care provisions to the individuals. The differences in terms of social and cultural identities for different ethnic and racial groups require that somewhat heterogeneous is based on demographic factors. The scope also includes the length of time and age the elements are strong indicators of the identification upon which the countries come from. Misconceptions regarding homogeneity for certain ethnic groups, such as Asian American or Hispanic, contribute to further inequalities based on the use, quality and availability of ultimate healthcare services. Most of the differences are found within cultures and countries of origin for the United States residents. Different cultures accept, recognize, treat and diagnose health concerns through different ways (Gelberg, Andersen, & Leake, 2000). Native Hawaiian, Pacific Islanders, and Asian Americans often consider expressions of physical illness as personal weakness. There is a higher likelihood as compared to the westerners in expressing emotional distress based on their respective physical symptoms (Bravemen, & Egerter, 2008). Stigma and shame are categorized as powerful hindrances in seeking treatment for addictions or health among Asian Americans. Marginalized populations have lower levels of reporting health concerns to family and friends. An addition the issue’s complexity is the severity of the trauma facing Southeast Asians before migrating to America. Such complexities result in high posttraumatic stress disorder rates and increased depression for various groups. Part of the minority populations within America based their outcomes on lack of health issues awareness and economic factors and barriers to care services (Gonzalez, Tarraf, Whitfield, & Vega, 2010). Behavioral health disparities in terms of treatment between non-Hispanic whites and African Americans are documented through inpatient psychiatric care. African Americans are significantly probable to undergo hospitalization (Gauld, 2009). Delays on solicitation of professional treatment, high rates of incorrect diagnosis and readmission contribute to such variations. African Americans consider absence of providers with culturally sensitivity and clinicians’ geographic underrepresentation as significant hindrances to health care access. Lastly, African Americans comprise close to 41 percent of homeless populations where some of them have serious illnesses occurring at high rates (Löfgren & Leeuw, 2011). Poor outreach campaigns affect access to health care especially for the eligible communities as well as the lack of materials’ availability in different languages. This is because of fear of reporting and retribution to government on their immigration status while applying for extended public benefits (Löfgren & Leeuw, 2011). There are other forms of access to elements of care barriers including poverty, low parental education, excessive wait times and transportation problems. Integrated health care presented within patient-centered and culturally competent framework should address the root causes for health disparities while reducing individual, system and provider barriers. Success is achieved through use of thorough training on cultural competencies. Cultural competences within delivery of health services among ethnic and racial minority populations bear profound effects to access of health care (Galea, Tracy, DiMaggio, & Karpati, 2011). Diversity in the workforce is significant in the delivery of linguistically and culturally competent care that represents the marginalized population. Availability of well-trained workforce in the health care sector is one of the pressing issues in health care that the nation faces especially within the rural, frontier and border areas. Absence of diversity for health care workforces is a significant contributor towards health care disparities among the LEP populations and ethnic minorities. The reason is that it limits meaningful access and the availability to care that is linguistically and culturally competent. Efforts of promoting health equity through addressing social determinants in terms of health within research are essential and tricky to utilize. Further, Latina and black women have higher levels of stress as compared to white women who are non-Hispanic (Bauer, Chen, & Alegría, 2010). Interventions take the design of addressing disparities based on delivery of services to ethnic and racial minority populations and encounter limited impacts to health care outcomes and equity. The observation is largely due to factors within which institutional and organizational levels are not addressed. Linguistic and cultural competencies are sets of congruent attitudes, policies, and behaviors coming together to enable effective work for different cross-cultural situations. Care that is both culturally competent and patient-centered is critical in the improvement of health care quality and reduction of health disparities (Bao, et al 2011). The unequal and systematic resource distribution is critical in optimal health including access of healthy food and safe environments that are based on the levels of exercise with significant impacts on marginalized populations. There are elements of low geographic location and socio-economic status. Most of the low-income areas bear fewer grocery stores as compared to higher income regions. Gas stations and corner stores have a typical responsibility charged higher for similar items within the grocery stores. Lack of adequate public transportation or automobile reduces access to healthy and affordable food. More accessible and less expensive foods often have high fat and calories. Limited knowledge and time for food preparation increases consumption and demand for processed or prepackaged foods (Bravemen, & Egerter, 2008). Cultural competence refers to various factors that affect health disparities across ethnic and racial minority societies. Public health efforts in the last decade identify various conditions that people encounter and have affected health significantly. The social health determinants create a list that includes design, access to health care, community housing, access to healthy foods, employment, occupational safety and environmental pollutants (Bauer, Chen, & Alegría, 2010). The inequitable social and environmental conditions’ impact in which individuals live bears significant impacts on pervasive and persistent health ethnic minority populations and plaguing racial disparities. New integrated health care models aim at meeting the elements of ethnic and racial minority populations that are involved in providing linguistically and culturally competent care. The measures also result in increased access based on system, practice and community level initiatives and adaptations (Gonzalez, Tarraf, Whitfield, & Vega, 2010). Patients who constantly struggle with fears and stigma regarding antidepressant medication in doctor-patient communication could address their shortcomings through adopting communication that is patient-centered. Incorporation of patients within treatment, solicitation of preferences, and including physician communication systems improve the empathy for and understanding of stigma issues. Decision making allows for issues regarding medication, have been identified as optimal practices for reducing mental health disparities. The growth of behavioral health and interdisciplinary physical training programs focusing on integrated primary care models will improve the access and utilization of health care services (Galea, Tracy, DiMaggio, & Karpati, 2011). Some examples include the establishment of medical homes and team management for chronic disease as well as specific models to integrate mental and physical health services. The application allows for the establishment of partnerships aimed at reducing minority health disparities. Subsequent workforce development policies and strategies include patient navigators for ethnic minorities as well as community health advocates and health workers who can reach the respective community members to avail self-management skills, support, and education. The lack of scientific proof for success in integrated health care services offered through culturally competent and patient-centered settings hinders adequate focus on key barriers and concerns. The issues are raised on most individuals affect populations based on greater forms of risks for substance use and marginal health attention for populations within ethnic and racial minorities and those having limited English proficiencies (Gauld, 2009). Identification of critical success components for integrated models of health care among ethnic and racial minorities emphasizes on provider language fluency and cultural coping behaviors the implication is essential in the elimination of health care disparities. The achievement of optimal health requires inclusion of more non-clinical strategies. Health care concerns should be addressed through improving the coordination of different organizations and agencies with activities that address health determinants. Issues requiring attention include education, agriculture, housing, health, and employment (Gelberg, Andersen, & Leake, 2000). Appropriating ways of increasing availability of healthy and affordable food for underserved societies encourage major farmers’ markets and grocery chains to situate stores within such communities. Appropriate measures should necessitate interventions at a community-level towards negotiating health promotion such as tobacco control programs, diabetes self-management and exercise initiatives coupled with school-based strategies. The collective scope of strategies allows for the improvement of graduation rates as well as reversing trends in obesity (Bao, et al 2011). Integrated care settings require proper assistance to patients based on careful navigation across a wide array of systems. Irrespective of the extensive body of research literature that demonstrates integrated health care effectiveness, the scope of implementing various settings faces critical barriers. Currently, issues relating to sustainability and dissemination of integrated care models place hindrances at the health care forefront in discussions among practitioners, policy makers, and researchers. Successful translation of the previous research based on integrated health care allows for the practice of vulnerable populations. It also involves consecutive requirements of additional consumers of health, input and guidance from the community and their family members. Behavioral health care and national experts within fields of health, substance abuse and linguistic and cultural competency have imperative determinants of the process. The practice transformation, policy change and financial incentives are required in broad sustainability and implementation of improved health status and elimination disparities for ethnic and racial minority communities. It is important to be persistent in committing to local, national and state leadership while challenging and creating research evidence bases. References Bao, Y. H., Alexopoulos, G. S., Casalino, L. P., Ten Have, T. R., Donohue, J. M., Post, E. P., Schackman, B. R., & Bruce, M. L. (2011). Collaborative Depression Care Management and Disparities in Depression Treatment and Outcomes. Archives of General Psychiatry, 68(6), 627-636. Bauer, A. M., Chen, C.-N., & Alegría, M. (2010). English language proficiency and mental health service use among Latino and Asian Americans with mental disorders. Medical Care, 48(12), 1097-1104. Brach, C., & Chevarley, F. M. (2008). Demographics and Health Care Access and Utilization of Limited-English-Proficient and English-Proficient Hispanics. Rockville, MD: Agency for Healthcare Research and Quality. Bravemen, P., & Egerter, S. (2008). Overcoiming Obstacles to Health. Princeton, N.J.: Robert Wood Johnson Foundation. Galea, S., Tracy, M., Hoggatt, K. J., DiMaggio, C., & Karpati, A. (2011). Estimated Deaths Attributable to Social Factors in the United States. American Journal of Public Health, 101(8), 1456-1465. Gauld, R., (2009) The New Health Policy. New York: McGraw-Hill International Gelberg, L., Andersen, R. M., & Leake, B. D. (2000). The behavioral model for vulnerable populations: Application to medical care use and outcomes for homeless people. Health Services Research, 34(6), 1273-1302. Gonzalez, H. M., Tarraf, W., Whitfield, K. E., & Vega, W. A. (2010). The epidemiology of major depression and ethnicity in the United States. Journal of Psychiatric Research, 44(15), 1043-1051. Löfgren, H., Leeuw, E., (2011) Democratizing Health: Consumer Groups in the Policy Process. New York: Edward Elgar Publishing Papanicolas, I., Smith, P., (2013) Health System Performance Comparison: An Agenda For Policy, Information And Research: An agenda for policy, information and research. New York: McGraw-Hill International Read More