Problems and Barriers of African American Women - Essay Example

Describe appropriate solutions to alleviate the problems and barriers African American Women are facing accessing healthcare and Solutions to alleviate challenges facing healthcare workers in delivering healthcare to the population (African American Women) The US Census Bureau revealed that health coverage was unavailable to 45.7 million in 2007. Of this figure, the communities of color accounted for more than 50%. Government insurance programs were preferred by many. Twenty million registered with Medicaid were racial minorities (US Census Bureau, 2007). Though 34 % of population is constituted by the communities of color, 55 % of the uninsured is constituted by them. The African American constitutes 19.5 %. The likelihood of having health coverage is directly proportional to the income. On comparing the incomes of the non Hispanic whites to that of the African American, the latter get an income which is 62 % that of the whites while the Hispanics obtained 70 %. Medicaid covered 23.8 % of African American adults and 44.3 % children (US Census Bureau, 2007). Apart from poor health coverage, they also had a greater risk of more health problems due to their meager income. 24 % of the population living in poverty is constituted by the African American. Of the 8.1 million of the uninsured children of America, 12.2 % was constituted by the African American children. Barriers to Health Care and solutions General reasons History denied the opportunity of health care to the African Americans as slaves (Kennedy et al, 2007). Disparities in the income level, education, treatment decisions, socio-cultural factors and failures by the medical profession are continuing disparities in African American people (Blendon et al, 1995). Socio-economic status affects the outcome of health and disease but African Americans are “doubly disadvantaged because of the low status, discrimination and residential segregation” (Mechanic, 2005). Distrust of the system Distrust of the health care system and research participation make the African Americans biased against both (Kennedy, 2007). The under-representation of African Americans in the nursing profession worsens this distrust (Johnson, 2001). Kennedy (2007) has explained this same point under the heading “shortage of minority care providers”. Historical disparities could have formed the grounds on which such a distrust arose and ballooned. Facts reveal that the racial minorities have indeed participated in various studies as “guinea pigs” as they claim. Disrespect by the care provider Disrespect puts off people, however poor they are. African American women believe that the degrading and humiliating experience of getting health care discourages them from further attempts at reaching for health care (Kennedy et al, 2007). Attempts are being made at clinics to welcome them and treat them respectfully (Johnson, 2001). Inadequate knowledge of functions The absence of knowledge of the availability and role definition of the Community nurse midwife and the nurse practitioner of the primary care services is seen to be the first barrier to utilization of the health services (Johnson, 2001). Many mistakenly believed that midwives were for attending to pregnant ladies and conducting deliveries. The nurse practitioner and registered nurses have different functions of which the general community has little awareness about. Due to the overlapping of functions, the differences between the registered nurse and the community nurse midwife and nurse practitioner have not yet been understood by the community. Nursing education not uniform The nursing education is varying in different institutions. Some go for the bachelor’s degree, others for the masters’ and some others for community nursing. Had there been only a single degree for nursing, the public, professionals and clients of the health services would have found it easier to identify them (Johnson, 2001). Education needs to be standardized. The nurses also should take the initiative of advertising to the public as to their boundaries of work Lack of health insurance Lack of health care insurance was a significant barrier which was preventing 55 % of the women and children from getting timely health care for reasons of financial constraints (Johnson, 2001). Women on Medicaid belonged to the group of socio-economically disadvantaged and unemployed. Even if employed, they would not be having insurance as they could not afford it. Moreover their employers may hinder them from losing time on their work. The underserved population may be defined by more than their “their demographic characteristics, socioeconomic factors, or health resource availability” (Patsdaughter, 2005). Other factors that could be causing the underserving may be high risk behaviors, vulnerable disease and social stigma, in which case, even rich people can form the group. These factors need to be handled in a detailed health programme in order to reach a solution. Inadequate relationship between physician and patients Patients believe that the doctor who sees them needs to have a relationship with them: he needs to be of the same race (Kennedy, 2007). This is difficult to achieve due to the sparse distribution of physicians and nurses of African American origin. A solution can be found by providing incentives to girls of African American origin to be educated as nurses and encouraging them to join the health services. The new President of the US, Barrack Obama, has taken steps in this direction. Cultural competence The inadequacy of the care providers in being culture-sensitive is another prime cause for the mistrust that African Americans exhibit towards the health care system (Kennedy, 2007). Ignoring the verbal and non-verbal behavior of the minority and treating them respectfully as patients who have approached for relief of some illness would help to change their attitudes towards the health care system. Health-seeking behaviors of parents Access to the health services for children greatly depended on the health –seeking behaviors of parents, other time-consuming issues or financial problems (Johnson, 2001). Medicaid was the insurance usually opted for. However the mothers claimed to take their children only to the emergency room as they could not afford to otherwise as they would be singularly supporting the children. In spite of these ideas, women were very much aware about the significance of immunization. Appointment problems Provider gender, long waiting hours, difficulty of scheduling appointments leaving aside family commitments, disrespectful treatment by office staff and the providers are some of the other barriers (Johnson, 2001). Female providers are preferred and accepted by the mothers and other women as they are believed to sympathies with their problems more. Consultation times most often coincide with the working hours of the women and school time. This clashing of times forces the women to select by priority. Waiting at clinics for long is also unsatisfactory. Appointments are now scheduled to allow no lag time so that the time factor is not a reason for women opting out of appointments. Low income women from the minority groups are likely to experience discrimination, unresponsiveness, getting substandard treatment, shown a lack of cultural sensitivity and disrespect. Lack of communication or poor understanding of clients can prevent women from visiting them for care. Preferences for nurse practitioner Women generally accept the nurse practitioner clinics where they get maximum satisfaction (Johnson, 2001). They are treated respectfully and made to feel like a person. Cost effectiveness and client satisfaction are documented more with primary health care. There are suggestions that services of the community nurse midwife and the nurse practitioner be advertised so that the attendance goes higher. This kind of feedback has lead to the evolution of some strategies. Flyers, church connections and health fairs have used the opportunity to advertise the services of the CNM and NP. Hours of visit, services and procedures are being changed based on feedback (Johnson, 2001). References: Blendon, R.J., Scheck, A.C., Donelan, K., Craig, A., Smith, M., Beatrice, D., et al. (1995). “How White and African Americans view their health and social problems: Different experiences, different expectations [Electronic version]. The Journal of the American Medical Association, 273, 341-346 Johnson, M.O. (2001). “Meeting Health Care Needs of a Vulnerable Population: Perceived Barriers”. Journal of Community Health Nursing, Vol. 18(1), p.35-52, Lawrence Erlbaum Associates Inc. Kennedy, B.R., Mathis, C.C. and Woods, A.K. (2007). “African Americans and their distrust of the health care system: Healthcare for diverse populations”. Journal of Cultural Diversity, Vol. 14, No. 2. Tucker Publications Inc. Mechanic, D. (2005). “Policy Challenges In Addressing Racial Disparities And improving Population Health”, Health Affairs, Vol. 24, No. 2 Patsdaughter, C.A. (2005). “Expanding definitions of cultural groups and underserved populations toward access to and quality health care for all”. Journal of Cultural Diversity, Vol. 12, No. 4, Tucker Publications Inc. U.S. Census Bureau, Income, Poverty, and Health Insurance Coverage in the United States: 2007, available online at http://www.census.gov/prod/2008pubs/p60-235.pdf. 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