Improving Access to Healthcare and Medication - Essay Example

? Global Health I. Introduction Health equity relates to the “absence of systematic disparities in health between and within social groups that possess diverse levels of underpinning social advantages or disadvantages. Health equity details “when all people possess the opportunity to gain full health potential” and none is disadvantaged from attaining this position owing to their social position or other socially determined circumstance. Health disparities result from inequalities within the distribution of the underpinning of health across populations. Although, there is no universally employed definition of access to health services, the paper utilizes the definition of timely utilization of service as per the need. The global access to health has been impacted significantly by social and environmental factors that yield marked differences in health status (Collins 2003, p.97). As a result, the core focus centers on understanding and intervening within the underpinning causes of health inequity. The World Health Organization has outlined a number of indicators for health access, namely: life expectancy and mortality; health service coverage; selected infectious diseases; risk factors; health expenditure; health inequities; health information systems and data availability; and, demographic and socioeconomic statistics. The inequalities in global access to health do not only manifest between countries, but also within countries and closely associate with the level of social disadvantage (Gulliford & Morgan 2003, p.3). The Case for Health Disparities Health disparities remain broadly defined as variations in disease prevalence or treatment based on aspects such as sex, race, or ethnicity, income, education attainment, geographic location, or sexual orientation. Health disparities adversely impact on groups of people, who systematically encounter enhanced socio-economic impediments to health based on their racial/ethnic group, socioeconomic status, age, gender, sexual orientation, geographic location, gender identity, or other characteristics associated with discrimination or exclusion (Mullins, Blatt, Gbarayor, Yang, & Baquet 2005, p.1873). Globally, several efforts directed at highlighting and minimizing health disparities that have involved numerous agencies as they evaluate the countries’ march towards adoption of policy-driven and health-centred objectives. Despite the changes implemented over the last decades, health disparities around the world still exist, especially among the minority groups. The Journal of the American Medical Association highlights race as a critical determinant within the level of care, whereby ethnic minority groups frequently receive less intensive and lower care. Health disparities are also not pegged on race, ethnic, and cultural differences alone as such disparities remain also fuelled by the sexuality minority groups. Studies manifest that an individual’s sexual minority status may restrain access to health care. In some cases, the homosexuals, transgender groups, and bisexual population perpetually experience the diverse range of health access problems connected to their sexuality. The discrimination and minimized access to medical care, coupled with social and cultural experiences aggravate these problems (Collins 2003, p.98). In terms of gender, women in the U.S usually manifest better access to healthcare compared to men. This can be explained by the fact that women mainly have higher rates of health insurance and report enhanced likelihood to seek medical care. Although, gender and race play a critical role in explaining healthcare inequality within the U.S., socioeconomic status bears the greatest determining factor in shaping an individual’s level of access to healthcare. Indeed, socio-economic differences manifest between racial groups and impacts on the health status of the groups (Bravemen 2006, p.167). Overall, the reasons for disparities in healthcare access are numerous, but can encompass lack of insurance coverage; lack of financial resources; lack of regular sources of care; legal barriers, structural barriers; the health care financing system; scarcity of health care providers; linguistic barriers; health literacy; age; and, lack of diversity within health care workforce. II. Improving Access to Health Care and Medication A. Why is this issue important? Tackling health inequities has largely remained as a priority for health policymakers, whether nationally and internationally. As health enhancements have slowed, the degree and depth of health inequalities within the developed world have become too evident to be ignored. The health inequalities have exposed that increases in social inequalities are among the fundamental causes of health inequities. Health cannot be divorced from other aspects underlying social life and, therefore, health inequalities remain inextricably engaged with other conflicts over national and international social, political, and economic policies (Gulliford & Morgan 2003, p.4). Social determinants of health influence factors that link to health outcomes. These conditions are impacted on by the amount of money, resources, and power that individuals possess. B. How does it affect the world? At one, instance, it was perceived that health inequalities were merely the results of unequal access to health care. The basic assumption at that period detailed that health would improve, and health inequalities would disappear with the onset of universal access to care. Presently, the prevalence of disease and injury perceived as emanating from social causes and the core emphasis lies in the social determinants of health and the social determinants of health inequalities. Indeed, the combination of various social characteristics such as ethnicity/race, income, or geography can generate many significant differences within life expectancy or infant mortality compared to any of these alone. The bulk of literature highlights the socio-economic differences in health; nevertheless, some of the social may possess additive health effects resulting from social exclusion or the lower socio-economic status of individuals manifesting certain characteristics such as a certain race, ethnic, or race. III. Barriers The utilization of health care is employed as an operational proxy for access to health care. Access to health care can be outlined as bearing four dimensions, namely: availability, geographic accessibility, acceptability, and affordability (Merson, Black & Mills 2012, p.10). Barriers to accessing health services can emanate from the demand side determinants detailing factors influencing the capability to employ health services at individuals, household, and community level, while supply-side determinants detail aspects intrinsic to the health system that hamper service uptake by individuals and the community. A. Availability Demand-side determinants to health access with regard to availability centers on aspects such as health workers, drugs, equipment, and demand for services. Supply-side determinants to availability entail waiting time, wages and quality of staff, education, price and quality of drugs and other consumables, and information on health care choice providers. B. Affordability The demand-side determinants to affordability details aspects such as costs and prices of services and access to household resources and willingness to pay. Supply-side determinants to affordability entail direct price including informal fees and opportunity costs. C. Accessibility Demand-side determinants with regard to acceptability encompass characteristics of the health services and user’s attitudes and expectations. Supply-side determinants to accessibility entail management or staff efficiency, technology, household expectations, and community and cultural preferences, norms, and attitudes. D. Awareness Health access may be limited by low awareness of knowledge on healthcare. The connection between health access and education is milder compared to the association between health access and income. Given that stereotype, bias, and clinical uncertainty may impact on a clinician’s diagnostic and treatment decisions, education can be cited as one of the most critical tools that form part of the overall strategy to eradicate health disparities. E. Geographic Accessibility Demand-side determinants to geographical accessibility relates to the service location and household location while supply-side determinants to geographical accessibility entail indirect costs to households. Other aspects that hamper access to health care appear to be missing from both framework include unwelcoming staff or poor interpersonal skills, as well as intricate billing systems at hospitals. Similarly, there is lack of assertiveness by users who come from a poor background that heighten the difficulty of accessing services. The absence of time or opportunity to dispose assets, when accessible, guarantee the availability of cash at the time of pursuing care may also lead to lack of health access. IV. Solutions A. Role of CHN/PHN Healthcare practitioners have a duty to support strategies at local, state, and national levels to reinforce and sustain the public health system and enhance the health status of the communities and populations that they serve. The non-monetary interventions entail counseling and consumer information on health services, community participation, and social marketing/franchising. The interventions may also entail community-based interventions and accreditation to highlight better providers (Ivanov & Blue 2007, p.64). Health practitioners should also avail culturally tailored quality enhancement approaches by enhancing care for ethnic minorities by availing a mechanism for individualizing care. In most cases, nurse-led interventions within the arena of the wider system change and are frequently more effective compared to interventions that highlight physicians. Healthcare providers should be well versed with racial and ethnic disparities that limit access to healthcare (Ivanov & Blue 2007, p.65). Medical practitioners, in this case nurses and all global citizens, should treat all patients equally, while at the same time paying attention to the ideal language, comments, and practices appropriate to the patients irrespective of the sexual orientation. B. Partnerships Improvements within human health globally details one of the significant challenges for the 21st century. Despite the massive advances and vast expansion of the global economy, countries still face fresh and overwhelming health access threats that are intimately linked to poverty. Responding to supply-side barriers entail provision of critical healthcare services, regulatory approaches, integrated outreach services, providing culturally sensitive healthcare delivery, and enhancing the management of health care services through supervision and feedback mechanisms (Chin, Walters, Cook, & Huang 2007, p.7). There are numerous ways of addressing global health challenges, and one of them features forming partnerships that span across countries and agencies aimed at tackling health access directly. This translates to developing diagnostic tests, preventative measures, treatments, and vaccines that are directed at the world’s most urgent global health needs. This may also entail training health care practitioners to deliver healthcare to where needed. Partnerships are essential in enhancing awareness regarding global health issues, as well as regarding disparities in health access; advocating for an increase in funding to bridge the gap in health care access as well as for research and training; and, rooting for the most effective utilization of funds to discover and develop fresh medical interventions and bring them to where they are needed most (Bravemen 2006, p.168). C. Strengthen Health System The provision of healthcare details a shared responsibility, and the lack of access to medicines and diagnostics can be cited as one of the numerous systemic causes of healthcare inequality. Prolonged neglect and erosion of the public health infrastructure can be cited as having contributed significantly in entrenching health disparities at both national and international levels. A significant contributing factor to this minimized capacity to respond adequately to health disparities can be cited as loss of public health positions and the gradual decline with public health workforce nationally and internationally (Casas-Zamora & Ibrahim 2004, p.2055). Research has consistently indicated that a limited number of non-medical determinants underpin the greatest health disparities. Health services can either minimize or enhance health disparities based on how they are implemented and/or adopted by the population. As such, primary health care innovations, coupled by reforms to enhance comprehensiveness and accessibility bear the greatest benefit to enhance healthcare access among disadvantaged populations (Casas-Zamora & Ibrahim 2004, p.2056). Reinforcing health promotion and preventative programs together with partnerships that respond to the economic, community, and environmental characteristics that impact on the uptake can significantly enhance program effectiveness. A world antagonized by health inequalities presents ethical challenges for global health. Local, state, national, and international responses to health disparities ought to be rooted in ethical values regarding health, and its distribution since ethical claims possess the power to motivate, delineate principles, duties and responsibilities, and possess global and national actors morally responsible for attaining common objectives (Ruger 2006, p.998). The ethical principles sanctioned in minimizing global health inequalities include the intrinsic value of health to well-being and demand equal respect for all human life, the significance of health for individual and collective agency, and the urge to address disproportionate effort to aid disadvantaged groups (Ruger 2006, p.999). V. Conclusion From a global perspective, prominent issues in public health encompass: disparities manifest in health status and access. For instance, questions arise regarding resource allocation hinge, in part, on value judgments regarding the relative importance of small enhancements in quality of life for a majority of the population compared to life-saving intervention that would yield benefits to only a section of the population. With regard to international cooperation in health surveillance and monitoring, the implementation of health regulation mirrors the commitment of countries to collective action. Eliminating health disparities can be regarded as the appropriate and smart thing to do given that health disparities impose a steep cost on the U.S. economy and bear a heavy cost on citizens' health and productivity. The interventions pursued to remedy the disparities in global access to health should incorporate guaranteeing cultural competence among health care providers and enhancing health literacy among the patients. References Bravemen, P. (2006). Health disparities and health equity: Concepts and measurement. Annual Review of Public Health 27 (1): 167-194. Casas-Zamora, J., & Ibrahim, S. (2004). Confronting health inequality: The global dimension. American Journal of Public Health 94 (12): 2055-2058. Chin, M., Walters, E. A., Cook, C. S., & Huang, S. E. (2007). Intervention to reduce racial and ethnic disparities in health care. Medical Care Research and Review 62 (5): 7-28. Collins, T. (2003). Globalization, global health, and access to healthcare. The International Journal of Heath Planning and Management 18 (2): 97-104. Gulliford, M .C. & Morgan, M. (2003). Access to healthcare. London, UK: Routldge. Ivanov, L. L., & Blue, C. L. (2007). Public health nursing: Leadership, policy, & practice. Australia: Delmar Cengage Delmar. Merson, M. H., Black, R. E., & Mills, A. J. (2012). Global health: Diseases, programs, systems, and policies. Burlington, MA: Jones & Bartlett Learning. Mullins, D., Blatt, L., Gbarayor, M. C., Yang, H. & Baquet, C. (2005). Health disparities: A barrier to high-quality care. American Journal of Health-System Pharmacy 62 (18): 1873-1882. Ruger, J. P. (2006). Ethics and governance of global health inequalities. Journal of Epidemiology and Community Health 60 (11): 998-1002. Read More