Health care providers and institutions take an active role in raising awareness about health disparities, identifying at risk populations and addressing barriers to care in their communities.
The term health disparities refers to preventable differences in providing health care and access to health care that are experienced among members of different populations. According to the National Institutes of Health (NIH), health disparities emerge from factors such as race, ethnicity, gender, sexuality, class, disability and more.
The Cause for Concern
A wide-scale disparity exists in the quality of health care across different ethnic and racial groups. These disparities occur in the incidence of disease as well as in the rate of adverse health outcomes and mortality.
In the United States, health disparities are a well-known problem among ethnic minorities such as African Americans, Asian Americans, Native Americans, and Latinos. Studies have shown that these groups have a higher prevalence of chronic conditions along with higher rates of mortality and poorer health outcomes when compared with the white population. For example, according to the CDC, the incidence rate of cancer among African Americans is 10% higher than among whites. African Americans and Latinos are also approximately twice as likely to develop diabetes.
Types of Disparities Affecting Health Care
Health disparities result from complex and intersecting factors. These might include a lack of insurance, an inability to pay for care, a shortage of qualified local health practitioners, language barriers, cultural bias among practitioners, and a variety of other social, cultural, and environmental factors.
Examples of the minority groups that are the most impacted by these factors include racial and ethnic minorities, lesbian, gay and transgender individuals, women, children, the elderly, disabled people and individuals from lower socioeconomic backgrounds.
Some of the reasons that minority groups experience disparities in health care are discussed below.
- Lack of insurance: Individuals who lack adequate health insurance and are unable to pay for it are more likely to delay health care and to go without the necessary health care or medication they should have been prescribed.
- Lack of available finances: Health insurance plans often limit the number of services available to minorities as well as the number of providers they can use reducing their access to health care services. Without the ability to pay for additional services they often go without.
- Irregular source of care: Minorities are less likely to be able to visit the same doctor on a regular basis and tend to rely more on clinics and emergency rooms. Without a regular health care source, people have more difficulty obtaining their prescriptions and attending necessary appointments.
- Legal obstacles: Low-income immigrant groups are more likely to experience legal barriers. For example, insurance coverage through Medicaid is not available to immigrants who have been resident in the U.S for less than five years.
- Structural barriers: Lack of transport to health care providers, inability to obtain convenient appointment times and lengthy waiting room times reduce the likelihood of a person successfully making and keeping their health care appointment.
- Lack of health care providers: The number of health practitioners and diagnostic facilities is often inadequate where minority populations are concentrated.
- Language barriers: Language differences can make it difficult for people to understand basic information about health conditions, medication instructions or when they should visit their doctor. Communication can also be hindered by patients’ cultural beliefs and practices on health and disease.
- Discrimination on the part of the provider: Discrimination can occur if providers have a stereotyped impression of a certain racial or ethnic group, whether this is done consciously or not.
Ending Health Care Disparities
Most physician groups and institutions have initiated measures to reduce or eliminate these disparities. Some of the measures that are being implemented include community outreach and appointment follow-up programs, expansion of accessible health care service centers, the consistent collection and evaluation of barrier to care data, and establishing cultural and linguistically competent standards for care.
Many health care providers are able to accommodate the needs of foreign language speakers and people with impaired hearing through interpreter services. Continually ensuring that staff is trained to offer these services and coordinate health care in a culturally competent way with the minority groups improves the patient-provider relationship and outcomes.
Significant progress has been made in closing the gap in areas such as immunizations and prescribing medicine. But eliminating these disparities is challenging because their causes are intertwined with a variety of social, cultural, and environmental factors that influence the patients’ health outcomes. Despite the measures in place, some minorities still fare worse in the management of blood pressure, cholesterol, and glucose, even though the care they receive has improved. In order to make a transformative change, we must make connections between a person’s health problems and other life circumstances.
“Eliminating disparities requires truly patient-centered care—that is, individualized care by caregivers who acknowledge that patients’ beliefs, behaviors, social and economic challenges, and environments dictate their health outcomes,” writes Marshall Chin MD MPH, in the New England Journal of Medicine.
It will be through addressing the critical link between lack of education, poor health, and poverty that health outcomes will be improved. The burden of ending health disparities should be shared by inviting other stakeholders such as the local school systems, government officials, and business leaders to work together with health care institutions.
As a community, we need to dig deeper into the social determinants to address long term health disparities that impact a persons’ well-being. By focusing on and tackling systemic issues like high school graduation rates and career pathways for students to support economic sustainability in our neighborhoods we can help improve overall health for all in the community.
Assuring that people have the tools and resources that they need to be healthy can lead to social and physical environments that promote quality of life, healthy development, and healthy behaviors across all life stages.