Biologic, socioeconomic and environmental factors, like race, ethnicity, sex, age, income, and geographical location, create “determinants of health”. Each plays a role in how patients receive and respond to health interventions. For example, food deserts make fresh produce and healthy foods difficult to access and areas with high crime rates create barriers to exercise. Each of these socioeconomic barriers ultimately affects a person’s health, creating the health disparities that dictate adverse health outcomes for some ethnic groups.
A Problem Across All Healthcare
Minority groups consistently bear worse health outcomes for a variety of conditions and diseases and are generally more negatively affected in health disparities. In 2007, the maternal death rate for African American, non-Hispanic or Latino, women was almost 3 times higher than white women, non-Hispanic or Latino (Office of Disease Prevention and Health Promotion [ODPHP]). Hispanics have a higher prevalence of lung disease, like asthma and chronic obstructive pulmonary disease, and higher rates of obesity than non Hispanic Whites. (Chartbook for Hispanic Health Care,2015). While improvements in outcomes continue, they are not equally experienced across all groups. For example, while non-Hispanic whites saw a marked decrease in infant death rate, American Indian or Alaskan Natives saw a steady infant death rate of 8.3 infant deaths per 1000 live births from 2006 to 2017 (ODPHP, 2017c). Racial and ethnic minorities are more likely to be poor or near poor and are less likely to have a highschool education than non-Hispanic Whites, perpetuating health inequalities (Chartbook for Hispanic Health Care,2015).
Given that in the 2010 Census, 36% of the US population, or more than 100 million people, identified themselves in a racial or ethnic minority, improving the health of the nation lies in correcting these discrepancies (CDC).
Barriers to Care
Health disparities are perpetuated along all of healthcare. Obtaining insurance and navigating insurance policies confuses even the most educated native English speaker. Inherent systematic biases and racism create obstacles that disporportionately affect minority groups. Furthermore, the needs of marginalized groups are not well understood from an organizational level. This is apparent in the Healthy People 2020’s goals for the LGBTQ population, where initiatives aimed simply to improve data collection and monitoring systems to better understand healthcare obstacles (ODPHP, 2014).
On an individual level, lack of access to quality care, unique provider biases, language barriers, and health literacy further disenfranchise those that are more likely to lack access to healthy foods and safe streets.
Often in minority and marginalized groups, health disparities complicate even simple conditions and treatment. Clinicians must be aware, knowledgeable of their community, and able to adapt care. By resisting to modify medical advice based on individual circumstances, patients are further ostracized and outcomes are affected. Identification of personal bias is imperative in effectively treating patients of all backgrounds. In understanding our own individual preconceived notions, patients will not be subjected to a biased diagnosis or treatment plan (Braveman & Gottieb, 2014).
Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it’s time to consider the causes of the causes. Public health reports (Washington, D.C. : 1974), 129Suppl 2(Suppl 2), 19–31. https://doi.org/10.1177/00333549141291S206
Center for Disease Control and Prevention: Office of Minority Health and Health Equity. (2021). Minority Health. Health Equity. Retrieved April 06, 2021 https://www.cdc.gov/minorityhealth/index.html
Deficits in Minority Health: A Major Problem
By: Devin Pinaroc, MSN, FNP-C
Biologic, socioeconomic and environmental factors, like race, ethnicity, sex, age, income, and geographical location, create “determinants of health”. Each plays a role in how patients receive and respond to health interventions. For example, food deserts make fresh produce and healthy foods difficult to access and areas with high crime rates create barriers to exercise. Each of these socioeconomic barriers ultimately affects a person’s health, creating the health disparities that dictate adverse health outcomes for some ethnic groups.
A Problem Across All Healthcare
Minority groups consistently bear worse health outcomes for a variety of conditions and diseases and are generally more negatively affected in health disparities. In 2007, the maternal death rate for African American, non-Hispanic or Latino, women was almost 3 times higher than white women, non-Hispanic or Latino (Office of Disease Prevention and Health Promotion [ODPHP]). Hispanics have a higher prevalence of lung disease, like asthma and chronic obstructive pulmonary disease, and higher rates of obesity than non Hispanic Whites. (Chartbook for Hispanic Health Care, 2015). While improvements in outcomes continue, they are not equally experienced across all groups. For example, while non-Hispanic whites saw a marked decrease in infant death rate, American Indian or Alaskan Natives saw a steady infant death rate of 8.3 infant deaths per 1000 live births from 2006 to 2017 (ODPHP, 2017c). Racial and ethnic minorities are more likely to be poor or near poor and are less likely to have a highschool education than non-Hispanic Whites, perpetuating health inequalities (Chartbook for Hispanic Health Care, 2015).
Given that in the 2010 Census, 36% of the US population, or more than 100 million people, identified themselves in a racial or ethnic minority, improving the health of the nation lies in correcting these discrepancies (CDC).
Barriers to Care
Health disparities are perpetuated along all of healthcare. Obtaining insurance and navigating insurance policies confuses even the most educated native English speaker. Inherent systematic biases and racism create obstacles that disporportionately affect minority groups. Furthermore, the needs of marginalized groups are not well understood from an organizational level. This is apparent in the Healthy People 2020’s goals for the LGBTQ population, where initiatives aimed simply to improve data collection and monitoring systems to better understand healthcare obstacles (ODPHP, 2014).
On an individual level, lack of access to quality care, unique provider biases, language barriers, and health literacy further disenfranchise those that are more likely to lack access to healthy foods and safe streets.
Often in minority and marginalized groups, health disparities complicate even simple conditions and treatment. Clinicians must be aware, knowledgeable of their community, and able to adapt care. By resisting to modify medical advice based on individual circumstances, patients are further ostracized and outcomes are affected. Identification of personal bias is imperative in effectively treating patients of all backgrounds. In understanding our own individual preconceived notions, patients will not be subjected to a biased diagnosis or treatment plan (Braveman & Gottieb, 2014).
Want to Learn More…
Minority Health and Health Equity
Reducing disparities in health care
Disparities in Healthcare Quality Among Racial and Ethnic Minority Groups: Fact Sheet
National Healthcare Quality and Disparities Reports
References:
Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it’s time to consider the causes of the causes. Public health reports (Washington, D.C. : 1974), 129Suppl 2(Suppl 2), 19–31. https://doi.org/10.1177/00333549141291S206
Chartbook for Hispanic health care. (2015, October). Agency for Healthcare Research and Quality. Retrieved April 06, 2021, from https://www.ahrq.gov/research/findings/nhqrdr/2014chartbooks/hispanichealth/part1.html#QDR.
Center for Disease Control and Prevention: Office of Minority Health and Health Equity. (2021). Minority Health. Health Equity. Retrieved April 06, 2021 https://www.cdc.gov/minorityhealth/index.html
Office of Disease Prevention and Health Promotion. (2007). Maternal deaths (per 100,000 live births) By Race/Ethnicity. Healthy People 2030. Retrieved April 06, 2021, from https://www.healthypeople.gov/2020/data/Chart/4897?category=3&by=Race/Ethnicity&fips=-1
Office of Disease Prevention and Health Promotion. (2014). LGBTQ 1-1. Healthy People 2030. Retrieved April 06, 2021, from https://www.healthypeople.gov/node/4802/data_details
Office of Disease Prevention and Health Promotion. (2017a). C-1. Reduce the Overall Cancer Death Rate. Healthy People 2030. Retrieved April 06, 2021, from https://www.healthypeople.gov/2020/data-search/Search-the-Data#objid=4047;
Office of Disease Prevention and Health Promotion. (2017b). Disparities Overview by Health Insurance Status. Healthy People 2030. Retrieved April 06, 2021, from https://www.healthypeople.gov/2020/data/disparities/summary/Chart/4121/11
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