RACIAL AND ETHNIC DISPARITIES IN THE HEALTHCARE SYSTEM 9
Racialand Ethnic Disparities in the Healthcare System
Anideal society exists where everyone can live a healthy liferegardless of his or her racial or ethnic background. However, racialminorities in the country experience more health problems compared toother individuals. Factors such as differences in language,socioeconomic status, and access to healthcare among the minoritygroups provide an explanation to some of the disparities in health.Additionally, some of the patients do not have trust in thehealthcare system, and such biases can affect clinical interactions.Racial and ethnic disproportions exist in our healthcare system, andwhen policymakers take the appropriate actions, they can address thehealth needs of the minority groups.
Shaverset al. (2012) evaluate the prevalence, practices, and institutionalpolicies linked to racial and ethnic discrimination in the healthcaresetting. Minority communities often receive poor care in thehealthcare system. However, the elimination of these disparities ishard due to the lack of understanding of the role that ethnic andracial discrimination play in the healthcare system (Shavers et al.,2012). Although this source assesses the impact that perceiveddiscrimination has on patients in the healthcare setting and theprevalence of ethnic and racial prejudice, it has some weaknesses.For instance, it does not evaluate the actual occurrence ofdiscriminatory events and their impacts on the affected individuals.
Onthe other hand, White, Haas, and Williams (2012) seek to find out thecause of the disparities in the healthcare by race and ethnicity.Therefore, the researchers focused on the residential segregation ofpeople by race and ethnicity, and its contribution to the disparitiesin the healthcare system. Segregation has influenced the use, access,and quality of health services in clinical care (White, Haas, &Williams, 2012). When healthcare resources are not distributedequitably, the long-term health of the communities with a lowsocio-economic status is adversely affected. While the authors use apositive tone in their arguments, they make it clear that the medicaltreatment offered to minorities cannot be compared to that which isgiven to other groups of people. However, there is no use of theprecise measures of segregation since the study on relies on theracial composition of neighborhoods as the proxy of separation.
Differencesin race and ethnicity also affect stroke epidemiology as well as theclinical care of the patients, and this is what Cruz-Flores et al.(2011) evaluate in their study. Disparities in the provision ofstroke care include the lack of awareness about the risk factors orthe condition, its symptoms, and not knowing that urgent treatment isnecessary (Cruz-Flores et al., 2011). These inconsistencies,primarily, affect individuals from the marginal groups, and theyresult in lower access to quality healthcare, they explain thedifferences in the rates of stroke mortality. Although the authorsuse and informative tone to provide recommendations for an increasein the access to resources, the source does not clarify therelationship between stroke outcomes and race.
Levineet al. (2011) similarly found that the racial minorities older than65 years who are also stroke survivors have the worst access tomedication and physician access compared to whites. The reducedaccess to health care among this group of people implies that theyare at a higher risk for the recurrence of stroke. Although thisstudy reveals the level of physician care that different ethnicgroups receive, it does not include the impact of factors such asincome and comorbidity.
Whilethe government made considerable improvements to the Veterans Affairs(VA) health care system, Trivedi et al. (2011) observed that therewere racial gaps in the VA medical centers. The authors use anobjective tone to describe how the VA has transformed over the years,and how veterans from ethnic minority groups are more dependent onthat healthcare system compared to other individuals. Although thequality of care in government health care systems has improved overthe years, there are still disparities for outcome measure in theassessment of cholesterol, blood glucose, and blood pressure (Trivediet al., 2011). The weakness of this study, however, is that it doesnot evaluate other mediators of disparities such as the prescriptionof medication.
Sincethe majority of other studies focused on the race and ethnicdifferences in adults, Flores and Lin (2013) sought to find out thetime trends of the discrepancies in the access to care amongchildren. The use of medical services is high among children, anddetermining the disparities would be significant. Most of theminority children experience disparities in the access to healthcare,and such imbalances remain for long (Flores & Lin, 2013). Whilethis study examines a broad range of trends in racial and ethnicdiscrepancies in health care among children, the parental reportsused for obtaining data might be inaccurately representing theinformation from other sources.
Mentalhealth is the other area where racial and ethnic differences appearto be the reason for disparities in the treatment of the condition asAkincigil et al. (2012) finds out. The study conducted by theseresearchers aimed at examining how the differences in race andethnicity affect the diagnosis and treatment of depression among theelderly individuals in the community (Akincigil et al., 2012). Ethnicminorities, especially the African-Americans, are the least likely toget a diagnosis for depression compared to other groups of people inthe community (Akincigil et al., 2012). This source uses an assertivetone to present the findings. Although it is apparent that stigma andcommunication difficulties could affect the management of depression,the survey used does not capture the cultural factors that bringabout the differences in depression care.
Woolfand Braveman (2011) evaluate the root causes of the disparities inthe healthcare system including the social determinants,macroeconomics, and incomes. All these factors reflect the ethnic andracial discrepancies in the healthcare system since the quality ofmedical care that individuals receive depends on aspects such astheir income level. This source illustrates that racial and ethnicdisparities exist in the healthcare system. The elements that have animpact on health issues including the exposure to particularsocioeconomic conditions are the same ones that result in disparitiesin the reception of quality healthcare.
Thescreening of cancer is a critical aspect in the early detection andprevention of a variety of health conditions. Shi et al. (2011)evaluated the association between preventive care disparities andrace/ ethnicity in the country between 2000 and 2008. The rates ofscreening for some types of cancer have increased for all ethnicgroups, but the mammogram, and Pap tests decreased among the racialminorities (Shi et al., 2011). These disparities occur due tocultural beliefs that prevent access to health care, languagebarriers, and lack of knowledge about preventive measures. Wheeler etal. (2013) also found that there are differences in the treatment ofpeople with breast cancer by race.
Disparitiesalso occur in the management of renal disease, even though theMedicare program was meant to make the treatment of this conditionmore accessible (Almgren & Lindhorst, 2011). The comparison ofthe adequacy of dialysis by the AHRQ revealed that there aresignificant disparities in the management of renal disease, with theethnic minorities having the lowest rates (Almgren & Lindhorst,2011). Equally important, Dovidio & Fiske (2012) posit that poorhealth is the result of discrimination outside the clinical setting,and the minority groups believe that their race adversely affects thequality of healthcare they receive. Despite the existence of racialdisparities in healthcare, several measures can be taken to addresssuch issues.
Thereis a multidimensional etiology to the differences that exist in thehealthcare system, and these include the language barriers,stereotypes by the provider, and cultural beliefs (Lopez et al.,2011). Lopez et al. (2011) suggest that investing in healthinformation technologies should take into consideration the qualityof healthcare for every patient since they often cause thedisparities. On the other hand, Koh, Graham, and Glied (2011) providea rationale for reducing ethnic and racial gaps in the healthcaresystem. This action plan includes the improvement of communicationand translation services, increasing diversity in the workforce, andaddressing the needs of the minority groups (Koh, Graham, &Glied, 2011).
Minoritycommunities receive inadequate care in the healthcare system.Whenthere is an inequitable distribution of healthcare resources, thelong-term health of the communities with a low socio-economic statusis adversely affected. Governmenthealthcare systems have made improvements in the quality of care theyprovide, but there are still disparities for outcome measure in theassessment of cholesterol, blood glucose, and blood pressure. Theaspects that lead to the development of health issues including theexposure to particular socioeconomic conditions are the same onesthat result in disparities in the reception of quality healthcare.
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