Healthcare disparities pose a major challenge to the diverse 21st century America. Demographic trends indicate that the number of Americans who are vulnerable to suffering the effects of healthcare disparities will rise over the next half century. These trends pose a daunting challenge for policymakers and the healthcare system. Wide disparities exist among groups on the basis of race/ethnicity, socioeconomic status, and geography. Healthcare disparities have occurred across different regional populations, economic cohorts, and racial/ethnic groups as well as between men and women. Education and income related disparities have also been seen. Social, cultural and economic factors are responsible for inequalities in the healthcare system.
The issue of racial and ethnic disparities in healthcare have exploded onto the public stage. The causes of these disparities have been divided into health system factors and patient-provider factors. Health system factors include language and cultural barriers, the tendency for racial minorities to have lower-end health plans, and the lack of community resources, such as adequately stocked pharmacies in minority neighborhoods. Patient-provider factors include provider bias against minority patients, greater clinical uncertainty when treating minority patients, stereotypes about minority health behaviors and compliance, and mistrust and refusal of care by minority patients themselves who have had previous negative experiences with the healthcare system.
The explanation for the racial and ethnic disparities is that minorities tend to be poor and less educated, with less access to care and they tend to live in places where doctors and hospitals provide lower quality care than elsewhere. Cultural or biological differences also play a role, and there is a long-running debate on how subtle racism infects the healthcare system. Inadequate transportation or the lack of knowledge among minorities about hospital quality could also be factors of inadequate care. Racial disparities are most likely a shared responsibility of plans, providers and patients. There’s probably not one factor that explains all of the disparity, but health plans do play an important role. Racial and ethnic disparities in healthcare do not occur in isolation. They are a part of the broader social and economic inequality experienced by minorities in many sectors. Many parts of the system including health plans, health care providers and patients may contribute to racial and ethnic disparities in health care.
It is seen that there are significant disparities in the quality of care delivered to racial and ethnic minorities. There is a need to combat the root causes of discrimination within our healthcare system. Racial or ethnic differences in the quality of healthcare needs to be taken care of. This can be done by understanding multilevel determinants of healthcare disparities, including individual belief and preferences, effective patient-provider communication and the organizational culture of the health care system.
To build a healthier America, a much-needed framework for a broad national effort is required to research the reasons behind healthcare disparities and to develop workable solutions. If these inequalities grow in access, they can contribute to and exacerbate existing disparities in health and quality of life, creating barriers to a strong and productive life.
There is a need to form possible strategies and interventions that may be able to lessen and perhaps even eliminate these differences. It is largely determined by assumptions about the etiology of a given disparity. Some disparities may be driven, for example, by gaps in access and insurance coverage, and the appropriate strategy will directly address these shortcomings. The elimination of disparities will help to ensure that all patients receive evidence-based care for their condition. Such an approach will help establish quality improvement in the healthcare industry.
Reducing disparities is increasingly seen as part of improving quality overall. The focus should be to understand their underlying causes and design interventions to reduce or eliminate them. The strategy of tackling disparities as part of quality improvement programs has gained significant attraction nationally. National leadership is needed to push for innovations in quality improvement, and to take actions that reduce disparities in clinical practice, health professional education, and research.
The programs and polices to reduce and potentially eliminate disparities should be informed by research that identifies and targets the underlying causes of lower performance in hospitals. By eliminating disparities, the hospitals will become even more committed to the community. This will help to provide culturally competent care and also improve community connections. It will stimulate substantial progress in the quality of service that hospitals offer to its diverse patient community. Ongoing work to eliminate health disparities will help the healthcare departments to continually evaluate the patient satisfaction with services and achieve equality in healthcare services.
It is important to use some interventions to reduce healthcare disparities. Successful features of interventions include the use of multifaceted, intense approaches, culturally and linguistically appropriate methods, improved access to care, tailoring, the establishment of partnerships with stakeholders, and community involvement. This will help in ensuring community commitment and serve the health needs of the community.
There is the need to address these disparities on six fronts: increasing access to quality health care, patient care, provider issues, systems that deliver health care, societal concerns, and continued research. A well-functioning system would have minimal differences among groups in terms of access to and quality of healthcare services. This will help to bring single standard of care for people of all walks of life.
Elimination of health care disparities will help to build a healthier America. Improving population health and reducing healthcare disparities would go hand in hand. In the health field, organizations exist to meet human needs. It is important to analyze rationally as to what actions would contribute to eliminate the disparities in the healthcare field, so that human needs are fulfilled in a conducive way.
Meenu Arora has contributed her articles for both online and hard copy magazines. Her articles have also been published in international magazines. Presently working in the healthcare industry, she has also written and edited Health Q-A columns for international magazine for 5 years.