Health Disparities in Lower Socioeconomic Communities

HEALTH DISPARITIES IN LOWER SOCIOECONOMIC COMMUNITIES

Abstract

Most Americans believe that health care should be made accessible to all those who are sick or injured, regardless of socioeconomic status or other circumstances. Many Americans also consider the unreasonable cost of medical care as the most disconcerting dimension of the healthcare system and believe that the cost is a huge impediment for many people to receive access to healthcare. This paper advocates an examination of the health disparities that the US healthcare system has and how people of lower socioeconomic status are affected by them. Approaching the disparities that many Americans encounter in healthcare through an effective framework can provide the foundation for developing more vigorous evidence to influence healthcare policies for improving access and reducing disparities. Disparities in health and healthcare in the United States has been an enduring challenge. As a result, many groups receive less and worse quality health care in comparison to other groups which in turn, produces poorer health outcomes. This paper provides an in-depth synopsis of health care disparities, including what disparities are as well as their significance in healthcare.

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Introduction

Many Americans have access to health care which allows them to reap the benefits fully from the United States’ health care system. On the contrary, there are also many others that face obstacles that make it challenging to attain basic health care services. Ethnic minorities and people of low socioeconomic status (SES) are disproportionately represented among those with these access problems. The World Health Organization says, “There is ample evidence that social factors, including education, employment status, income level, gender and ethnicity have a marked influence on how healthy a person is. In all countries, whether low, middle, or high income – there are wide disparities in the health status of different social groups,” (World Health Organization, 2011). People who don’t have health insurance are less likely to obtain the necessary care they need for disease prevention. Examples of these disease preventions are cancer screenings, advising for diet and exercise, and vaccinations for ailments such as the flu. In addition, people without health insurance typically do not receive the suggested care they need for disease management. In an article addressing the socioeconomic disparities in health, the authors, Adler and Newman stated, “Socioeconomic status, whether assessed by income, education, or occupation, is linked to a wide range of health problems, including low birthweight, cardiovascular disease, hypertension, arthritis, diabetes, and cancer. Lower socioeconomic status is associated with higher mortality, and the greatest disparities occur in middle adulthood,” (Adler and Newman, 2002). Eradicating the issue of health disparities will entail acknowledging all the components of socioeconomic status and the ways in which they influence health. Although the United States has somewhat acknowledged the problems that the uninsured face, there has been discouragingly little progress that has been made. This nation’s issue of poor access to health care is adversely effective at both a personal and societal cost. For example, if individuals do not receive vaccinations, they may become ill and thereby, increase the chances of others being infected with the disease as well. Essentially, this increases the burden of disease for society as well as the burden that is placed on people individually.

The Importance of Health Insurance

The effects of not being insured can have a predominantly severe impact on an individual's health and stability. According to an article about access to health care on the  New York State Department of Health’s website, “Access to quality care is important to eliminate health disparities and increase the quality and years of healthy life for all,” (“Priority Area,” 2011). People who are uninsured tend to delay seeking care, have trouble attaining care when they eventually seek it, and also may have to endure the full burden of health care costs. Eventually, the aggregate consequences of being uninsured increase and result in a population that is at a more susceptible risk for subpar health care and health status.

Health insurance is meant to safeguard individuals from the burden of high health care costs. Despite that, even with health insurance, the financial burden of health care can still be high and is actually increasing every year. Out-of-pocket payments and high premiums can be a substantial obstacle to accessing the necessary medical treatment and preventive care. The quality of healthcare is a product of the collaboration between the patient and the healthcare provider. According to the American College of Healthcare Executives’ website, they believe, “Ensuring the availability of affordable healthcare is a shared responsibility of healthcare organizations as well as the government, community groups and the private insurance market,” (Access to Affordable Healthcare, 2016). Individual and personal factors of the stakeholder and the patient, and also factors affecting the healthcare organization all contribute to the quality of healthcare services. The quality of healthcare can be enhanced by compassionate leadership, appropriate planning, education and training, accessibility of resources, employees, and also collaboration and assistance among providers.

It is quite baffling that although the United States spends more money on health care than any other nation in the world, Americans still do not receive the necessary care they need. Preventive care has the potential to be an effective and beneficial aspect of our health care system. However, it is an underutilized tool which results in more spending on complex and progressive diseases. Patients who suffer from chronic diseases such as heart disease, hypertension and diabetes many times do not receive the proven and efficient treatments such as drug therapies or self-management services that allow them to effectively and conveniently manage their conditions. These problems are intensified due to a deficiency of management of care for patients with chronic diseases. In a study published by the American Psychological Association examining the complexities between health disparities and poverty, they stated, “Equitable access to health care is not evident and those in less affluent neighborhoods have greater disease incidence and increased mortality and morbidity rates, particularly for angina, myocardial infarction, and heart failure,” (American Psychological Association, 2014). Reducing disease rates among people of lower socioeconomic status needs to be evaluated and conducted from both an individual level and societal level and also needs to prevent and treat chronic diseases, especially in disadvantaged neighborhoods. Health professionals must encourage health policy in order to achieve progress in reducing the disease rates. The underlying deterioration of the health care system is not shocking since health care providers do not have the tools they need to communicate and collaboratively work effectively with other health care providers to improve patient care.

Improving our health care delivery system so that we can essentially improve the quality and value of care is crucial as well as addressing the issues of increasing costs, poor quality, and the increasing numbers of Americans who do not have health insurance coverage. Reforms should improve and expand access not just to care, but to the right care at the right time and in the right place. These reforms should promote an environment where people are healthy and prevent common yet avoidable impediments of illnesses to the greatest extent possible. Thoughtfully and thoroughly planned changes should encourage and support increased access to healthcare which is contrary to the current system, which supports more tests, procedures, and treatments that could essentially be unnecessary and detrimental to one’s health.

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Conclusion/ What Can I do to Help?

Health equity is achieved when everyone is afforded the opportunity to achieve their full health potential and no one is at a disadvantage to attain this full health potential because of their socioeconomic status. Health disparities are health differences that are closely related to social or economic disadvantages that have a negative impact on the people it affects. In the article, “To Denigrate, Ignore, and Disrupt” by Arline Geronimus and J. Phillip Thompson, they discuss the adverse effects that living in poverty can have on an individual’s body. In the article, they stated, “Dominant racial ideologies themselves have negative health effects on African American communities. Together, these ideologies and policies undermine Black health by adversely impacting the immune, metabolic, and cardiovascular systems, fueling the development or progression of infectious and chronic disease,” (Geronimus and Thompson, 2004). It is important to acknowledge all the factors that contribute to an individual’s overall health as this will help provide a holistic approach to the solutions that may improve the healthcare system. Residence in disadvantaged neighborhoods, racial discrimination in health care, and the stress caused by discrimination can all work together to negatively impact the state of one’s health. An effective healthcare system aims to eliminate these health disparities and improve the health of all groups of people to produce healthier communities.

Health and health care disparities are still a huge issue in the United States. Health disparities lead to certain groups being at a substantially higher risk of being uninsured, having limited or no access to care, encountering poorer quality of care, and essentially experiencing much worse health outcomes. While health and health care disparities are typically observed through the lens of race and ethnicity, they happen across a comprehensive range of dimensions and display a complex series of individual, social, and environmental factors. As the population becomes increasingly diverse along with people’s individual needs, it is becoming more and more imperative to address the issue of disparities in health and health care. Only this way, will we be able to make a positive and beneficial impact on this flawed health care system we have in the United States.

REFERENCES

• World Health Organization: 10 facts on health inequities and their causes. (2011, October). Retrieved October 21, 2019, from who.int website: http://www.who.int/features/factfiles/health_inequities/en/
• "Affordable Care Act." www.medicaid.gov, www.medicaid.gov/affordable-care-act. Accessed 3 May 2017.
• Priority Area: Access to Quality Health Care. (2011, December). Retrieved December 13, 2017, from www.health.ny.gov website: https://www.health.ny.gov/prevention/prevention_agenda/access_to_health_care/
• Access to Affordable Healthcare. (2016, November). Retrieved December 13, 2017, from www.ache.org website: https://www.ache.org/policy/access.cfm
• American Psychological Association: Examining the Complexities between Health Disparities and Poverty. (2014, March). Retrieved October 21, 2019, from www.apa.org website:
• https://www.apa.org/pi/ses/resources/poverty-complexities-bibliography.pdf
• Geronimus, Arline, and J. Phillip Thompson. To Denigrate, Ignore, and Disrupt: Racial inequality in health and the impact of a policy-induced breakdown of African American communities. N.p.:   n.p., 2004. Print.