America exists as a highly ethnically diverse democratic country. In the mid-twentieth century, Edward Murrow voiced a budding hope about the improving standards of equality across races and genders (NPR, 2005). Equality within the American society describes the equitable sharing of all national resources across diverse social groups such as race, gender, and sexual orientation. Since the eradication of segregation in America, numerous strategies aimed at standardizing healthcare across races have been put in place. However, despite these efforts, there still exist persisting and puzzling health disadvantages to African Americans (Mays, Cochran, & Barnes, 2007).
Principles of Public Health Ethical Statement
In an ideal situation, ethics in public health is a moral tool that focuses on the improvement of the public’s health and welfare. The directive to ensure and protect the health of a population while avoiding abuse of power and bias or discrimination ought to be the core of public health ethics. Equity in healthcare is cannot be measured by the uniformity of services across multicultural societies. As a guideline for institutional and individual consciousness in America, the public health code of ethics should highlight core principles that are crucial to the improvement of public health and welfare while implementing culturally sensitive approaches to healthcare services and disregarding all constructs of bias.
Public health should reaffirm the principles of autonomy, justice, and beneficence, as stipulated in the codes of bioethics, with a core principle, to respect the sanctity of life by safeguarding human rights.
Public health should inspire and endorse cultural diversity training for all individuals involved in public health sector.
Public health should advocate for culturally diverse work environments by employing staff from culturally diverse backgrounds in the industry.
Public health should advocate for cultural diversity on boards, committees, and other policy-making organizations at national and state levels
Public health should encourage the development of strategies to counter racism within the health sector.
Using this approach, ethics in public health becomes a form of social justice. It advocates for individual rights and promotes social good by acting as an unbiased and culturally sensitive tool within the health sector.
Ethical Issues
Growing up in an ethnically diverse society, I became aware of the differences in healthcare resource distribution within my environment from an early age. Health facilities located in neighborhoods with low socioeconomic income seemed to always be in dire states when compared to health centers located in areas of medium to high socio-economic incomes. These health facilities were always overcrowded with patients, understaffed and often lacked the necessary resources required for the proper functioning of a healthcare facility. Ethnic minorities such as African Americans make up more than ninety percent populations in neighborhoods with low socioeconomic income. While a career in public health avails me an opportunity to work directly with the community in raising disease awareness and prevention, I am more interested in designing and implementing culturally sensitive policies within the public health sector. I believe that my involvement in this sector will build my career goals which are aimed at contributing to the achievement of health equity among all Americans.
Even after the Heckler report of 1985 which indicated a significant difference in the health status of African Americans compared to Caucasian Americans, disparities in health among African Americans continue to worsen (Mays, Cochran, & Barnes, 2007). The health differences of African Americans are influenced by cultural and lifestyle differences, genetic traits, socioeconomic status and health care provider bias. The evidence of health disparities among this minority group is indicated by the increasing differences in disease rates (Kilbourne, Switzer, Hyman, Crowley-Matoka, & Fine, 2006). Compared to the Caucasian population and other minority groups, increasing prevalence of diseases such as hypertension, heart disease, and diabetes is evident among African-American minorities.
The existing bias in healthcare resources and services is an indication of the violation of individual rights and has resulted in health inequity among African Americans. Guillory & Thomas, (2002) note that improving the health outcomes of individuals and the community by preventing adverse health outcomes is one of the core principles of ethical practice in public health. The directive to promote the health of the public has become innately moral. It describes the obligation of health providers and institutions to improve the well-being of communities without any elements of bias or discrimination.
Today, even with existing legislature and policies aimed at eradicating discrimination within the health sector, African Americans still bear a disparate burden in disease incidence, death rate, disability, and injury (Mays, Cochran, & Barnes, 2007). Studies in discrimination within the health sector measure the extent to which patients believe they are treated unfairly, differently and are consequently disadvantaged due to their racial or ethnic orientation. The perceived discrimination has been linked to high blood pressure and poorer self-rated health (Mays, Cochran, & Barnes, 2007).
The lack of health equity within African Americans communities prevails because of issues of ethnicity and socioeconomic class in American society. The negative differences in health equity among African Americans serve only to preserve historical inequities faced by vulnerable groups of the American population. Historically laws and practices openly discriminated against minority groups and favored prominent social groups. Even though these discriminatory laws have since been eliminated from policy and legislature, they still exist in practice.
Suggested Solutions
Health disparities are ethically wrong and merely serve to demonstrate historical injustices to minority groups. The consequences of health disparities work against the universal do no harm principles of ethical standards. The differences in health disparities in America results in inequities that deny affected individuals rights to life, liberty and the pursuance of happiness (Jones, 2010). Race-discrimination health pathway models, suggest the influence of environmental stimuli such as violence, inadequate education, and negative social connectedness in health inequity.
It is the responsibility of individuals and institution in the health sector to alter the conditions that harm health. There is a need to develop interventions that strive for social justice, fairness and health equity among African Americans. These interventions should encourage the growth and enactment of broad multi-cultural health care delivery models to meet the specific health requirements of culturally diverse societies.
Public health policies should focus on the development and implementation of modifications in curricula of undergraduate health sector related programs to include multicultural awareness training. This will ensure that staff in health care are sensitive to diverse cultural resulting in transcultural competence in practice. Ethical practices should encourage educational programs and research that focus on and patient outcomes for health problems specific to African American minority populations.
There should be increased recruitment and retention of personnel from culturally diverse backgrounds in faculties, committees and other bodies of education, health services and policy organizations involved in the health sector. There is a need for regular training and programs that promote positive cross-cultural interactions within the work environment.
Since there is a strong correlation between health equity among African Americans and social class, there is need to improve multiple aspects of their social environment. Elements such as education quality, unemployment, insecurity, and violence are environmental factors that indirectly influence health outcomes of patients. They contribute significantly to patient stress levels which often undermine wellness regiments. Health equity in African Americans can be achieved by improving multiple aspects of low-income neighborhoods, such as security, education, and employment.
Ethical practices in public health should support the enactment of public policies that aim to eliminate larger social problems associated with poverty such as illiteracy and unemployment which tend to be prevalent in neighborhoods with high minority populations (Jones, 2010). Lastly, public health ethical practices should support the enforcement of laws that emphasize community empowerment and provide penalties and punishments against ethnic discrimination.
References
Guillory, J. & Thomas, J. (2002). A Code of Ethics for Public Health. American Journal Of
Public Health, 92(7), 1057. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/
Jones, C. (2010). The Moral Problem of Health Disparities. Am J Public Health, 100(S1), S47-
S51. http://dx.doi.org/10.2105/ajph.2009.171181
Kilbourne, A., Switzer, G., Hyman, K., Crowley-Matoka, M., & Fine, M. (2006). Advancing
Health Disparities Research Within the Health Care System: A Conceptual Framework. Am J Public Health, 96(12), 2113-2121. http://dx.doi.org/10.2105/ajph.2005.077628
Mays, V., Cochran, S., & Barnes, N. (2007). Race, Race-Based Discrimination, and Health
Outcomes Among African Americans. Annual Review Of Psychology, 58(1), 201-225. http://dx.doi.org/10.1146/annurev.psych.57.102904.190212
NPR: This I Believe. (2005). Npr.org. Retrieved 25 April 2016, from
http://www.npr.org/thisibelieve/about.html
