According to the 2012 census, the United States total population is estimated to be over 313 million; this represents a 9.7% increase within a period of 10 years (Thomas, 2014). Moreover, the composition of the population is one of the most diverse in the world; it’s made up of people with different racial and ethnic backgrounds ranging from Caucasians or the Whites, the Blacks or African Americans, American Indian and Alaska Native, Asian, Native Hawaiian and other Pacific Islanders, and the Hispanics or Latinos. As a result, the diverse U.S. population has serious implications on the United States health care system. One of such implications is the evidence of health disparities where some racial and ethnic minorities such as African Americans and Hispanics are disproportionately affected by some diseases than the majority whites. Another impact of the diverse population on health care is in the provision of patient care services and practice of nursing, different population have varied healthcare needs thus the need for a culturally competent workforce. Therefore, disparities in healthcare not only lead to inequities but also hinders enhancement of quality healthcare.
Various studies on healthcare disparities show that Caucasians are more satisfied with the quality of their healthcare compared to Hispanics and African Americans. The lower percentages in the rates of satisfaction with the quality of health care among African Americans and Hispanics can be attributed to several factors. Some of these factors are ethnic or racial discriminations, socioeconomic status and access to healthcare services. According to Sorkin, Ngo-Metzger & De Alba (2010), racial and ethnic minority groups in the United States rated the quality of health care they receive lowly than the non-Hispanic whites who rate it highly. According to their study, the low ratings of quality of health care among the African Americans and Hispanics is attributed to the feeling of discrimination the minorities experience whenever they go to health care organizations. The minority groups especially the African Americans and Hispanics rate quality of health care provided based on their perceived discrimination, in this regard, the patients from the two minority groups often perceives that they are always subjected to negative attitudes in health care institutions when they are receiving patient care because of their racial or ethnic background. Such discrimination can be in the form of taking longer times waiting to be attended to compare to the waiting time taken by the whites (Sorkin, Ngo-Metzger & De Alba, 2010). From the above narrative, it is, therefore, clear that there is a significant relationship between apparent racial discrimination and quality of care among the African Americans and the Hispanics.
The second factor that influences the differences in rates of satisfaction with the quality of health care among African Americans and the Hispanics is their socioeconomic status. Many studies have shown that one o the most critical aspects of access to health care is the socioeconomic status. The low ratings in quality of health care among the African Americans and the Hispanics have been linked to their low socioeconomic status (Thomas, 2014). It is evident from various studies that lack of health insurance among a majority of African Americans and the Hispanics due to their low socioeconomic status affects access and quality of care provided in that they are more likely not to receive some specific medical procedures compared to the Whites who are insured. As a result, their satisfaction with the quality of care reduces considerably. The third factor is the issues of low literacy, language and communication barriers. A majority of the African Americans and the Hispanics are not fluent English speakers; therefore, wherever they seek health care services communication with the health care providers might be problematic. In scenarios where there are no interpreters to help in communication in the care process, quality of health provided can be affected adversely. This is the case with most African Americans and the Hispanics, thus low ratings of health care quality.
Disparities in health refer to inequalities in provision and access to healthcare among different population groups such as socioeconomic status, ethnicity, age, gender, geographic location sexual orientation and disability status (Artiga, 2016). Groups which lack access to and receive poor quality health care services are more likely to experience poor health outcomes compared to others which have more access to and high-quality care. As a result, those who do not access health care services or receive poor quality care services normally experiences elevated burdens of illnesses and mortalities. Some of the strategies that can be used to overcome differences in care include implementing policies that expand health insurance to cover all vulnerable populations in order to enhance access to and provision of quality care (Artiga, 2016). Secondly, is ensuring that the healthcare workforce is diverse and is culturally competent to ensure quality care is provided to all cultural groups. Lastly, the states and the federal government should focus on reducing or eliminating causes of poor health among the minority groups such as low levels of education and poverty.
Health indicators refer to the summary of measures that are normally intended to express particular aspects of health or the performance of a health system in a community or specific group. Examples are life expectancy, mortality and morbidity indicators (Office of Disease Prevention and Health Promotion, 2017). They are important tools in public health because they help in designing policies that are aimed at improving health. Moreover, health indicators act as a guideline towards the achievement of optimal health goals for the community and groups. The leading health indicators identified by Healthy People 2020 are 26 grouped into 12 main topics.
The 12 are access to health services, clinical preventive services, environmental quality, injury and violence, maternal, infant and child health, mental health, nutrition, physical activity and obesity, oral health, reproductive and sexual health, social determinants substance abuse and tobacco (Office of Disease Prevention and Health Promotion, 2017). Various organizations such as national, state and community are addressing the Healthy People 2020 topics in different ways. An example is a strategy to enhance nutrition and prevent diseases in New York City through improved access to fresh fruits and vegetables. Other ways through which the priority health topics are addressed is through the nurse-family partnership model in Louisiana that seeks to improve maternal and child health. Lastly is the extra mile program in Nebraska that has resulted in reduced sales of alcohol to youth in Omaha.
References
Artiga, S. (2016). Disparities in Health and Health Care: Five Key Questions and Answers | The Henry J. Kaiser Family Foundation. Retrieved from http://kff.org/disparities-policy/issue-brief/disparities-in-health-and-health-care-five-key-questions-and-answers/
Office of Disease Prevention and Health Promotion. (2017). 2020 LHI Topics | Healthy People 2020. Retrieved from https://www.healthypeople.gov/2020/leading-health-indicators/2020-LHI-Topics
Sorkin, D. H., Ngo-Metzger, Q., & De Alba, I. (2010). Racial/ethnic discrimination in health care: impact on perceived quality of care. Journal of General Internal Medicine, 25(5), 390-396.
Thomas, B. (2014). Health and health care disparities: the effect of social and environmental factors on individual and population health. International journal of environmental research and public health, 11(7), 7492-7507.
