Introduction
Access to quality, safe, and affordable healthcare is a priority of every person worldwide. Most countries in the world, especially, the United States of America (USA), have continued to put more efforts towards improving the delivery of care to ensure every citizen enjoys quality and safe health outcome. Health disparities act as one of the major issues affecting the delivery of health in the U.S. Health disparities affect different groups of people in the country, but it's more common among racial and ethnic minorities and underserved communities. The increasing documentation of disparities in healthcare calls for an urgent need to address the issue through introducing major healthcare reforms that will eventually eliminate health disparities. The following paper discusses health disparities and the role of professional nurses in addressing the issue.
Health disparities and the role of professional nurses
Causes of health disparities
The advancement of the nursing professional in the twenty-first century encounters numerous challenges related to shifting demographics and the never-ending disparities in the healthcare. The presence of these issues calls for continuous attention and action from all health professionals to help improve the delivery of care and ensure every citizen receives equal treatments. The issue of health disparity appears in many forms and affects all levels of care and is present in all practice environments. Nurses worldwide should eliminate health disparities by providing health care to all people without discrimination. However, everyday patients complain of poor healthcare services especially in the United States because some health providers are demonstrating high levels of discrimination. Many health outcomes depend on the wealth of the individual in the U.S.
Experts in the field of healthcare research have found numerous factors contributing to the increasing rates of health disparities in the US despite efforts by the health department to promote access to health for all citizens. One of the groups that have contributed a lot to the research and monitoring of disparities in the healthcare is the Center for Disease Prevention and Control (CDC). CDC started monitoring and responding to challenges facing the nation's health sector more than 60 years ago focusing more on health problems affecting the least and most vulnerable Americans. According to the CDC January 2011 report, social inequalities between different groups living in the US affect health outcomes leading to health disparities. The report documented the existence and persistence of substantial disparities in morbidity, hazardous environmental exposures, risk behaviors, and mortality among various segments of the U.S. population (Center for Disease Prevention and Control, 2011, pp. 7-9).
The nature of the workplace environment experienced by nurses influences healthcare outcome among patients. Research conducted by Olszewski, Parks, and Chikotas (2007) linked occupational health and safety to health disparities among US citizens. The study reviewed Health People 2010 objectives to evaluate the impact of work-related assaults on nurses’ performance. The lack of appropriate actions towards improving occupational safety and health among nurses leads to risks of violence in the workplace. The stressed health professional may extend their behaviors to patients especially the vulnerable populations. According to Olszewski, Parks, and Chikotas (2007, p. 122), the occupational health and safety objectives of the Healthy People 2010 give professional nurses a chance to establish and implement effective workplace policies that help promote a safe and healthy work environment. Health disparities are more common in the American workforce than Whites because of poor working conditions and lack of effective professional relationship between providers at all levels of the profession.
On the other hand, the healthy people 2020 have focused on reducing and eliminating health disparities over the last two decades. The goal of the Healthy People 2000 was to reduce disparities in health among Africans. On the other hand, the Healthy People 2010 focus was on total elimination of health disparities among all vulnerable populations in the U.S. The group expanded the goal further in Healthy People 2020 to focus on achieving health equity, improve health delivery among all groups, and eliminate disparities to achieve health equality. Health equity acts as an important factor that ensures every person attains the highest level of health care. Nurses have the role of valuing each person equally; hence, helping eliminate health disparities (HealthyPeople.gov, 2016, pp. 1-2).
The US population consists of people from diverse backgrounds associated with culture, ethnicity, race, and economic backgrounds. The US healthcare calls for universal access to health care to reduce health care disparities. One of the major contributors to the lack of universal access to health care is the high cost of medical care. The amount of spending recorded by the U.S. health care sector exceeds that of other developed countries by a very big margin. The Agency for Healthcare Research & Quality (AHRQ) documents the healthcare delivery modes in the U.S. including the quality, access, cost, use of services, and health care outcome (Olszewski, Parks, and Chikotas, 2007, p. 118). AHRQ has recently documented the high cost of care and lack of universal access to care as one of the leading causes of health disparities in the nation. The high cost of delivering health care in the U.S acts as a major contributor to health disparities in the country, especially among vulnerable populations. However, the U.S. healthcare sector introduced various reforms in the healthcare delivery that helped reduce the cost of care and allow more people access safe and quality care.
The impact of health disparities on people
Everybody has the right to access safe, quality, and affordable care irrespective of the cultural, social, economic, and political background. Disparities in health have resulted in many problems among them access to quality care among vulnerable populations in the U.S. Researchers in the field of healthcare realized the existence of health disparities exceeds common causes associated with ethnicity/race, lack of access to health care, and poverty. Health disparities lead to many significant problems including persistence of chronic diseases among vulnerable populations, delayed in health care reforms, and under development. Nurse professionals have a big role to play in preventing the existence of health disparities in their areas of practice.
The role of professional nurse in preventing health disparities
The United States healthcare sector has advocated for health care reforms over the last two decades as evidenced by the Healthy People goals. Everybody must take part in improving the nature of healthcare delivery in the country by promoting safe and quality care at all times. Health professionals, especially, professional nurses, have the greatest responsibility in promoting and advocating for health care reforms to help the country eliminate disparities in health care and health outcome. Many disparities in health are related to discrimination demonstrated by health professionals on their lines of duty. Theunissen (2011) conducted an investigation to determine the role of nurse professionals in improving health disparities focusing on the indigenous Maori community of New Zealand. The investigation revealed that indigenous communities worldwide experience significant health disparities in their respective countries. The main cause of disparities in health among the community was discrimination that introduced bias in the delivery of care. According to Theunissen (2011, p. 283-285), nurses have the duty to promote quality care through advocating for equal rights of all citizens irrespective of their culture and ethnic backgrounds. Nurses should always intervene whenever they see other health providers discriminating some communities to promote a culturally appropriate care.
Diversity in the workplace influences the mode of delivery of care that ends up affecting patient outcome. Philip and Malone (2014) conducted an investigation to determine the role of increasing racial/ethnic diversity in the profession of nursing to reduce health disparities. One of the major populations affected by health disparities in the U.S. are the racial/ethnic minorities. Promoting diversity in the nursing workforce helps reduce disparities in healthcare by ensuring a culturally competent working environment. Philip and Malone (2014) revealed an increase in the number of racial/ethnic minority populations by the year 2060 based on the changing demographic trends. The rise in population will require more effective strategies to ensure these people get access to quality and safe care to safeguard their health and wellbeing. Nurses will have increased responsibilities during this time to ensure the big population gets proper care. Diversity efforts among nurses workforce today has a significant impact on reducing health disparities and assure the vulnerable population of ending disparities in the future.
On the other hand, professional nurses continue to seek methods of eliminating disparities through research and practice. The application of online databases such as research papers published within the last decade provide professional nurses with adequate skills and knowledge on how to overcome health disparities in their respective health care organizations. One of the groups affected by disparities in health is the youth, especially those convisticated of one or more forms of crimes. The youth represents the segment of the future population in the nation and health care providers should focus on ensuring this population lives a healthy lifestyle. The increasing rate of mental health disparities among the youth calls for quick interventions of psychiatric nurses. Psychiatric nurses should introduce programs aimed at providing alternatives to incarcerations for youths in juvenile mental health courts as an intervention towards eliminating mental health disparities.
According to Burris, Breland-Noblem, Webster, and Soto (2011, pp. 117-119), the nation should give psychiatric nurse adequate training on the use of psychotropic with youths in forensic setting to allow them offer medical health to youths found guilty of crimes. Mental health court systems play a critical role in preventing mental health disparities through creating a juvenile justice environment.
The vulnerable populations experience the greatest suffering when it comes to access of quality, safe, and affordable care in the U.S. Nurse professionals at all levels have a duty to ensure universal access to primary health care for the vulnerable populations. Professionals working in the nursing and midwifery workforce experience many patients from different cultural, racial, and socioeconomic backgrounds. Dawson, Nkowane, and Whelan (2015) conducted a systematic review that showed that the lack of adequate nurses and midwives to cater for the high number of people in need of medical attention in different communities leads to disparities in health.
The group recommended health organizations to introduce approaches that help manage staffing supply and distribution in all marginalized areas of the country. Additionally, they recommended continuous supervision, elimination of huge workloads, establishment of a performance contracts, and improved remuneration on nurses and midwives. The implementation of these recommendations helps expand the role of nurses and prepare them to practice without discrimination. Additionally, it allow people to access health care from different locations; hence, eliminating health disparities (Dawson, Nkowane, and Whelan, 2015, pp. 18-23).
In the effort to ensure universal access to primary health care and eliminate disparities in health among vulnerable populations, the American Hospital Association (AHA) renewed its commitment to eliminating health disparities through the #123for Equity Pledge to Act Campaign. The program has more than 700 hospitals participating in March 2016 with the aim of increasing cultural competency training. Additionally, it stratifies one or more quality measures based on income, race, ethnicity, and other social determinants of health that influence the patient outcome. The program helps nurses end health disparities by empowering them with skills and knowledge through advancing their education to other specialties such as executive leadership, case management, and infection control (Timothy, 2016).
Finally, nurse professionals address the issue of health disparity by studying specific populations affected by the issue. Nurse advocacy helps end health disparities among African Americans because they are among the minority groups suffering from health inequality and poor access to health care services. Harrison and Falco (2015) conducted a study to investigate health disparity and nurse advocate where they reviewed current studies on the delivery of care to African Americans. Numerous studies investigated revealed powerful evidence that the U.S. health sector suffers from racism even after controlling other causes of disparities such as access to health insurance, socioeconomic status, and type of healthcare delivery. The article called upon nurses to advocate for equity in delivery of care and avoid racial bias in health care delivery as a solution to health disparities in the country. A nurse professional should identify vulnerable patients and assist them acquire good care and advocate for the same in the rest of the workforce (Harrison and Falco, 2015, pp. 262-263).
Conclusion
Many countries globally experience the weight of health disparities among both indigenous and non-indigenous people. Many factors contribute to the existence of health disparities in different health sectors but the most common are racial/ethnic, poverty, and access to health care. The discussion shows that everybody has a role to play in reducing and eliminating healthcare disparities. The Healthy People organization helps in reducing health disparities by introducing objectives and interventions for meeting their goals to ensure every individual accesses good health care. Numerous approaches towards increasing the contribution of nurse professionals in preventing health disparities have worked over years. Moreover, nurse professionals’ help in ending health disparities through research and practice by introducing evidence-based approaches that will assist the health sector achieve health equity and justice today and in the future.
References
Burris, F. A., Breland-Noble, A. M., Webster, J. L., and Soto, J. A. (2011). Juvenile Mental
Health Courts for Adjudicated Youth: Role Implications for Child and Adolescent Psychiatric Mental Health Nurses. Journal of Child and Adolescent Psychiatric Nursing, 24(2011), 114-121.
Center for Disease Prevention and Control. (2011, Jan 14). CDC Health Disparities and
Inequalities Report, United States. Morbidity and Mortality Weekly Report, Vol. 60. 1-114.
Dawson, A. J., Nkowane, A. M., and Whelan, A. (2015). Approaches to improving the
Contribution of the nursing and midwifery workforce to increasing universal access to primary health care for vulnerable populations: A systematic review. Human Resources for Health, 13(97), 1-23.
Harrisson, E., and Falco, S. M. (2005). Health disparity and the nurse advocate: Reaching out to
alleviate suffering. Advances in Nursing Science, 28(3), 252-264.
HealthyPeople.gov. (2016). Disparities. Office of the Disease Prevention and Promotion.
Retrieved July 1, 2016 from https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities
Olszewski, K., Parks, C., and Chikotas, N. E. (2007). Occupational safety and health objectives
of Healthy People 2010; A Systematic Approach for occupational health nurses-Part II. Continuing Education, 55(3), 115-125.
Phillips, J. M. and Malone, B. (2014). Increasing Racial/Ethnic Diversity in Nursing to Reduce
Health Disparities and Achieve Health Equity. Nursing in 3D: Diversity, Disparities, and Social Determinants, 2(129), 45-50.
Timothy, H. (2016, March 8). Ending disparities: What can nurses do? The Sentinel Watch.
Available at: http://www.americansentinel.edu/blog/2016/03/08/ending-health-disparities-what-can-nurses-do/
Theunissen, K. E. (2011). The nurse’s role in improving health disparities experienced by the
indigenous Maori of New Zealand. Contemporary Nurse, 39(2), 281-286.
