Nurses often play a very critical role in the implementation of healthcare policies; this is because nurses are well conscious and have a better understanding of healthcare systems and delivery mechanisms. Healthcare policy process becomes more efficient and also effective when all relevant stakeholders are involved in its formulation and implementation. The current U.S healthcare system is undergoing a lot of reforms in trying to conform to the new laws, regulations and policies put in place by various government agencies. The goals of these reforms are reducing healthcare costs, enhancing accessibility and improving the quality of care (Benton, 2012). Moreover, the changes in United States health system are expected to address the perennial health disparities among different racial communities especially the minority groups.
Disparities in health and healthcare are two serious longstanding challenges facing the United States healthcare system; it affects the quality of healthcare and quality of life in general for the affected populations. It’s something that its existence has been documented for many years in the United States, and although considerable improvements have been made concerning population health over the last few years, some disparities have continued to exist, and some have even amplified. Health inequality and health care disparities are two interrelated terms that differ significantly. Health inequality describes a situation where the burden of illness, injuries or mortalities affecting a particular population is higher in relative comparison with another different group within the same country or within unchanged geographical boundaries (Kaiser Family Foundation, 2012). The disparity is said to be present if a group of people or population records a higher rate of suffering, from some diseases and deaths than others. On the other hand, healthcare disparity refers differences that exist regarding access to care, health coverage and the quality of care provided by various groups. Other terms that can be used in place of health disparity are health inequity and health inequality; it simply means the existence of health discrepancies that are determined in a social context, are considered to be uncalled for, unjust and is avoidable.
The two, i.e. health and healthcare disparities are more often than not viewed as something to do with race and ethnic background from which the individuals affected come from. However, variations typically exist in many dimensions transversely besides race and ethnicity which are the major. Disparities also occur based on gender, age, sexual orientation, the location of the group, disability conditions as well the socioeconomic status of populations (Office of Disease Prevention and Health Promotion, 2016). Health and health care disparities is an important aspect of healthcare that needs to be addressed with the seriousness it deserves because it impacts negatively by limiting progress in health and quality of care for the population affected, this leads to unnecessary costs being incurred for community health.
Having realized the adverse impacts of lifelong disparities on Americans, the United States government, through the Department of Health and Human Services came up with a plan in 2010 to reduce and eliminate cases of ethnic and racial health inequalities by 2020 (Kaiser Family Foundation, 2012). The plan envisions the United States to be a nation free of any form of health and healthcare disparities, and it has some key priorities, approaches, measures to be taken and objectives they will use to accomplish their vision. Also involved in these efforts of lessening cases of health disparities are States, various private organizations as well as communities. However, despite the efforts being made by the Federal and States governments to reduce health disparities, many groups of people in the United States are still at a different risk of lacking access to quality care, getting poor clinical outcomes and being uninsured. These disparities, in particular on the possibility of being uninsured, generally affects individuals with low incomes and minority groups, also known as people of color than the Whites. The minority groups which are at a higher risk of lacking a health insurance cover relative to the Whites include Latinos, African-Americans, Hispanics and Alaska Natives/American Indians. Studies carried out by different healthcare agencies in the United States also shows that the minority as mentioned above groups have higher incidences of some chronic diseases such as cancer, diabetes, and asthma, have poor health outcomes and also elevated mortality rates in comparison to the White population.
Health Resources and Services Administration statistically presents the disparities in various diseases among the minority groups and the Whites, according to this administration, African Africans cancer incident rates are 10% more compared to the Whites (Mandal, 2016). Similarly, it is estimated that Latinos and African Americans are likely to suffer from diabetes at a rate which is two times more than that of the White population. Moreover, it is estimated that approximately more than 2 million Hispanics/Latinos are suffering from asthma; Puerto Rican Americans is considered to be the most affected by asthma accounting to more than three times that of the entire Hispanic population (Mandal, 2016). Furthermore, in comparison with the White population, African Americans have asthma rates which are 28% higher than that of the Whites. Women of Hispanic, Asian and African-American race are also affected disproportionally by systemic lupus erythematosus (SLE), which is approximately more than three times than White females (Mandal, 2016).
In addition, there exists a health disparity in the rates of infectious diseases across different ethnic and racial groups in the United States. For example, cases of Hepatitis C are more widespread amongst African Americans than other population groups; they represent more than 22% of all Hepatitis C cases reported in the United States. This is a very high percentage because African Americans only represent 13% of the total United States population (Centers for Disease Control and Prevention, 2013). On STDs, Africans Americans accounted for approximately 70% and 50% of gonorrhea and syphilis respectively. Such incidences of health disparities between the two racial populations are mainly attributed to healthcare disparities such as lack of access to healthcare. Also aspects such as individual and behavioral factors, exposure to some environmental problems, the level of education and poverty contribute to these health disparities (Agency for Healthcare Research and Quality, 2014).
The severe health disparity or problem that affects United States minority populations is the possibility of being uninsured. This difference mainly affects people of color and those with low-income levels. African Americans, Alaska Natives, and Hispanics are the ones mostly affected by this disparity. According to the Kaiser Family Foundation (2012), the U.S population is highly heterogeneous and is projected that by 2050, minority groups will make up more than half of the U.S total population. It is also anticipated that the gap between those with high incomes and the poor will increase. The foundation also states that people of color are more likely to be uninsured in comparison to the Whites, the evidence showing this disparity is the numbers. It is estimated that for every three Hispanics and Alaska Natives/American Indians, more than one are not under any health insurance cover or plan (Centers for Disease Control and Prevention, 2013). These numbers in comparison with those of the Whites, is approximately triple, this, therefore, it means that more people of color are not insured relative to those of the White. Similarly, Asians and African Americans are more prone to not having a health insurance than the Whites; studies show that at least one in every five African Americans and Asians do not have an insurance cover.
Lack of health insurance is even more severe among individuals of Hispanic race and ethnic groups; the likelihood of coverage interruption is higher among Hispanics than the Whites. It’s estimated that 50% of Hispanics in U.S are at some point in a year uninsured. This percentage is high than that of the Whites Americans who have less than 20% of their population uninsured in a particular year (Centers for Disease Control and Prevention, 2013). The high rate of the uninsured among the people of color is attributed to some factors affecting minority groups disproportionately. They include the cost of insurance; since many are in the low-income category, they cannot afford to pay monthly on annual insurance premiums. Lack of knowledge on various existing public programs as well as their respective eligibility criterion also increases the number of those who are uninsured.
The impact of lack of health insurance cover on the people of color prevents them from accessing quality healthcare. This therefore generally impacts on their quality of life, additionally; the disparity is costly to the government. This is regarding direct costs incurred by the government in providing medical care to people of color for illnesses that would have been prevented if health disparities were not there, a lot of work hours is lost when the employed people fall sick. The American Nurses Association (ANA) considers healthcare to be a fundamental human right, their position, therefore, is that all Americans are entitled to quality healthcare and should access it notwithstanding their race or ethnic background (American Nurses Association, 2010).ANA support provision of healthcare to all Americans as a way of reducing health and health care disparities.
Conclusively, I believe that it is important to advocate for the people of color and other minority groups so that the health disparities they are facing especially on health insurance cover are reduced or eliminated. Besides this being important from social justice point of view, it also improves their quality of healthcare hence contributing to quality life among the minorities.
References
Agency for Healthcare Research and Quality. (2014). Disparities in Healthcare Quality Among Racial and Ethnic Minority Groups | AHRQ Archive. Retrieved from http://archive.ahrq.gov/research/findings/nhqrdr/nhqrdr10/minority.html
American Nurses Association. (2010). Nursing Beyond Borders: Access to Health Care for Documented and Undocumented Immigrants Living in the US. Retrieved from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/Issue-Briefs/Access-to-care-for-immigrants.pdf
Benton, D. (2012). Advocating Globally to Shape Policy and Strengthen Nursing Influence. Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No1-Jan-2012/Advocating-Globally-to-Shape-Policy.html
Centers for Disease Control and Prevention. (2013). CDC Health Disparities and Inequalities Report — United States, 2013. Retrieved from http://www.cdc.gov/mmwr/pdf/other/su6203.pdf
Kaiser Family Foundation. (2012). 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/
Mandal, A. (2016). What are Health Disparities? Retrieved from http://www.news-medical.net/health/What-are-Health-Disparities.aspx
Office of Disease Prevention and Health Promotion. (2016). Disparities | Healthy People 2020. Retrieved from https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities
