Discovering A Problem Exists

Health disparities are a big problem in the United States. Unnecessary differences in healthcare quality, access and other crucial factors does not only affect those directly facing disparities (Orgera & Artiga, 2018). Health disparities lower the overall quality of care and population health for all individuals in the United States, as well as resulting in unnecessary costs (Orgera & Artiga, 2018). Certain individuals do not deserve to suffer poor health due to their socioeconomic status or race/ethnicity. Population health affects everyone, and the sooner the masses realize this, the sooner positive change can be made. The United States’ population is becoming increasingly diverse (Orgera & Artiga, 2018). As the nation diversifies, an increase in health disparities will follow. It is important for everyone to acknowledge disparities exist and take steps to lessen the burden, and eventually reverse them. In order to do so, it is critical that national leadership engage the population and coordinate government entities to make change (Center for Disease Control and Prevention, 2018). Interventions at state and local levels are found to be the most effective way to make change (Center for Disease Control and Prevention, 2018).

Health is closely related to education level (Center for Disease Control and Prevention, 2018). Less education puts an individual at a higher risk for chronic disease and injury, as well as negative health outcomes. There is irony in that good health contributes to academic success, which is needed to obtain higher education (Center for Disease Control and Prevention, 2018). One glaring disparity that could be eliminated or lessened dramatically is education, which would increase positive health outcomes. However, society would have to recognize and accept that education contributes to health disparities. In addition, the concept that there are health disparities would also need to be widely accepted. America is not immune to health disparities, and there are plenty of them present in the nation today.

Focusing on Communities

“The Centers for Disease Control and Prevention’s (CDC) recent interim report on Healthy People 2010 worried that among the 195 disparities objectives there has only been measurable improvements in 24 categories, declines in 14, and no change in 157” (Center for Disease Control and Prevention, 2007).

Concerns

“Many initiatives do not embody the kind of community voice, support, and participation that is necessary for sustainable long-term results.”

“Many initiatives are divorced from other significant community-development strategies that have the potential to influence the known determinants of health disparities.”

• Housing
• Safety
• Education

“Initiative not built on a platform of governance, management, and adequate stable financing that assures a continuity of response from prevention, to early detection, treatment, and evaluation”

Disparity reduction includes clinical services

Disparities funded by academic medical centers, health systems, or organizations

Many health disparity programs address cardiovascular disease, asthma, diabetes, and different types of cancers

Addressing the socio-economic fundamental of health disparities in communities

• “Designed to enhance the strengths and assets that already exists in communities”
• Place-based approaches to health disparities
• Social capital and health
  • “Evidence between social trust and health outcomes is striking and suggests that these are complementary frontiers worthy of exploration for addressing health issues along with raising income or educational attainment”
  • “Many community factors contribute to differential health outcomes by race and ethnicity, over and above individual characteristics” (Bigby, 2007)
  • “Sources of community influences are numerous and complex, including risks created by the built environment such as lead in housing, access to healthy foods, lack of community resources such as parks and green spaces that promote activity etc.”
• Community building approaches
• Emphasize the development of community capacity and community connections in order to produce better health outcomes such as safe housing conditions and health status
• LISC (Local initiatives Support Corporation)
• Uplift distressed communities
• “Providing capital, technical, expertise, training, and information”
• National health disparities agenda
• “Reality is that many public health interventions are not coupled with community building strategies” (Kieffer and Reischman, 2004)
• Reach 2010
• CDC created a program addressing health disparities in six areas: immunizations, cardiovascular disease, breast and cervical cancer screenings, diabetes, and infant mortality.
• The six target populations were African Americans, American Indians, Alaskan Natives, Asian Americans Hispanics, and Pacific Islanders
  • I.e., “Bronx Health Reach, involved 40 community-based organizations with a heavy emphasis on faith-based approaches to reducing rates of diabetes and related cardiovascular morbidity and mortality”

Uncovering the Cause Of The Problem

Although many researchers have tackled the problem of health disparities, no definite consensus has been reached as to the cause of this phenomenon. As previously stated, health disparities can be caused from an array of issues such as socioeconomic status, lack of health insurance, unequal access to healthcare facilities, unemployment, and lack of education.

• “Disparities result from a complex interplay of factors at the individual, interpersonal community, and macro levels” (Jones, Crump, and Lloyd 2012)
• “The National Institutes of Health proposed a definition of health disparities research as identifying, understanding, preventing, diagnosing, and treating health conditions” (National Institute of Health, 2009).

Progression towards uncovering the source of the problem begins with more research initiatives. The elimination of health disparities in the United States depends on quality “research focused solutions” in order to understand prevention and the necessity of medical services.

• “Further development of monitoring systems will allow for community and official responses targeted to the needs of specific at-risk subgroups at local and regional levels” (Jones, Crump, Lloyd, 2012)

In addition, many individuals are unaware of health disparities within their own communities. The National Institute of Health has created and implemented plans to reduce health disparities in minority communities and elsewhere.

• Some goals include, “developing research capacity at minority serving institutions and providing outreach through dissemination of public health information to minority populations” (NIH Disparities Strategic Plan and Budget, 2004-2008)