Disparities to Health in Healthy People 2020

Disparities to Health in Healthy People 2020

Introduction

As a population becomes increasingly diverse, the health care systems face new opportunities and challenges as they strive to deliver better care according to the needs of society. Health disparities refer to differences in health and health care between groups that are closely linked with social, economic, and environmental disadvantages. Inequalities are experienced in dimensions such as sexual orientation, race and ethnicity, socioeconomic status, age, gender, disability status, and geographical location (Akinboro et al., 2016).  According to Healthy people 2020, the disparity is defined as a health difference that is associated with social or environmental disadvantages. Such inequities tend to affect individuals who regularly experience extreme obstacles based on their race or gender. Over the years, racial and ethnic minorities have experienced redundancy upon reception of medical care, and this still exists as a challenge to them.

Tools to Identify Health Care Inequities

The Health Research and Educational Trust of America identifies various tools that will aid in identifying and provide amicable solutions to solve health inequality cases. The department seeks to address such issues to create a more diverse and peaceful coexistence between people across different genders, geographical backgrounds, social-cultural beliefs, and individuals with different sexual orientations. Firstly, the trust identified diversity assessment tool (DAT) used by hospital and health care leaders as a foundation to evaluate the diversity and cultural proficiency of their organizations. The device also seeks to identify what practices and activities are put in place or require to be implemented.

Diversity Assessment Tool possesses a challenge to health care organizations to provide equitable care equally to all people. The tool helps these firms to create a diverse workforce that will provide culturally proficient care. Diversifying the health care workforce helps instill technical know-how to these caregivers that embrace cultures of all types and is aware of all customs and how they affect patients’ views on health care. It promotes sensitivity in health care service delivery. Strategies are developed, for instance, to advance the careers of women and ethnically diverse individuals in health care management. This factor encourages American health care organizations to emulate the same methodology.

Diversity Assessment tool identifies four vital actions that, if put in place, may help achieve a disparity free setting. Organizations should create an assessment checklist that evaluates the diversity of a firm and identifies practices to be implemented. Secondly, action steps need to be developed to provide a to-do list of ways of creating awareness within an organization. Additionally, case studies on successful cultural proficiency programs may be reviewed to increase the knowledge base (Weech-Maldonado et al., 2012). Existence of bibliography to help an organization learn more about diversity and cultural proficiency.

Besides the diversity assessment tool, the American Hospital Association (AHA), prescribes the Cultural Competent Self-Assessment tool as an alternative measure to list out disparity issues. According to Weech-Maldonado et al. (2012), the self-audit tool helps to evaluate where an organization sits within a spectrum of cultural competence.

Alternatively, data collection is a measure that is used to gather information regarding race, ethnicity, and language (REAL) data concerning the inequity that exists in the administration of health care to the minority groups. The more accurate the data is, the higher the ability to earnestly assess and respond to disparity cases. Organizations should prioritize the collection of real data, align the right patient tools to collect self-identified REAL data. Training of organization staff should be considered to help them contemplate the essence of reducing health disparities. Data analysis is carried out on the already collected data systematically and thoroughly to benefit the health care providers with efficient results. Useful data analysis provides insights into factors that contribute to health inequities; therefore, highlighting solutions on how to respond to them appropriately.  According to Fiscella & Sanders (2016), analysis is efficiently carried out through stratification of available health and drug plan data by race, ethnicity, and language and collaborating with providers to analyze and address health disparities. It also involves enhancing dashboards and reports with REAL data and sharing the data on identified health inequalities with leaders, health providers, and partners to arrive at better solutions.

Organizations can adopt a culture of equality tool. Leaders and staff can improve their capacity to address disparities by establishing a strong organizational commitment to equity. This can be achieved through elevating health equity into the mission statement, designating leaders and providers to champion health disparities, empowering employees with resources to implement focused interventions, and providing training in cultural competence to all employees, providers, and staff.

According to the Institute of Medicine’s (IOM) report of 2002, health disparities are evident because high-quality care has not been delivered equally to all members and patients. The report stated that variations in quality and poor outcomes associated with health disparities were a result of low-value health care.

A Screening Tool to address Barriers to Health Care

According to recent research carried out by pediatric students from the University of Pennsylvania to identify screening tools that point out social determinants of health in pediatric care, there exist fewer devices on the same as compared to other health departments, for instance, the prenatal care. The American Centers for Medicare and Medicaid Services (CMS) and Accountable Health Communities (AHC) models were developed to test whether addressing such system barriers through universal health-related social needs (HRSN) screening and enhanced clinical-community linkages can improve health outcomes and impact costs (Billioux, Verlander, Anthony, & Alley, 2017). Evidence provided by various researches indicates that non-medical health-related social needs such as food insecurity, housing instability, and exposure to interpersonal violence impacts health care utilization and health services outcomes. The American Hospital Association, in collaboration with the National Health Research Institute, identified the AHC HRSN screening tool as a measure to identify and address various health barriers.

The Accountable Health Communities HRSN screening tool was developed to identify unmet needs in the health sector across five main domains. The scheme is designed to be short, accessible, coherent, reliable, and consistent. The tool is meant to be answered by individual respondents, parents to the patients, or the caregiver on behalf of the target individuals. It includes questions that aid in identifying the beneficiaries eligible for the model, standard demographic queries for evaluation purposes, and screening questions for supplemental domains available.

According to this tool, the housing instability domain reflects on the unmet housing needs that include, poor housing quality, inability to pay rents, and homelessness. Poor housing limits individuals to access efficient medical care. Therefore, resulting in careless and unhealthy living (Page-Reeves et al., 2016). Food insecurity, as described by the United States Department of Agriculture, refers to the inability of people to access enough food for an active, healthy life. The AHC HRSN screening tool identifies chances of food insecurity among various communities that help develop alternatives to counter such a challenge. The societies reviewed include the low income earning families with young children. The American Academy of Pediatrics recommends that pediatricians screen children for food security. This helps develop mechanisms that are compatible with malnutrition challenges, thereby obscuring such difficulty before getting worse.

Transportation needs, on the other hand, refer to the inability to access transport services that necessitate the acquiring of medical services; in areas where there exist poor roads, medical facilities tend to be unreachable. Therefore, residents of such regions are posed with more enormous health challenges; hence the mortality rate is low. The AHC screening tool includes queries that identify unmet transportation needs among communities dwelling on Medicare and Medicaid beneficiaries.

Administering and Implementation Plan for this Tool

Implementation of this tool entirely depends on the affected individuals, their respective families, and the health care providers. The centers for Medicare and Medicaid Services provides for a focus of five main health care limit domains based on the criteria of; existing high-quality evidence linking the HRSN to poor health. The increased healthcare cost, whether healthcare providers can meet the need or whether the health caregivers do not systematically address the need.

While administering the tool, there is the essence of identifying the broadest set of HRSNs that can be freely noted and realized by the community health caregivers. This helps to broadly list out the issues that are affecting the delivery of health care at great extents; therefore, enabling arriving at amicable decisions. Careful observations also aid in identifying any unmet needs, especially in areas that receive a low rate of health services. Such a plan requires highly qualified individuals who are familiar with specific geographical regions.

Alternatively, the clinical delivery services are essential in assisting in covering vast needs in a shorter period. Such services provide efficiency in dealing with individualized needs. Such an exercise engages navigators and community health providers who are bitterly suited to such services. For instance, when caregivers identify an example of food insecurity, ultimately, the drivers of the said problem come along, and appropriate solutions are put in place. For a successful implementation, the simplicity of the AHC HRSN tool is a driving factor in ensuring that the target group comprehends it in the right manner. It also provides routine screening in busy clinic workflows. The strategy initially is meant to cover as many areas as possible to ensure equality in health care administration.

The role of each of the stakeholders in the implementation of this screening tool is vital for its overall success. The individuals, for instance, are required to portray the utmost honesty during the practice. This helps create a sincere working group where the issues addressed are attainable, and the involved organizations can meet them. The caregivers, on the other hand, should have the necessary skills that enable them to carry out the plan efficiently. They should be good observant as well as possess excellent communication skills that help them attain various information on the unmet needs in society.

Feasibility of AHC HRSN Screening Tool in a Clinical Setting

The AHC HRSN tool is essential in a clinical setting. This scheme helps in identifying unmet needs in a community that contributes mostly to disparities in health care. The device also helps come up with solutions that mitigate such inequities, therefore, ensuring equitable service delivery to all persons regardless of their sexual orientation, race/ethnic backgrounds, disability status, or geographical regions. The tool aids in creating a minority-free health society where all individuals can access medical services at any time. The model also assists in creating a race-free environment among the health care professionals that enables them to deliver services to all clients without favor or discrimination.

Expectations on the Tool

Cooperation from the involved stakeholders in the implementation of the plan will help in yielding the desired results. The fundamental goal of the tool is to point out all the unmet needs in a particular society or on various individuals. For instance, cases of food insecurity and housing problems. The scheme is also expected to provide possible solutions that will assist in countering the already identified needs (Purnell et al., 2016). The AHC HRSN screening tool aims to help lessen cases of disparity in the American setting.it also helps create a diverse working environment that is fair for every individual. The plan is expected to ensure that there is equality in the administration of health care services.

Conclusion

Health care is an essential basic need that must be availed to every individual at any time. Issues of health inequality have become predominant over the years among the American people. The American Health People 2020 has continuously addressed the issue of disparity over the years. With the help of various measures to identify such instances of inequities in health care, the government can conclude and act in favor of its citizens to ensure they receive the best medical care possible.  Disparities are based on race, ethnic backgrounds, sexual orientations, or geographical regions. Every state law aims to create a diverse atmosphere where individuals can access all services freely without fear of discrimination. Diversification also ensures that the available workforce offers services equitably to all individuals. This helps curb cases of racism and rebels that may indefinitely result in revolutions in a country. With the invention of various methods of identifying cases of disparity and the available solutions to these issues is efficiently improving the health sector. For instance, the Diversification Assessment tool has helped create awareness for the healthcare workforce on the importance of equality. It has created an understanding of different cultures, beliefs, and opinions. This has helped achieve unification in the health sector hence has helped reduce the mortality rate in different communities.

References

Akinboro, O., Ottenbacher, A., Martin, M., Harrison, R., James, T., Martin, E., … & Cardarelli, K. (2016). Racial and ethnic disparities in health and health care: an assessment and analysis of the awareness and perceptions of public health workers implementing a statewide community transformation grant in Texas. Journal of racial and ethnic health disparities, 3(1), 46-54.

Billioux, A., Verlander, K., Anthony, S., & Alley, D. (2017). Standardized screening for health-related social needs in clinical settings: The accountable health community screening tool. NAM Perspectives.

Fiscella, K., & Sanders, M. R. (2016). Racial and ethnic disparities in the quality of health care. Annual review of public health, 37, 375-394.

LaForge, K., Gold, R., Cottrell, E., Bunce, A. E., Proser, M., Holcombe, C., … & Clark, K. D. (2018). How six organizations developed tools and processes for social determinants of health screening in primary care: an overview. The Journal of ambulatory care management, 41(1), 2

Page-Reeves, J., Kaufman, W., Bleecker, M., Norris, J., McCalmont, K., Ianakieva, V., … & Kaufman, A. (2016). Addressing social determinants of health in a clinic setting: the WellRx pilot in Albuquerque, New Mexico. The Journal of the American Board of Family Medicine, 29(3), 414-418.

Purnell, T. S., Calhoun, E. A., Golden, S. H., Halladay, J. R., Krok-Schoen, J. L., Appelhans, B. M., & Cooper, L. A. (2016). Achieving health equity: closing the gaps in health care disparities, interventions, and research. Health Affairs, 35(8), 1410-1415.

Weech-Maldonado, R., Elliott, M. N., Pradhan, R., Schiller, C., Hall, A., & Hays, R. D. (2012). Can hospital cultural competency reduce disparities in patient experiences with care?. Medical care, 50, S48.