Health Disparities: Reducing the Impact of Societal Inequities on Patient Care

 

Systemic inequalities in the United States have a lengthy and well-documented history. Employment, education, housing, and health are all sectors where inequities exist. A health disparity, according to Healthy People 2020, is "a specific type of health difference that is closely linked to social, economic, and/or environmental disadvantage; health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, segregation, and/or environmental disadvantage."

Women and people of colour have been found to have less accurate diagnoses, fewer treatment options, and poorer pain management, as well as poorer clinical results. In comparison to non-Hispanic Caucasian women, pregnancy-related death rates are 3-4 times greater for non-Hispanic Black women. Native Americans and Alaskan Natives have a 60 percent higher infant death rate than their white counterparts, according to a study published in 2014. Unintended pregnancy is more common among Black and Hispanic women than among Caucasian women, and it has been associated to a variety of negative perinatal outcomes. Disparities in healthcare access, use of health care, and greater incidence rates of some chronic diseases have been found among military veterans even outside of the civilian healthcare system. Access to mental health treatment and a lack of health insurance are linked to considerable discrepancies in mental healthcare among ethnic minorities, just like they are with healthcare in general.

Given the foregoing, health care practitioners must ensure that they are not only raising awareness of societal injustices, but also recognising the influence they can have on treatment delivery, patient self-management, and provider-patient collaborative treatment planning. The tactics described below are not intended to be a comprehensive solution to a systemic problem; rather, they are intended to be some suggested starting steps in opening up discourse, How to Implement Patient-Centered Care  encouraging systemic assessments, and emphasising the significance of continual monitoring and process improvement.

Self-evaluation is the process of determining one's own strengths and weaknesses.

Be aware of our own unconscious biases toward people who are not like us. Continued staff development training, subject matter expert consultation, anti-racist education, case consultations, and peer evaluations should all be used to promote cultural competency as a standard.

Interrogate:

Instead of presuming that certain habits, attitudes, or behaviours are shared by all members of a racial or ethnic group, don't be afraid to gently inquire of your patients and peers.

Treatment Planning in Partnership:

It's important to remember that treatment planning is a joint effort between the patient and the treatment team. Allow the patient to speak up and listen carefully to their concerns.

Medication Adherence Issues: What Are the Obstacles?

On a regular basis, evaluate your patients' drug adherence. Dissect noncompliance and the variables that may be influencing it, such as historical or cultural mistrust and/or treatment hurdles.

Dynamic Family/Relationships:

Allow patients to speak confidentially about their worries without their spouse or family member there. Only with the patient's approval, discuss the treatment plan with partners. Encourage parents to allow a split appointment for their teen minors, in which the teenager can be seen alone before the parent/guardian returns at the conclusion.

Barriers to Communication

Allow for the employment of experienced translators and book them ahead of time. Don't assume that just because a patient brought a friend or family member to their appointment, that they want their health information shared with them. To reduce self-consciousness about inadequate English skills, normalise translation use and make it obvious that using one is not an inconvenience.

Barriers to Funding:

Consider any associated expenditures that may obstruct follow-up or drug adherence when laying out treatment recommendations. Assist the patient in getting access to medicine discount programmes if at all possible. Don't make the mistake of assuming that all patients have health insurance.

Obstacles to Transportation

Discuss with patients their capacity to attend follow-up appointments or any medical consult referrals that are recommended. When possible, talk about scheduling many sessions on the same day to save money on driving, tolls, and the patient's reliance on others.

Surveys of Patients

Use a patient survey to get feedback on the services you provide. Keep an eye out for patterns and places that are regularly lacking. To resolve complaints/areas of concern, create a corrective action plan.

Employee Development:

Staff should be trained on cultural competency on a regular basis, as well as how diverse demographic issues affect patient care. Ensure that cultural competency expectations are incorporated into routine processes and procedures by your employees.

Author:

Dr. Sheffield is a Licensed Clinical Psychologist with a wide range of clinical, therapy, and programme management expertise with adults and youth from a variety of socioeconomic and cultural backgrounds. She has worked with non-profits, schools, hospitals, and clinics both locally and overseas as a consultant. Dr. Sheffield has written over a hundred pieces for the general public on parenting and self-help. She is a member of the Science Cheerleaders, a nationwide non-profit 501(c)3 organisation comprising of current and former NFL/NBA professional cheerleaders with STEM degrees who engage, support, and empower youngsters and young women to pursue professions in science, technology, engineering, and math.