Healthcare in the United States has its own characteristics that every healthcare manager should take into consideration. The main problem in health care is the existence of health disparities. Coined by the National Institutes of Health in 1999, it means “differences in the incidence, prevalence, mortality and burden of diseases and other adverse health conditions that exist among specific population groups” (Shanks, 2016, p. 489). Health disparities can be addressed to some extent through the development of appropriate policies and health standards.
Implemented Decisions to Reduce Health Disparities
One of the most effective ways to solve health disparities was to create service standards in healthcare and form special organizations concerned with these problems. Initially, the state and healthcare system did not consider the problem of health disparities extensively until the 1980s and 1990s (Shanks, 2016). The first decisive step was the establishment of the Office of Minority Health (OMH) in 1986, which concentrated on public health programs designed for minority groups (Shanks, 2016). OMH collaborates with private and public sectors to find solutions, provide fundings to organizations dedicated to promoting health equity and cultural proficiency.
Fundamental change happened in 2000 when the National Standards on Culturally and Linguistically Appropriate Services were settled. These standards presented the set of practical recommendations for health care services to counter health disparities. For example, medical care services need to recruit a more culturally and linguistically diverse workforce, offer language assistance to non-native English speakers, collect demographic data (Shanks, 2016).
Another method to reduce health disparities in healthcare was the change of universities’ curriculums in order to add classroom hours for talks about minorities’ treatment in healthcare. As Bonvicini (2017) reports, policy documents by the American Association of Medical Colleges slightly changed the situation with content on LGBT healthcare disparities in US medical schools through the increase of hours devoted to it. Besides, medical staff can also be trained, with 86% of hospitals providing special cultural proficiency trainings (Shanks, 2016). These measures helped create a more minority-friendly atmosphere in medical service that allows receiving proper healthcare to all groups.
Recommendations for change
Actions that were already made are not enough for full-fledged equal healthcare. However, different scholars propose different actions based on what they consider the main driver for health disparities. Shanks (2016) focuses on internal issues of healthcare service related mostly to the level of diversity and education of staff and data collection on health problems in different local communities. Hospitals and clinics need to have a diverse and multilingual workforce that knows the main health problems in the region through data collected.
Some authors discuss some other issues which lead to health disparities. Churchwell et al. (2020) indicate the influence of structural realism on the existing state of affairs. This group of scholars found that “reducing health disparities will require restructuring systems to improve conditions that affect health in workplaces, neighborhoods, and schools” (Churchwell, 2020, p. 461).
Therefore, the state should implement some interventions for promoting employment opportunities for marginalized groups, eliminate residential segregation and break the discrimination in the education system. Such structural changes should help change the situation with health disparities by creating a more favorable living environment for minorities, free from racism and discrimination. In addition, an interesting problem was noted by Summers-Gabr (2020), which is the inaccessibility of broadband connections in rural areas. Because of this, these populations cannot access the increasingly popular telemedicine, which also leads to health disparities. Equipping rural areas with Internet infrastructure can help with some of the challenges of inequality to medical access.
Case Study – Health Disparities Across the United States
The reasons for health disparities are often difficult to discern. Although there are some basic reasons why inequality and inequity happen, every specific case demands a more detailed focus. If a region with a disproportional number of diseases exists, the state officials should react by issuing health policies to counter the problem. For example, if the distance between the community and the nearest health center is high, the officials need to send a mobile clinic and appropriate staff members to help groups in danger. If people in the region suffer from obesity and diabetes, the media should encourage people to lead a healthy lifestyle. The main logic is conducting a thorough investigation of the problems.
If I were a health educator, I would need to inform the community about health problems that prevail in the region. For that, the usage of available datasets is needed. American Hospital Association reports that most hospitals collect patients’ demographic data on race, ethnicity, and primary language (Shanks, 2016). Health educators should rely on these sources for creating some policy. Nevertheless, the main source of information is the datasets of most spread diseases in the region. With the help of that data, health educators could form a clear picture of what disease their Department should focus on. Concerning the case presented in the book by Shanks, the main focus is on finding funding to create affordable health care for women. The situation will radically change only when hospitals appear in the region that can help women with such diseases.
Health disparities are a critical problem for American society. Healthcare managers should elaborate detailed standards for healthcare that will help marginalized groups to get proper healthcare. Although state officials and non-governmental organizations have already achieved progress, future changes are needed. The suggested changes were the hiring of more diversified and trained staff and the elimination of structural racism. The case study showed the importance of work with databases and statistics to understand the problems of communities.
Bonvicini, K. A. (2017). LGBT healthcare disparities: What progress have we made?. Patient Education and Counseling, 100(12), 2357-2361.
Churchwell, K., Elkind, M.S., Benjamin, R.M., Carson, A.P., Chang, E.K., Lawrence, W., Mills, A., Odom, T.M., Rodriguez, C.J., Rodriguez, F., Sanchez, E. (2020). Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association. Circulation, 142(24), e454-e468.
Shanks, N. H. (Ed.). (2016). Introduction to health care management. Jones & Bartlett Publishers.
Summers-Gabr, N. M. (2020). Rural–urban mental health disparities in the United States during COVID-19. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S222.