Health Care Disparities

Mya Brooksby, Savanna Bryson, Hayden Christensen, Tyler Daley, Halie Souza
Introduction
● Definition: “preventable circumstances relating to individuals’ health status
based on social factors” (USC EMHA Online, 2021).
● Measured by mortality, mental illness, burden of disease, and life expectancy.
● Racial and ethnic disparities are the most prevalent disparities
● Also determined by gender, sexual orientation, disability status, and economic
status (Baciu, et. al, 2017).
Why should nurses care?

● We are on the front lines of patient care

● We can help create solutions that will improve quality of care for patients
● Advance toward health equity
 Factors Contributing to Health Care Disparities
“Health disparities were defined as “differences in health outcomes and their determinants between segments of the population, as defined by
social, demographic, environmental, and geographic attributes””

● Social Determinants: poverty, education, housing, access to healthy food.

● Race and ethnicity: studies have shown that certain racial and ethnic groups, such as African Americans, Native Americans, and
Hispanic Americans, have higher rates of certain health conditions and also have less access to health care than non- Hispanic whites.
● Health literacy: individuals with lower levels of health literacy may have difficulty understand and navigating the healthcare system,
which can lead to poorer health outcomes.
● Access to care: limited access to health care, including lack of insurance and difficulty in finding providers who accept insurance, can be a
major barrier to receiving necessary medical help.
● Socioeconomic status: lower income and education levels are associated with higher rates of health disparities, and people with lower
socioeconomic status have less access to health care, less knowledge about health and fewer opportunities to maintain good health.
● Location: people living in rural areas may have limited access to health care services and providers.
● Language barriers: limited English proficiency can affect access to care and lead to misunderstandings between patients and care
providers.
● Bias and discrimination: some health care providers may hold biases and stereotypes that affect the quality of care they provide to
certain patients, leading to disparities in health outcomes.
Schillinger, D. (2020). The intersections between social determinants of health, health literacy, and health disparities. Studies in Health Technology and Informatics, 269, 22-41. https://doi.org/10.3233/SHTI200020
 Impact on Patient Access to Services/Quality Care:
Many people in see a physician at least once a year, often these visits result in receipt of a medication prescription
(Chisholm-Burns, et al., 2017).

● Many patients may choose not accept medication therapy due to the cost of the prescription.
● A study was conducted in a rural minority area in Tennessee and concluded that pharmacies located in
communities with low average income levels, low employment rates, and high scores for personal crime risk were
less likely to fill their prescriptions that were written to them (Chisholm-Burns, et al., 2017).

Similar to this population that was studied there are many other minority populations all over the United States. If
patients aren’t getting the adequate access they need for healthcare they may experience a higher mortality rate.

● As technology and new line of treatments are advancing in healthcare, it may not be accessible by every patient
who may need it.
● As a result, inadequate, inaccessible, and/or poor medical care further exacerbates increasing healthcare costs
that have broad implications for the overall quality of care experienced by all Americans (Riley, 2012).
Impact on Patient Outcomes:
● Overall, health care disparities will create negative patient outcomes.
● A recent study published by the Western Journal of Emergency Medicine examines the outcomes
among COVID-19 patients based off of racial and ethnic disparities. Here are the results:
● “After adjusting for demographic, clinical factors, time, and hospital site, Hispanic/Latinx patients
had a significantly lower adjusted rate of admission compared to White patients (odds ratio [OR]
0.51; 95% confidence interval [CI] 0.34-0.76). Black (OR 0.60; 95% CI 0.43-0.84) and Asian
patients (OR 0.47; 95% CI 0.25 - 0.89) were less likely to be admitted to the ICU. Conclusion:
Non-White patients accounted for a disproportionate share of COVID-19 patients seeking care
in the ED but were less likely to be admitted. Hospitals serving the highest proportion of
minority patients experienced the worst outcomes, even within an integrated health system
with shared resources” (Serrano, et. al, 2022)
● The study also suggested that limited capacity during the pandemic likely attributed to the
exacerbation of healthcare disparities.
Source: Ndugga, N., & Artiga, S. (2021, May 12). Disparities in health and health care: 5 key questions and answers. KFF. Retrieved January 23, 2023, from
https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-health-and-health-care-5-key-question-and-answers/
Source: Ndugga, N., & Artiga, S. (2021, May 12). Disparities in health and health care: 5 key questions and answers. KFF. Retrieved January 23, 2023,
from https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-health-and-health-care-5-key-question-and-answers/
Role of the Nurse to Decrease Health Care
Disparities
Nurses carry responsibility and play a large role in decreasing health care disparities. This includes at an
individual, organizational, and policy level (Oruche & Zapolski, 2020). Below are some ways nurses can
best make a difference in decreasing health care disparities

● Advocate for the patient (Bender, 2022).

● “Be aware of implicit bias or stereotypical assumptions about patients with different backgrounds”
(Oruche & Zapolski, 2020).
● Advocate for policy changes which encourage patient-centered care (Oruche & Zapolski, 2020).
● Teach incoming nursing students about a variety of different cultures and cultural expectations.
Impact on the Future:
Medical professionals advance health equity by working to improve access to care and reduce uninsured rates.

Possible solutions include:

● Health care providers can engage with policymakers

● Urging action to help communities impacted by these factors
○ For example, they can use health disparity data and evidence-based clinical knowledge to recommend
expanding health coverage to individuals with limited health care access. (2021)

Solutions for the future:

● Increase awareness of racial and ethnic disparities in health care among the general public.
● Strengthen patient-provider relationships in publicly funded health plans.
● Apply the same managed care protections to publicly funded HMO participants that apply to private HMO
participants.

Nurses play a large role in addressing the underlying causes of poor health. Nurses influence how well and long people live,
helping to create individual- and community-targeted solutions, and work with various other healthcare professionals to
implement solutions.

In order to impact the future - the quality of care that’s provided for health disparity populations and the health care system
must be coordinated to achieve better outcomes.
Summary:

In conclusion health care disparities are very prominent throughout the world and are
experienced in many different ways and caused by many different factors. One thing that
all health care disparities have in common is that they all cause a significant impact on the
well-being and health of individuals and communities. This leads to worse health outcomes
and shorter life expectancies for marginalized groups. The reasons behind this are very
complex and in order to achieve health equity and improve the overall health of the
population it is essential to address these disparities, and make positive changes.
 References:
- 6 examples of Health Disparities & Potential Solutions. USC EMHA Online. (2021, April 27). Retrieved January 23, 2023, from
https://healthadministrationdegree.usc.edu/blog/examples-of-health-disparities/
- Baciu, A., Negussie, Y., & Geller, A. (2017). The State of Health Disparities in the United States. NCBI Bookshelf. A Service of the National
Library of Medicine, National Institutes of Health.
- Bender, M. (2022, August 10). The role of nurses in addressing health disparities. UCI Nursing. Retrieved January 23, 2023, from
https://nursing.uci.edu/2022/08/nurses-addressing-health-disparities/#:~:text=One%20of%20the%20most%20powerful,or%20even
%20cultural%2Dcompetence%20training
- Chisholm-Burns, M. A., Spivey, C. A., Gatwood, J., Wiss, A., Hohmeier, K., & Erickson, S. R. (2017). Evaluation of racial and socioeconomic
disparities in medication pricing and pharmacy access and services. American Journal of Health-System Pharmacy, 74(10), 653–668.
https://doi.org/10.2146/ajhp150872
- Ndugga, N., & Artiga, S. (2021, May 12). Disparities in health and health care: 5 key questions and answers. KFF. Retrieved January 23,
2023, from
https://www.kff.org/racial-equity-and-health-policy/issue-brief/disparities-in-health-and-health-care-5-key-question-and-answers/
- Oruche, U. M., & Zapolski, T. C. B. (2020, December 1). The role of nurses in eliminating health disparities and achieving health equity.
Journal of psychosocial nursing and mental health services. Retrieved January 23, 2023, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827216/
- Riley, W. J. (2012). Health disparities: gaps in access, quality and affordability of medical care. Transactions of the American Clinical and
Climatological Association, 123, 167–174. *Permission from Dr. Lewis to use.