Racial Disparities in the Health Care SystemAriah Sentner
Antelope Valley College
This review is about the racial disparities people face in our health care system every day. It will be reviewed on what a racial disparity is and examples shown for better understanding. Also going over how these racial disparities happen in our system without going under supervision or getting fixed within our government. These disparities are also proven to cost us more than having equal healthcare we will review them. Research will show us ways that we will be able to battle these racial disparities in order to let have a more equal health care system in the future. So let us begin with a dive into the research that tells us more about racial disparities throughout our health care system.
What are Health Care Disparities in legal terms?Before analyzing data we first need to understand the topic at hand. Heath Care disparities have been around in our system for many years. We need to know what a racial disparity is in order to fully understand the research on the topic. Racial disparities is something that researchers do not fully have a specific definition for, instead the operalization that is used throughout many studies is a distinct difference in care and/or conviction between different people of different races. This is meaning that is a Caucasian is making the same amount of money as an African American but gets better healthcare, there in tells that there is a racial disparity. This is also the case if a Latino is receiving a lighter sentence in court for the same crime compared to an African American. Anyone can be affected with racial disparities but more often than not African Americans and Latinos deal with it the most. Health disparities may also be defined as the differences in health status of different groups of people. Some groups of people have higher rates of certain diseases, and more deaths and suffering from them, compared to others. “Also this could be defined as disparities among groupings of people are usually expressed as shortfalls in performance on some measure from the performance of a reference group (Lille-Blanton, M., Maleque, S., and Miller, W., 2008, p. 693).”
How racial disparities are shown throughout our health care system.
“Disparities in US health care are a source of considerable public health and policy concern, with substantial evidence that minorities and low-income Americans experience greater barriers to care and worse health outcomes across numerous measures (Sommers, B., McMurtry, C., Blendon, R., Benson, J., Sayde J., 2017, p.44).” “Racial disparities are formed within the healthcare system by allowing basic healthcare to have different meanings a crossed states and even cities. Even though we have made progress in closing the life expectancy between African Americans and whites from 7.6 years in 1970 to 3.8 years in 2010, a disparity remains — largely from blacks’ higher death rates at younger ages from heart disease, diabetes, and cancer, as well as higher risks for HIV infection, homicide, and infant mortality (Ayanian, J, 2015, p.2).” “Disparities persist across and within SES and racial and ethnic groups for various health indicators including life expectancy, overall health status, and chronic disease prevalence. Screening rates and preventative care has a lot to do with these differences (Lille-Blanton, M., Maleque, S., and Miller, W., 2008, p. 695).” “African Americans are the most common to have these differences compared to Caucasians. The efforts must be coupled with broader policies and partnerships to promote community health through racial equity in education, employment, housing, and the judicial system (Ayanian, J, 2015, p.2).” “Some studies have shown that there is a lack of trust in their doctors when it comes to the expressed voice of minorities. People from racial minority backgrounds report less trust in their doctors and have poorer health outcomes (Levine, C., Ambady, N., 2013, p.867).” “Although these disparities have multiple roots, one important set of explanations involves racial bias, which may be non-conscious, on the part of providers, and minority patients’ fears that they will be treated in a biased way (Levine, C., Ambady, N., 2013, p.867).” Through, these policies maybe we can change these death and health disparities within our system. “No one should suffer alone when it comes to their health and no one should be sitting at home badly injured or sick because they do not receive equal healthcare. Reducing the excess burden of disease, disability, and death among disadvantaged racial, ethnic, and socioeconomic groups could increase the productivity of the economy and soundness of the U.S. tax base and reduce the fiscal demands of health care and other social programs (Lille-Blanton, M., Maleque, S., and Miller, W., 2008, p. 696).”
The costs involved when having health care disparities.
Eliminating health care disparities is a vital point in order to help save our government money. Racial health disparities are associated with substantial annual economic losses nationally, including an estimated $35 billion in excess health care expenditures, $10 billion in illness-related lost productivity, and nearly $200 billion in premature deaths. “Concerted efforts to reduce health disparities could thus, have immense economic and social value (Ayanian, J, 2015, p.3).” These are big numbers that if eliminated could save our government tons over the years. This is why it has now been mandated by congress that the federal government produce the annual National Healthcare Disparities Report as part of the effort to monitor national progress in the health care field. These disparities also hit the local employer and would help our citizens save money along the way also. “For example, reducing disparities in effective asthma treatment by 10% for African American workers could save more than $1,600 per person annually in medical expenses and costs of missed work (Ayanian, J, 2015, p.3).” “Similarly, eliminating racial and ethnic disparities in access to outpatient mental health treatment could reduce costs, particularly for people on Medicare or Medicaid, by limiting emergency room visits and hospitalizations for mental illness and other medical conditions such as diabetes and heart disease (Ayanian, J, 2015, p.3).” With so many benefits we can have that effect by helping the government budget, the employer, and the person in America why can we not work to a better tomorrow?
Where to start on elimination of health care disparities.
To know where to begin on helping the public eliminate these disparities we need to know which items are most propionate within the health care system. “According to the department of health and human services states that he top six areas in which racial and ethnic minorities experience serious disparities in health access are infant mortality, cancer screening, management of cardiovascular disease, diabetes, HIV Infection/AIDS, and Immunizations (Department of health and human services, 1998, p.372).” “Once we see the biggest health problems that people deal with when having these disparities we can work to eliminate them. The department implemented a plan back in 2000 called Healthy people 2010 in order to start working on racial disparities in the health care system (Department of health and human services, 1998, p.372).” “Let’s review this plan in order to understand it fully. To guide this effort, the Secretary is establishing a senior-level steering committee in the Department, chaired by the Assistant Secretary for Planning and Evaluation (Department of health and human services, 1998, p.372).” “The charge to that committee is: To review the status of the six health disparity reduction goals for the Year 2000 and assure that the Department’s research, health services and prevention programs give priority to them (Department of health and human services, 1998, p.372).” “To conduct a process of consultation with minority community representatives and with the scientific and health services communities to improve our understanding of how to achieve both the near-term disparity reduction goals and the 2010 disparity elimination goal(Department of health and human services, 1998, p.372).” “To examine the Department’s research, data, service and prevention programs and recommend to the Secretary necessary changes in these programs to support the President’s goal of eliminating health disparities in the next century (Department of health and human services, 1998, p.372).”
“The Steering Committee will oversee efforts to examine how effectively the Department’s current programs are using their resources to support the elimination of health disparities and to recommend changes that would enhance their impact (Department of health and human services, 1998, p.372).” “It also will consider ways in which the FY-2000 budget can be designed to effectively support the President’s goals (Department of health and human services, 1998, p.373).” “Under the general guidance of the Steering Committee, working groups of Departmental experts will be convened for the six goal areas, to help shape strategy for achieving the goals and to monitor the progress (Department of health and human services, 1998, p.373).” “Consonant with the approach developed to guide the President’s Initiative on Race, the Department of Health and Human Services’ efforts in the current year will include dialogue, research and action (Department of health and human services, 1998, p.373).”
“As part of its efforts, the Department of Health and Human Services will broaden and strengthen its partnerships with State and local governments, with national and regional minority health and other minority-focused organizations, and with minority community-based organizations, those who have the greatest access to and knowledge of the communities (Department of health and human services, 1998, p.373).” “They will collaborate with other Federal departments, State, local, and tribal governments, and communities and professional groups to address broader determinants of health such as education, environment, income and other socioeconomic factors which contribute substantially to health outcomes (Department of health and human services, 1998, p.373).” “A series of structured planning and strategy sessions will be conducted with health experts and community representatives to review what we know about how to address each of the six health conditions and how well that knowledge is being applied at the community level. Barriers will be identified and strategies developed or refined to improve the effectiveness of the Department’s programs. In addition, our nationwide consultation to develop Healthy People 2010 involves organizations and individuals reflecting the views of minority communities (Department of health and human services, 1998, p.373).”
The Department will direct attention to improvements in monitoring and developing the local and national data necessary for determining priorities and designing programs. “As a first step in improving baseline data about the effectiveness of HHS programs in reaching minority populations, the Department has adopted a policy that requires all HHS-sponsored data collection and reporting systems to include standard racial and ethnic categories (Department of health and human services, 1998, p.374).” This inclusion policy will help monitor HHS programs to determine that Federal funds are being used in a nondiscriminatory manner and to promote the availability of standard racial and ethnic data across various agencies. “This policy will enable them to make a coordinated response to major health conditions of minority populations, monitor progress in meeting their needs, and help to ensure nondiscrimination in access to and provision of appropriate HHS services for various racial and ethnic groups (Department of health and human services, 1998, p.374).” Research focused on how to improve our interactions and interventions in minority communities will test approaches tailored to the specific cultural and social norms of these communities. “Results from small-scale studies will be incorporated into the design and management of the Department’s programs (Department of health and human services, 1998, p.374).” In addition, HHS will develop and disseminate strategies to assist researchers in their outreach to minority communities to foster partnerships and enhance the involvement of minorities in research studies. “In addition to ongoing research and program investments that are committed to improving the health of minority communities, a number of new projects will be implemented in fiscal year 1998 that are designed to test models for reducing disparities in specific minority communities (Department of health and human services, 1998, p.374).” “The Department’s programs to improve the economic security of low-income families and communities will be important contributions to improved health status of low-income populations–populations disproportionately composed of racial and ethnic minorities (Department of health and human services, 1998, p.374).” “The recently enacted State Child Health Insurance Program (CHIP), (Title XXI of the Social Security Act), which will be administered by the Health Care Financing Administration, will distribute $24 billion over the next 5 years among the States and territories (Department of health and human services, 1998, p.375).” “CHIP will be supplemented by an increased emphasis in the Medicaid program to identify and enroll eligible children. Taken together, these two approaches will seek to provide health insurance for at least half of the 10 million uninsured children in this country (Department of health and human services, 1998, p.375).” “Through a combination of education, outreach, and increased access to health care for the uninsured, a major step to eliminating racial and ethnic disparities in children’s health will be achieved (Department of health and human services, 1998, p.375).” “The President’s fiscal year 1999 budget proposes the beginning of a new five-year, $400 million set of activities addressing health disparities. Included in this is an additional $30 million for CDC to award up to 30 large community-based demonstration projects testing science-based approaches to achieve the six health disparity reduction goals (Department of health and human services, 1998, p.375).” “Results from these demonstrations will be important in shaping strategies to eliminate disparities, and for improving the focus and effectiveness of the Department’s current programs (Department of health and human services, 1998, p.375).” “An increase of $50 million in funding also is requested for FY 1999 for existing successful public health programs that, in partnership with community, advocacy, and tribal organizations, would expand and adapt proven public health strategies to better reach minority populations (Department of health and human services, 1998, p.375).”
Like mentioned above this was a project that was implemented some years ago it transformed into healthy people 2010, then continued into healthy people 2020. Although the plan was made many years ago this same plan is in effect today. This is one of the leading reasons that life expectancy between Caucasians and African Americans has gone down as stated before. This is starting to help but these disparities are still running the big portion of an individual’s life compared to the statistic’s change. This plan has been in place for 18 years and has only showed small feat in changing the overall health care of the individual. This also showed small feat in lowering the racial disparities in the health care system. On a side note with our new president implementing different things when it comes to possible elimination of Obama’s health care reform these numbers can change yet again either for the worst or for the better in our future.
To conclude there is much research on racial disparities in the health care system. In this paper we have reviewed the different meanings from researchers on what racial disparities mean and their operalization. Information was continued on how these disparities are shown throughout our health care system and also how they are recorded. We reviewed information on how much it is costing our governmental system to keep these disparities in place. It talked about how much potential money our health care system and government could have if these racial disparities were eliminated. There was a lot of information presented on the department of health and human services plan to get rid of these disparities and how they will record there growth. It was added about how this program was a main focus on the change of health care disparities because of the fact of time it has been in place. I also spoke about how this plan has evolved and shown to continue as a plan to this day as that is very relevant.
Ayanian, J. Z. (2015). The Costs of Racial Disparities in Health Care. Harvard Business Review Digital Articles, 3, 2-4. Retrieved April 10, 2018.
Department of Health and Human Services (1998). DHHS Report on Health Disparities. Eliminating Racial and Ethnic Disparities in Health: Response to the Presidential Initiative on Race. Public Health Reports, 113(4), 372-375. Retrieved April 4, 2018.
Levine, C. S., & Ambady, N. (2013). The role of non-verbal behaviour in racial disparities in health care: Implications and solutions. Medical Education, 47(9), 867-876. doi:10.1111/medu.12216
Lillie-Blanton, M., Maleque, S., & Miller, W. (2008). Reducing Racial, Ethnic, and Socioeconomic Disparities in Health Care: Opportunities in National Health Reform. The Journal of Law, Medicine & Ethics, 36(4), 693-702. doi:10.1111/j.1748-720x.2008.00324.xSommers, B. D., McMurtry, C. L., Blendon, R. J., Benson, J. M., & Sayde, J. M. (2017). Beyond Health Insurance: Remaining Disparities in US Health Care in the Post-ACA Era. The Milbank Quarterly, 95(1), 43-69. doi:10.1111/1468-0009.12245