Distinctions in healthcare and health experienced by groups based on environmental, social, as well as economic factors, also referred to as health disparities, are quite persistent across the United States (Hansen, 2014). Annually, these disparities result in significant fiscal and human expenses as certain individuals experience poorer living conditions, hardships in accessing healthcare services, and worse treatment and health status results compared to their peers in other populace categories. It is true that America has in the recent past witnessed a number of amazing advances in medicine, technology, and public health that allow individuals to be more productive, be healthier, and live longer (Kishore, Hernandez-Cansio & Morris, 2014). While this is the case of most Americans, some communities and groups are not witnessing similar advantages or privileges.
This paper will focus on two groups that are commonly cited as being underserved by the current healthcare system, and discuss, in chart format, how these populations could e better served with present or new programs. The cost impact of implementing a transformation in the service will also be discussed, and a conclusion provided at the end. The two groups are low-income and/or homeless individuals, and the chronically ill and disabled individuals.
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Discussion
Having a low income in the United States usually presents various issues for children and families, with access to healthcare being the most prevalent and complicated. Interestingly, those with low incomes are also disproportionately ethnic and racial minorities (Hansen, 2014). When studies indicate that being poor is highly correlated with poor health, physicians and hospitals are not only pulling out of poor city neighbourhoods where the sickest populace resides, but are also following privately insured patients to more wealthy regions instead of remaining anchored in communities with the highest healthcare needs (Kishore, Hernandez-Cansio & Morris, 2014). In a recent National Health Interview Survey, it was revealed that about 80% of adults, who reported to emergency departments over a one year period, did so because they lacked access to other healthcare providers (Hansen, 2014). This is an indication that emergency rooms which cannot refuse patients, and clinics in poor neighbourhoods which also do not refuse patients, are currently serving the large urban groups that once had more local hospitals and physicians. The figure below indicates the disparities in healthcare for the low income and homeless individuals compared to their high income earning counterparts.
Figure a: Disparities in healthcare for poor and homeless individuals
Source: www.kff.org
Notably, individuals with low income are less likely to have insurance coverage, and as a consequence, have less association with the healthcare system. On the other hand, given that those experiencing homelessness may not have a safe habitat to reside, they are more prone to risk for adverse health-associated consequences. According to the US Department of Housing and Urban Development report of 2017, an estimated 554,000 individuals in the United States were homeless on a given night (Kishore, Hernandez-Cansio & Morris, 2014). Moreover, it has been cited that it is harder to reach homeless persons because they tend to feel unwelcome or stigmatized.
Chronic illnesses generally account for three-quarters of the American healthcare costs as well as many early deaths and loss of productive years of life (Hansen, 2014). Unfortunately, health disparities are also present among the common chronic illnesses, such as diabetes mellitus, cancer, obesity, hypertension, and HIV/AIDS (Kishore, Hernandez-Cansio & Morris, 2014). Those suffering from chronic illnesses are at a higher risk of poor health consequences and they tend to use more healthcare money compared to their healthier counterparts. This means that they are also more likely to report poor health days compared to the overall population. On the other hand, the disabled persons have numerous interactions with the healthcare systems, but following their condition, they also have limited access to the necessary healthcare services. Notably, the chronically ill and the disabled persons may face similar unique challenges in obtaining such services (Hansen, 2014). This is indicated in the charts below.
Figure b: Healthcare disparities in individuals with chronic illnesses
Source: www.cdc.gov
Figure c: Health disparities for the disabled individuals
Source: www.cdc.gov
Despite the numerous challenges faced by these two groups commonly cited as being underserved by the current US healthcare system, there are a few approaches that can be taken by the federal government to better serve them using new or existing programs. There are also different costs that would impact the implementation of such a change in service. A majority of policymakers in health care acknowledge the health disparities witnessed by different populations and the associated fiscal costs to the state and healthcare system. Recently, healthcare givers who are considered to be culturally capable and are able to comprehend and relate with different groups, have been dispersed to help promote access to quality healthcare services (Kishore, Hernandez-Cansio & Morris, 2014). Moreover healthcare givers from ethnic and racial minority groups are often more likely to find jobs in underserved areas while giving services to the minorities, compared to their non-racial counterparts.
Figure d: Number of policies introduced between 2015 and 2017
Source: www.ncsl.org
The figure above indicates the number of policies introduced between 2015 and 2017 in an effort to address the role of healthcare providers in relation to health disparities for the underserved populations. If health disparities for the two groups can be abolished, indirect expenses would be much lower than $1 trillion. This means that state support or funding can assist in the creation or sustaining of emerging programs often implemented by state, government or rather other bodies (Hansen, 2014). It is unfortunate to observe that no single policy solution is present in addressing or eliminating the different determinants of interactions among various aspects at work in existing health disparities and health. However, it is important for professionals to pursue various angles, with the inclusion of policies both exterior and within the healthcare field.
Conclusion
Despite the fact that America has witnessed amazing advances in technology, public health, and medicine, it is quite unfortunate that some communities and groups are not witnessing or experiencing similar advantages. Health disparities particularly amongst underserved populations, are still persistent across the United States, and have been well recorded for many years. It is only recently that state legislators have followed up on different policy approaches to minimize health disparities in underserved communities and states.
References
Hansen, M.K. (2014). Racial and ethnic health disparities: Workforce diversity . Denver, Colo.: National Conference of State Legilsatures.
Kishore, S., Hernandez-Cansio, S., & Morris, C. (2014). Reforming the way health care is delivered can reduce health care disparities . Washington, D.C.: Families USA.
