Health disparities refer to variations in disease and the availability or access to treatment due to the difference in the socio-economic status of the exposed individuals and their geographical regions. In other terms, health disparities are differences in health between different classes of people, precisely poor health among socially, economically and ethnically disadvantaged individuals. Health disparities may be based on how many people are prone to getting certain diseases, how serious the disease is, how many people succumb to the disease, whether the population has access to healthcare and whether they have opportunities to receive screening for the diseases. Among the health disparities are cancer, HIV/AIDS, TB, Depression, obesity, and infant mortality. This article discusses the prevalence of health disparities surrounding infant mortality, the various factors influencing health and offers insight into the concepts put in place to come up with a relevant treatment plan.
Racial and ethnic differences adversely affect the rate of infant mortality. Infant mortality is the death of a toddler, often younger than one. These risks are mainly determined by the geographical location of the parent, the individual maternal risk attributes, low birth weight often surrounding the maternal gestational environment and risks, and lack of access to medical services ( DeNavas-Walt, 2013 ). The indicator of the overall health of a population is infant mortality and its rate continues to grow due to the stretching gap of health care equality among various ethnic and racial groups. Premature birth is the leading cause of a high infant mortality rate in ethnically disadvantaged regions. A mother’s education levels on pregnancy care, the medical infrastructure, and environmental conditions are directly linked to these regions. Other causes of infant mortality include, but not limited to congenital abnormalities, pneumonia, abnormal presentation of a fetus, prolonged labor, diarrhea, malnutrition, and measles.
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Health is a crucial asset and whether or not people become sick is determined by various inevitable factors. These factors include race and ethnicity, income and social status, geographical location, level of education, gender, disability or the ability of a person, social support, individual behavior, and genetics. Variations in social status and revenue contribute to health disparities. The higher an individual is in social and income rank, the better their health as they have access to better medical care whenever the need arises. The reverse is also true to lower-income individuals. Gender is also a major determinant of health as males and females are prone to exposure to a variety of diseases at varying stages of life. Health disparities between the gender groups are prevalent mainly due to the occupation and their roles in the society. For instance, increased drug use among young males could lead to certain drug abuse-related diseases affecting only males ( Gumà, 2019 ).
The geographical location of an individual contributes highly to health differences within the population. This is determined by an individual’s ability to access primary healthcare. Proper geographic distribution of health services especially in rural areas will greatly reduce the issue of health disparity. Safe air and clean water are attributable to great health as is good working conditions.
Race and ethnicity is a complex factor that influences health. Different genes possessed by different people around the world not only influence their hair, eye and skin color, but also certain health differences. The splinter group in ethnicity experiences poor health as compared to the majority of the population. This is trivially due to the fact that physicians in many medical institutions are combative to the minority ethnic groups (Matthews, 2015). In other words, the services offered in such institutions and the mode of operations may in one way or the other discriminate against minority ethnic groups as a result of ingrained norms and ethnic values that affect the way others perceive their health. Disability is a substantial determinant of health even though having a disability does not necessarily imply that one is unhealthy. Comparably, disabled people are more likely to experience challenges like finding employment, using fitness facilities, accessing medical facilities among others as compared to people living without disabilities (Frier, 2018). These challenges adversely affect the health of disabled individuals.
Genetics and inheritance also play a crucial role in determining one’s likelihood of developing certain illnesses such as various inherited genetic disorders. Some of these diseases include sickle cell anemia, Alzheimer’s disease, cancer, obesity, diabetes, hemophilia among others. An individual is most likely to develop an inheritable illness if one or both parents carry the gene. Another major determinant of health is individual behavior. For instance, when an individual begins to smoke or indulge in drug and substance use, their risk of disease increases. Consequently, if they decide to discontinue the abuse and misuse of these drugs, their health improves a great deal. A lot of public health campaigns stress on education to help individuals change their behavior that contributes to health issues such as diet improvement, physical activity among others. Social support also plays a crucial role in health. Great support from family and friends determines one’s health (WHO, 2010).
The Infant Mortality Rate in the USA
According to a study carried out by World Health Organization (WHO) in the year 2017, the infant mortality rate (IMR) has reduced substantially per 1000 live births since 1990 (WHO, 2017). This rate is however higher in the United States as compared to the European countries. By 2017, United States was ranked 168 out of 223 countries involved in the study with less than 7 deaths per 1000 live births from more than 37 deaths per 1000 live births in 1990 (WHO, 2017). The Southeast states of the United States of America reported the most cases of infant mortality with the average being 10 deaths per 1000 live births in recent years. This was attributed to the fact that quite a number of the people living below the poverty level in the United States were from the Southeast states as compared to the other states ( DeNavas-Walt, 2013 ). The leading cause of these deaths, among poverty levels, is the age of the maternal parent. Extremely low age and higher ages i.e., 40 and older report many cases of low birth weight and infant death.
Cultural factors influencing infant mortality
Cultural factors are less influential in determining infant mortality in the United States as compared to socioeconomic factors. The cases are however more prevalent in the Southeast states of the country with the largest numbers being attributed to African-American and Asian immigrants. A study carried out indicated that among the immigrant women who had less than 16 years of education reported a higher rate of infant deaths (Xiaojia, 2015). Some cultural and religious beliefs prohibit women from accessing medical services such as antenatal care as well as delivery. This contributes highly to infant mortality as the only assistance they get is from mid wives who in most cases lack sufficient training. This mostly ends up in still-births, low birth weight and in some cases both maternal and infant deaths. Lack of breastfeeding and weaning education may deprive an infant of colostrum, early or late introduction of supplementary food and unhygienic administering of supplements may all contribute to high infant mortality rates in developing countries.
Healthcare Challenges Facing Infant Mortality
Increased access to preconception and antenatal services would be a key factor in reducing pregnancy-linked problems as well as the risks of infant deaths. This care paves way for discovering underlying maternal and infant diseases consequently providing appropriate care and treatment to prevent death and disability. The health and development of an infant are determined by behavior, health and nutrition of their maternal parents during the early stages of infancy as well as pregnancy. Consumption of the recommended types and amounts of food during pregnancy can reduce the risk of complications leading to both the infant and mother’s death. Many people fail to understand that receiving preconception education is just as important as receiving proper antenatal care. Unintended conception is a major cause of many public health concerns such as poor maternal health and preterm birth. Receiving medical care is, therefore, a crucial aspect to bettering maternal and infant health.
Lack of advanced medical facilities and infrastructure especially in under-developed states is also a major contributing factor to the growing rate of infant mortality. This is due to the unequal distribution of medical resources with some areas having very little or none. Some of these medical facilities are not equipped to handle delivery complications and birth defects and the infants end up dying due to cases such as brain damage and oxygen deprivation. Lack of proper training to midwives and obstetricians is also a major concern. These healthcare providers lack the appropriate training to run tests on patients in order to find out if they require any form of attention or medical intervention (Rapaport, 2016). Infant mortality, often experienced in medical facilities are mostly as a result of underestimated risks by the midwives, which turn fatal eventually leading to the unpreventable death of an infant.
Social Cognitive Theory
Health promotion theories are models used in planning programs to assist in understanding and explaining health behavior so as to guide the recognition, improvement, and implementation of preventative and treatment measures. While choosing a health promotion theory, it is important for one to consider such factors as the health challenge, the target population and the situation within which the theory is being implemented. Social Cognitive Theory (SCT) discusses the influence of individual experiences, other people’s behavior and environmental factors affecting individual health behaviors. This theory provides opportunities for social support by imparting prospects and using observational learning to influence a change of behavior (LaMorte, 2018).
This theory engages groups of people particularly in poverty areas and uses skill-constructing practices to understand the influence of social and economic determinants of health and in turn, increase self-reliance and support positive behavior. Implementing Social Cognitive Theory in areas such as the Southeast states which infant mortality is prevalent will create awareness and in turn influence behavior change among culturally and poverty affected people. Implementing this exercise will involve training of individuals who will provide information and liability reduction materials to the population within the child-bearing age and most especially those living in the Southeastern states of the United States. Measures such as immunization of mothers, appropriate training for midwives, health education and advocating for institutionalized deliveries will go a long way in solving the issue of infant mortality.
References
Matthews, D. (2015). Sociology in Nursing 4: The Impact of Ethnicity on Health Inequalities. Nursing Times ; 111: 44. Retrieved from URL: https://www.nursingtimes.net/clinical-archive/public-health/sociology-in-nursing-4-the-impact-of-ethnicity-on-health-inequalities/5091396.article
Frier, A., Barnett, F., Devine, S. & Barker, R. (2018). Understanding Disability and the Social Determinants of Health: How does Disability Affect Peoples’ Social Determinants of Health? Disability and Rehabilitation , DOI: 10.1080/09638288.2016.1258090
Rapaport, L. (2016). Infant Death During Home Births Often Tied to Delivery Problems. Journal of Perinatal Medicine . Retrieved from URL: https://www.reuters.com/article/us-health-mortality-home-births/infant-deaths-during-home-birth-often-tied-to-delivery-problems-idUSKBN12X293
LaMorte, W. (2018). The Social Cognitive Theory: Behavioral Change Models. Boston University School of Public Health . Retrieved from URL: http://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories5.html
DeNavas-Walt, C., Proctor, B. D., & Smith, J. C. (2013). Income, Poverty, and Health Insurance Coverage in the United States: 2012. Current Population Reports P60-245. US Census Bureau .
Gumà, J., Arpino, B., & Solé-Auró, A. (2019). Social determinants of health at distinct levels by gender: education and household in Spain. Gaceta sanitaria , 33 (2).
Xiaojia, H., Akil, L., Aker, W., Hwang, H. & Ahmad, H. (2015). Trends in Infant Mortality in United States: A Brief Study of the Southeastern States from 2005-2009. International Journal of Environmental Research and Public Health, 12(5). DOI: 10.3390/ijerph120504908
