Health Disparity: Healthcare Access and Quality
A health disparity is a discrepancy that is witnesses among different population demographics as a result of differing social determinants of health. As a matter of fact, the inability to access quality healthcare itself is an important social determinant of health according to Powell (2016). The US Department of Health and Human Services (n.d.) in its Healthy People 2030 agenda of health access and quality states that one out of ten Americans do not have healthcare insurance. Because the United States is one of the most expensive countries in terms of healthcare services (Sultz & Kroth, 2018), the lack of health insurance means that a person or a family is not able to be referred for proper healthcare services since they will not be having a primary healthcare provider. Community Healthy People 2020 Obesity Objectives and Disparity Essay
This situation pertains simply because despite being rich in resources, the US does not have a Universal Healthcare (UHC) Program. This would be a single-payer system in the model of Medicare if it were to be made a reality. The cost of this would be a little bit high but the benefits to the population would be great and far-reaching in terms of a sound public health position (Cai et al., 2020). The closest the US has come to UHC and a healthcare for all policy is the enactment of the Patient Protection and Affordable Care Act or ACA 2010. This policy was revolutionary and brought into coverage a whopping 22 million Americans who had not been having health insurance (Kominski et al., 2017). The goal of the Healthy People 2030 Healthcare Access and Quality agenda is to expand access of the population to healthcare services that are of high quality and comprehensive (The US Department of Health and Human Services, n.d.). The purpose of this paper is to discuss access to quality healthcare as a healthcare disparity in the United States.
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Healthcare Access as a Disparity
As healthcare in the US is expensive, many people of moderate means and incomes cannot afford proper quality healthcare. This is especially true among the minority populations such as the African Americans and Hispanics. The reason for this is that these communities are disproportionately affected negatively by social determinants of health. For instance, most are poor (low socioeconomic status) and hence have low family incomes. Majority also have low educational achievement and live in deplorable sanitary conditions (Powell, 2016). These factors make them unable to pay for quality healthcare services compared to those Americans who are well of Community Healthy People 2020 Obesity Objectives and Disparity Essay
Action at the Local Level
At the local or state level, the ACA 2010 had provisions that mandated each state to follow a calendar of implementing particular provisions of the law that would see it guarantee its citizens optimum healthcare coverage. Some of these provisions to be implemented by states included formation of state-based insurance exchanges provision of tax credits to small businesses to assist in purchasing insurance, and enactment of consumer protections amongst others (Kominski et al., 2017). The other form of action at the local level involves advocacy by non-state players and professional organizations for there to be a UHC program through the lobbying of representatives.
Action at the National Level
The biggest action at the national or federal level to ensure equal access to quality healthcare was arguably the signing into law of the ACA 2010 by President Obama in his first term in office. The other particular actions included an increment in the federal share of Medicaid payments, creation of a prevention council at the national level, and the creation of a home visitation program at the national level amongst others.
Access to quality healthcare is a major health disparity in the US. Part of the reason is that healthcare in the US is expensive and there is no Universal Health Care (UHC). A number of actions have been taken and continue to be taken at the local and national levels to address this disparity. The major one was the enactment and signing into law of the ACA 2010 by the Obama-Biden administration.
Cai, C., Runte, J., Ostrer, I., Berry, K., Ponce, N., Rodriguez, M., Bertozzi, S., White, J.S., & Kahn, J.G. (2020). Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses. PLOS Medicine, 17(1), 1-18. https://doi.og/10.1371/journal.pmed.1003013
Kominski, G.F., Nonzee, N.J. & Sorensen, A. (2017). The Affordable Care Act’s impacts on access to insurance and health care for low-income populations. Annual Review of Public Health, 38. https://doi.org/10.1146/annurev-publhealth-031816-044555
Powell, D.L. (2016). Social determinants of health: Cultural competence is not enough. Creative Nursing, 24(1), 5-10. http://dx.doi.org/10.1891/1078-45188.8.131.52
Sultz, H.A., & Kroth, P.J. (2018). Sultz and Young’s health care USA: Understanding its organization and delivery, 9th ed. Jones & Bartlett Learning.
US Department of Health and Human Services (n.d.). Healthy People 2030: Healthcare access and quality. https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quali
Community Health: Healthy People 2020 Obesity Objectives and Disparity
The Healthy People 2020 health promotion and disease prevention objectives for obesity include tracking the number of adults who have met the guidelines placed by the federal government at the national level for the performance of aerobic and resistive exercises. This should be either 75 minutes of intense exercise or 150 minutes of moderate aerobic/ resistive exercises per week. They also include keeping a record of adults that are obese or with a body mass index (BMI) of equal to or above 30 kg/m2. The other objective is to track the number of children and teenagers who are obese. The last objective in this health concern of obesity is to keep a record of the impact of fresh total vegetable intake in the diets of persons who are two years old and above (US Department of Health and Human Services, 2022). The purpose of this paper is to look at obesity as a health disparity topic.
Obesity has been found by many studies to present a significant health disparity among the people of the United States and the world at large. The most significant and important social determinant of health that makes this possible is socioeconomic status or family income. It has been found that especially children and teenagers who come from low socioeconomic backgrounds are vulnerable to overweight (BMI of 25-30 kg/m2) and obesity (BMI of ≥30 kg/m2). This gets worse as they move into their mid teens (Kornet-van der Aa et al., 2017). It however so happens that this population demographic is overwhelmingly represented by the minority communities especially African Americans and Hispanics (Smith & Smith, 2016). Some of the reasons found to be responsible for this disparity are closely related to a low purchasing power due to poverty. Community Healthy People 2020 Obesity Objectives and Disparity Essay
The inability to purchase fresh fruits and vegetables consistently due to their high cost is a major contributing factor. For this reason, they end up consuming large amounts of the affordable cheap junk foods and sugary sweetened beverages both at home and at school. The other reason or social determinant of health is the insufficient educational achievement. Because the parents are poorly educated, it is difficult for them to understand the concept of diet and exercise as preventive measures against overweight and obesity. Yet another reason is the fact that most of these disadvantaged minority communities live in areas that have a lot of insecurity and this discourages outdoor physical for fear that one may be attacked or robbed. Lastly but not least, most of these poor communities do not live in areas that have recreational amenities for the same obvious reason of affordability. It is all of these factors that conspire to make the children and teenagers from disadvantaged backgrounds more vulnerable to overweight and obesity compared to their White well-off counterparts.
Overweight and obesity are risk factors for cardiovascular diseases, type II diabetes mellitus, hyperlipidemia, and hypertension (Hammer & McPhee, 2018). These are some of the deadliest non-communicable diseases that are responsible for a high number of mortality of Americans. Stroke, heart attack (myocardial infarction), and chronic kidney disease (from diabetes and hypertension) are some of the sequelae or complications (Hammer & McPhee, 2018; Madhusoodanan, 2018). For these reasons, it is imperative that preventive measures are put in place by way of health education targeting the affected demographic and population.
Measures at Local and National Levels
At the local level there are programs targeting schools where healthcare workers especially school nurses are involved in educating school administrations, parents, and children on the dangers of cheap sugary sweetened beverages and junk foods. They also educate on the important of exercise or physical activity such as walking. At the national level here are guidelines on exercise and nutrition that one needs to follow and abide by to remain healthy and within the normal BMI range.
Obesity is a condition that presents a significant health disparity between the poor and the well-to-do. Addressing the social determinants of health such as family incomes, education, and living conditions will go a long way in preventing obesity.
Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8th ed. McGraw-Hill Education.
Kornet-van der Aa, D.A., Altenburg, T.M., van Randeraad-van der Zee, C.H. & Chinapaw, M.J.M. (2017). The effectiveness and promising strategies of obesity prevention and treatment programmes among adolescents from disadvantaged backgrounds: A systematic review. Obesity Reviews, 18(5). https://doi.org/10.1111/obr.12519
Madhusoodanan, J. (2018). Hormones reveal the secret life of fat cells. Chemical and Engineering News, 96(40). https://cen.acs.org/biological-chemistry/biochemistry/Hormones-reveal-secret-life-fat/96/i40
Smith, K.B., & Smith, M.S. (2016). Obesity statistics. Primary Care: Clinics in Office Practice, 41(1), 121-135. http://dx.doi.org/10.1016/j.pop.2015.10.001
US Department of Health and Human Services (June 6, 2022). Nutrition, physical activity, and obesity. https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Nutrition-Physical-Activity-and-Obesity/data
Community Healthy People 2020 Obesity Objectives and Disparity Essay