Disparities in Health Care
Disparities in health care can be viewed from different perspectives. It can be viewed looking at the disparities when it comes to service and the disparities examined within each field. Now when I say disparities in service, this is more or less in reference to the services health care providers provide for the community. Some may feel as though no disparities exist, however, there is a large array of different disparities.
Disparities can be seen as 1) limited services to a certain community demographic whether it is based on race, class, employment status, religion, disease/disorder etc; 2) limited resources within a certain field such as lack of racial, ethnic, male or female presence; 3) unfair treatment in the field; or 4) unfair treatment in services.
One of the largest things discussed in the media relates to the limited services to a certain community demographic in reference to access to health care and quality of health care. Surprisingly, many don't notice how profound this is. I offer a challenge to anyone who thinks otherwise. Examine the differences in care you receive at your regular health care provider and then at a county hospital or local inner city clinic. One will quickly notice that staffing is often an issue as well as efficiency.
The following are examples provided by the National Healthcare Disparities Report accessible at http://www.ahrq.gov/qual/nhdr03/nhdrsum03.htm#Inequality. It's very interesting and I urge everyone to take a look at the site.
Inequality in quality exists
- Minorities are more likely to be diagnosed with late-stage breast cancer and colorectal cancer compared with whites.
- The use of physical restraints in nursing homes is higher among Hispanics and Asian/Pacific Islanders compared with non-Hispanic whites.
- Blacks and poorer patients have higher rates of avoidable hospital admissions (i.e., hospitalizations for health conditions that, in the presence of comprehensive primary care, rarely require hospitalization).
Disparities come at a personal and societal price
- Many racial and ethnic minorities and persons of lower socioeconomic position are less likely to receive recommended immunizations for influenza and pneumococcal pneumonia, the most common type of pneumonia. Once hospitalized, some ethnic and racial minorities, as well as lower income patients, suffer worse quality of care for pneumonia. These differential rates of vaccination and hospitalization present opportunities for provider-based and community-based interventions to reduce disparities.
Differential access may lead to disparities in quality
- Many racial and ethnic minorities and individuals of lower socioeconomic status are less likely to have a usual source of care.
Opportunities to provide preventive care are frequently missed
- Many racial and ethnic minorities and persons of lower socioeconomic position are less likely to receive childhood immunizations.
- Many racial and ethnic minorities and individuals of lower socioeconomic status are less likely to receive recommended immunizations for influenza and pneumococcal disease.
Knowledge of why disparities exist is limited
- Many racial and ethnic groups, as well as poor and less educated patients, are more likely to have report poor communication with their physicians.
- Many racial and ethnic minorities and poor patients report more problems with some aspects of the patient-provider relationships.
- Asians, Hispanics, and those of lower socioeconomic status have greater difficulty accessing health care information, including information on prescription drugs.
I will discuss the remainder of the points in my next couple of blogs!