Population Disparities, Research Paper Example

Several government reports and individual researchers report that health disparities exist in the American society, and there is not enough done to reduce the gap between different populations. The below essay is going to compare and contrast the reported health disparities of African Americans and Hispanic groups in New York, by reviewing related research and statistics.

Statistical Data Review

According to the National Healthcare Disparities Report (Agency for Healthcare Research and Quality, 2013), health outcomes and quality measures of minority groups are improving more in Hispanic populations than among African Americans. However, on a national and state level, health outcomes differ from one ethnic group to another, with whites being the most advantaged, and Hispanics/Blacks being disadvantaged. High mortality rates, lack of prevention, and untreated medical conditions account for the majority of disparities.

African American Disparities – Breast Cancer

The study (Agency for Healthcare Research and Quality, 2013) reveals that among African American women, advanced stage (high mortality chance) breast cancer per 100.000 people was significantly higher than among white people. The 2008 achievable benchmark (Agency for Healthcare Research and Quality, 2013, p. 41) was 81, and this number among African American women was close to a hundred in 2009, compared with below 80 among those from white background. Breast cancer related deaths (p. 45) were higher among African Americans, while among Hispanic groups, they were lower than among non-Hispanic whites.

On a New York City level (New York City Department of Health and Mental Hygiene, 2004), overall premature death related to cancer rates of African Americans were lower than the white population’s.

Hispanic Disparities – Diabetes

Among the Hispanic population, diabetes related illnesses were reported to be higher than among other groups in America. According to the Agency for Healthcare Research and Quality, (2013, p. 69), the number of adults aged above 20 with end stage renal disease due to diabetes per 1.000.000 people was over 300, compared with a number of 150 per a million for non-Hispanics. The study also states that it would take 60 years to achieve the benchmark goals of 71 per million people among Hispanics, according to current trends.

On the New York City level, however, Hispanic groups were less affected by deaths due to diabetes (New York City Department of Health and Mental Hygiene, 2004). In 2000- 2001, there were more than 30 deaths among Hispanic people related to diabetes, while more than 50 among Blacks.

New York’s Health Disparities

In order to understand the above trends in national and New York health care access, treatment, and health outcome disparities, it is important to review which factors contribute towards low health outcomes. One of the reasons, reported by the New York City Department

of Health and Mental Hygiene (2004) is lower income level and health insurance coverage. The report also states that low income and financial hardship contributes towards serious emotional distress. The comparison table (New York City Department of Health and Mental Hygiene, p. 10) concludes that the lower the household income is the greater the impact of emotional distress on one’s health is. The study also examines the neighborhood differences. It is evident that living conditions and communities impact one’s health outcomes, and it has been proven by the study. Comparing two areas: Chelsea and Clinton, and Crotona and Tremont, the research found that HIV rates per 100,000 population were significantly higher in the poverty-stuck neighborhood of Chelsea and Clinton. Exercise rates, smoking, poor diet, drug abuse, and mental illnesses have also been linked with health outcomes. As an example, elementary school obesity rate in New York was 31 percent among Hispanic children, while only 16 percent among Whites and 23 percent among Asians. Black New Yorkers were more likely to die from heart disease than Whites. The disparity is most visible among the age group 45-55, where the rate is 55 percent higher than among Whites. Similarly, colon cancer rates among Blacks aged 55-64 were 56 percent higher than rates of Whites (U.S. Department Of Health And Human Services, 2011).

Disparities, however, are not only present regarding critical illnesses. Conditions that can be prevented or treated also affect minority population more than Whites. As the New York City Department of Health and Mental Hygiene (2004, p. 17) confirms: “Black and Hispanic New Yorkers are more than twice as likely as Whites to use emergency care for asthma”.

Most and Least Affected Populations

Generally speaking, Whites’ health outcomes are much better than Whites’, Blacks, and Asians. Asian minority groups are less affected by obesity-related diseases, while Hispanic people are the more at risk of unhealthy diet. Health care access, according to the CDC (2011) has an impact on overall outcomes of health. As the report (CDC, 2011, p. 2) confirms: “Hispanics and non-Hispanic Blacks had substantially higher uninsured rates, compared with Asian/Pacific Islanders and non-Hispanic Whites. Iton (2010) linked poverty to low health outcomes. Low graduation rates among Blacks, low income of African American and Hispanic families result in living in adverse social/physical environments. This impacts individual health related behaviors, and increases disease risk. This, in turn, leads to poor health outcomes, and health disparities. Based on the above idea, it is evident that the population that lives in the most deprived neighborhoods will be the most disadvantaged. This indicates that the more financially and socially disadvantaged a population is he worse their health outcomes will be.

Policy Implications and Improvements

Iton (2010, p. 14) details the Satcher framework for intervention in order to tackle health disparities. The framework has five different focus areas that point policymakers in the right direction. The first domain is access to health care, including prevention. The Affordable Care Act of 2010 was designed to increase health insurance coverage among the most vulnerable populations in the United States, however, the same needs to be done on the local level, too. Health care providers need to ensure that they are able to connect with culturally diverse patients and help them get access to prevention and advice. Secondly, the framework talks about tackling individual health risk behaviors. This is an important issue, as in closed ethnic communities, customs and poverty often limit individuals’ choices, therefore, healthy options are not as visible as for other groups. The framework also mentions improving people’s physical environment. Reviewing the above mentioned asthma related statistics among Blacks and Hispanics, it is evident that the high rate of hospitalization and use of emergency services can be tackled through making policies that focus on physical environment improvements. Tackling the social environment of disadvantaged populations is also mentioned by the framework, however, this requires community involvement. In some cases, health care providers would need to go out to meet the public. Designing school-based preventive and health education programs has been proven an effective way of reaching out to disadvantaged communities. The final domain of intervention mentioned by the Satcher framework is the introduction of policies that target at-risk populations.

The New York City Department of Health and Mental Hygiene (2004, p. 24) highlights some important steps of intervention on a local level. The document highlights three important health service development areas. First, it is important to create projects for collaborating with communities, while expanding health care responsibilities. It is clear that neighborhoods impact health outcomes. Strengthening and empowering communities, holding meetings in community setting can be beneficial. Collaborating with schools and community centers in deprived areas can increase community participation. Embracing a multidisciplinary approach to health care, involving sociologists in research, for example, will help policymakers identity at-risk populations. Finally, adequate health care resource allocation to the most disadvantaged neighborhoods can reduce the gap and increase the quality of service for at-risk individuals.

Conclusion

As the New York City Department of Health and Mental Hygiene (2004, p. 24) confirms:   “the burden of illness and death among New Yorkers is connected to poverty and race/ethnicity. Given the ethnic diversity of New York, and the fact that there are huge income and community differences between various areas of the city, it is evident that policymakers need to focus on targeting disadvantaged populations with community health prevention and education projects. It has been revealed that low socio-economic status reduces the overall health access, and the lack of prevention increases health risks. This indicates that new, culturally relevant, focused prevention and education programs need to be developed in New York City, in order to close the gap in health outcomes of different groups.

References

Centers for Disease Control and Prevention (CDC) (2011) Fact sheet. CDC Health Disparities and inequalities Report. U.S. – 2011. Retrieved from http://www.cdc.gov/minorityhealth/CHDIR/2011/FactSheet.pdf

Iton, (2010) Tackling the root causes of health disparities through community capacity building. In: Tackling Health Inequities Through Public Health Practice. Hofrichter & Bhatia (eds.)

U.S. Department Of Health And Human Services (2013) National Healthcare Disparities Report, 2013. Retrieved from http://www.ahrq.gov/research/findings/nhqrdr/nhdr13/2013nhdr.pdf

New York City Department of Health and Mental Hygiene (2004) Health disparities in New York City. Retrieved from http://www.nyc.gov/html/doh/downloads/pdf/epi/disparities-2004.pdf