Racial and Ethnic Disparities in Health Care: Background and Significance

Disparities based on race and ethnicity has perpetually withheld the black community from accessing the conventional facilities pertaining to healthcare. The truth of our world is that there is an urgent problem of racial and ethnic disparities in health care and in this essay numerous factors which give rise to this inequality,are layed out which give rise to this inequality. Unfavorably, the recent studies reflect that racial disparities continue to disrupt the healthcare discipline even in the modern-day. According to a report published by the Institute of Medicine (IOM) in 2002, black Americans were primarily a subject to second-rate medical care, which was the primary reason for the respective community's poor health. Apart from this, disparity concerning healthcare is widely associated with indices of mortality, morbidity and life expectancy, something that is more than enough to draw the attention of authoritative bodies towards this prevailing prejudice. Nevertheless, there are nursing theories which can help eliminate this unfairness from the healthcare sector.

Description

Health disparity corresponds to health inequality, a phrase that was in practice in the 1990s, which means the unequal distribution of facilities. Racial and ethnic minorities have had to suffer through a lot of courtesy of the discrimination amidst the healthcare system. According to Graham, health disparity is but the difference in the health of the people belonging to different races and communities. This difference is mostly observed when analyzing the socioeconomic background of the sufferers. Socioeconomic aspects and racial disparity are very closely associated, especially in the United States. While the latter might be a significant and more considerable determinant amongst the two for the health disparity, there's no denying that both racial and ethnic discrimination and poor household leads to lower levels of health.

It is essential to address the needs of the ethnic minorities for they deserve an equal opportunity to avail the healthcare facilities rendered by the government. Nevertheless, the disparity never ceases to exist. Studies show that ethnic and racial minorities often reflect a low level of health care and the associated satisfaction. Besides, the data concerning various studies carried out in relation to racial and ethnic disparity reveal that black people have been subjected to a higher level of chronic illnesses, cancer and cardiovascular disease, etc. That said, an alarming aspect of this issue is that its status hasn't considerably improved with the advent of modern advancements. Researchers reveal that life expectancy has got better in the past decades; however, this factual assertion doesn't apply for ethnic minorities, who have suffered in this complicated society. 

In his guest editorial, Alan Nelson puts forth 'unequal treatment' as the significant factor contributing to the cause of the racial and ethnic disparity. The article further alleges that considering the modern environment where everyone is given equal facilities, the fact that minorities are mainly suffering from the diseases is simply unacceptable. Solving this problem requires nurses to comprehend the meaning of serving diverse communities. At the same time, they should be taught to treat everyone equally. For this exact reason, Madeleine Leininger's Cultural Care Diversity and Universality theory is ideal for dealing with racial and ethnic disparity.

Dr Madeleine M. Leininger, the founder of transcultural nursing, believed that nursing practices should remain aloof of the disparities. Consequently, she developed the Cultural Care Diversity theory to educate the nurses about the challenges associated with treating people from different communities. Leininger developed this theory because she saw that nurses were mostly oblivious to the confronting the issues related to minorities. Additionally, she sensed the importance of caring for people that belonged to diverse cultures. All-in-all, the cultural care diversity theory endeavors to entirely put a full-stop to the thought of racial and ethnic disparity because it is blatantly unjust.

The idea of trans-cultural nursing is sound for it garners a comprehensive communication bridge between the patient and the nurse. Besides, the theory is essential for recognizing the morals and developing a culture-oriented approach. The nurses who adopt this theory are more likely to be sensitive towards the people of color and care for their better health. 

Factors Influencing the Issue

There are numerous factors which can be attributed to the rise of racial and ethnic disparity. While these factors contribute to the disparity individually, their integration demonstrates that the whole healthcare system has been falsified for a prolonged period. 

Firstly, a major role is played by the socioeconomic background of the minorities. A portion of Hispanics and the black community are still enveloped within the socioeconomic inequalities. Because racial minorities have lesser facilities, they are expected to satisfy low-paying jobs. For this exact reason, they are incapable of paying the healthcare bills. Also, per the statistics demonstrated by Talk Poverty, a total of 21% African American and 18.3% Hispanics reside below the poverty line. The previous statistic when compared to that of Whites, 8.7%, is considerably less and quite reflective of the unjust people of color are subjected to. 

Secondly, academic institutions have a significant impact on the levels of disparity. For instance, the institutions that incorporate a diverse workforce will develop a deep comprehension of problems associated with minorities. In other words, if a healthcare professional belongs to a minority background, he/she will be more likely to recognize the complexities associated with a minority patient as compared to the white counterpart. Although the previous statement cannot always be appropriate, it holds true for most of the cases. It is essential to understand that academic institutions mostly lack the clinical and administrative leadership in the name of minority professionals. The incapability of institutions of hiring healthcare professionals from the minority background and vice versa widens the gap between the patient's communication and care.

Furthermore, the disparity results from clinical uncertainty. This facet is indirectly associated with the failure of academic institutions in hiring or training the right person. Clinical uncertainty is nothing but a synonym for a physician physician's perplexed mind on dealing with something new. It is a result of a doctor operating the patients based on previously learned and experienced facets, and this is where age, socioeconomic background, race and ethnicity come into the picture. The authors further assert that uncertainties during the treatment can directly lead to disparities in healthcare.

There's no denying that disparities have also stemmed from the biases exhibited by the health care providers. A study revealed that although there is no evidence of preferences amongst the investigated sample, some implicit or instead unconscious bias may affect the judgements. Whether or not bias is unconscious, it is immoral and therefore, unacceptable. This is because people should be more thoughtful regarding their outlook, behavior and allow others to reach common goals. In addition to this, National Academies Press stated that implicit bias has little role to play in contributing towards disparity; nevertheless, there are possibilities of non-Hispanic white practitioners treating the colored patients differently. The preceding statement, although not suggesting generality, is a very demanding statement, which needs immediate addressing. 

A surprising, yet very, constrained reason for disparity peduncles from the people belonging to minorities refusing to have a treatment. Racial and ethnic minority patients have been often observed, saying no to the procedures. There is a very concrete reason for their refusal in the name of mistrust. With the prevailing disparities between people belonging to minorities and their counterparts, it comes with no surprise that people refuse to treat themselves further. It is hard to believe that people amid the talk of race and ethnicity commit discrimination, which their conscious mind isn't always aware of.   

Another face of disparity is depicted in the survey conducted by Michelle van Ryn, where physicians reacted differently to the people of color and middle SES groups. Also, the difference was noted in the doctor's treatment methodologies, which were predominantly negative. The survey, thus, concluded that physicians frequently treated the patients considering their demographics. Other factors that influenced the behavior of physicians pertained to personality and behavioral tendencies. 

Implications to Nursing

Nursing practices are also affected by racial and ethnic disparities. A study 'Racial/Ethnic Disparities in Nursing' reveals that the number of non-white nurses in the USA is lesser than what should be expected when considering the population of different ethnic groups, especially African American Community. The study further relates this disproportion to the low-level of education that Latinos, Hispanics and other non-white groups receive.

The growing recognition of workforce diversity has allowed some researchers to contemplate and investigate the in-depth scenarios of disparities within the nursing domains. One of these scenarios outlines the concern for inequality in salary. No doubt, nursing as a field is subjected to occupational gaps; however, due to some undefined reasons, there is a significant gap in the pay of Black and Hispanic nurses as compared to the White and Asian nurses. The authors, upon analyzing the nursing scenario, discuss that Black and Hispanic nurses are comparatively lesser in number. In other words, their representation demographics, overall, lag far behind their counterparts.

Such disparities will not cease to exist unless and until concrete measures are taken by the administrative bodies in favor of nurses. The American Nurses Association is one such organization that strives for the betterment of nursing scenario. For that, they suggest the individual nurses address the issue, recognize its potential impact, confront discrimination and takes steps to prevent or tackle it. Also, ANA suggests that nurses partake in self-reflection programs where they can quickly comprehend their weaknesses and work towards the growth of their personal as well as professional career. In terms of their professional responsibility—nurses must be ready to conform to the required standards and follow the policies that ideally define civility and human rights. 

No doubt, nursing is easily affected by disparities courtesy of its close association with the academic institutions, which are the root cause of the differences or unfairness. Nevertheless, with proper measures in-store, the conventional working methods can always be constrained and put to bed. Hence, it’s imperative to address these issues with stricter and collaborative measures.

Proposal to Change

Although numerous measures can be taken to resolve the disparities related to healthcare, the most viable is the appointment of professionals from minority backgrounds. The efforts to increase the number of health professionals from diverse background date back to the 1970s; however, no concrete difference has been observed. Besides, as per the studies, non-whites are more likely to live in the neighborhood which lacks healthy resources.

Thus, an administrative effort should be made to put the diverse workforce into place. The advantages of such a workforce are innumerable. With the colored professionals at service, there will be hardly any trust issues, and the number of refusals mentioned above will decrease. In addition to that, professionals from minority backgrounds will be successfully able to infer the needs of the people, which will play a significant role in reducing the racial/ethnic disparities in health care.

With that being said, the Cultural Care Diversity and Universality theory will aptly suit the proceedings of the proposal. Because mass recruitment won't take place immediately, it will be Madeleine's theory that will pave the way for limiting the disparity in the meanwhile. Besides, its impact will act as a supporting element to the proposal because more and more people will recognize the peculiarities attached to the theory and consequently comprehend the true meaning. Most importantly, the approach has been developed based on experiences with patients, families, friends’ parents and groups and therefore, is an outcome of original thinking—a fact which is suggestive of the concept's ground importance. 

Additionally, the theoretical assumptions considered by Madeleine add a moral touch to it, which is very important for the healthcare systems to consolidate within their day-to-day workings. The theory asserts that care is the crucial factor of growth and concurrently acknowledges the existence of expressions, forms and patterns. Consequently, the theory implies that only when the nurse has excellent comprehension of the environment and the people, sustainable and equal healthcare systems can be fostered. 

With regards to the academic institutions—the theory incorporates the teaching, training and learning of professional care practices, which conform to the legal surroundings and perpetually work in favor of upright treatment. Besides, the theory emphasizes the need to have a grasp over the cultural values and traditional knowledge that are utterly important to garner an environment saturated with the concepts of support, assistance and encouragement. In simple words, the theory aligns appropriately with the increased hiring of non-white people at various academic institutions. 

Conclusion

Racial and Ethnic disparities in health care have been reduced but not to a considerable extent. The racial and ethnic disparities in health care essay laid out the numerous factors, which give rise to this inequality. For most of the part, socioeconomic background stands out as one of the most significant contributors to disparity for it disallows the people from minorities to leverage the facilities otherwise regularly available to the Whites. Furthermore, the paper emphasizes the vitality of hiring professional individuals from the diverse ethnic background because, as per the studies, culture plays a significant role in swift treatment, learning and training. Also, the hiring of competent professionals from minorities was the proposal that this paper rendered in the name of dealing with the issue and intervening in the best way possible. Besides, the Cultural Care Diversity and Universality theory was opted to align with the proposal mentioned in the preceding statement. Altogether, the approach properly complies with the notion of adding diversity to academic institutions to foster better communication and understanding and ultimately build trust in the minds of people belonging to racial and ethnic minorities. 

References

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