Session 5: Healthcare Disparities - POGOe



ELDER Project

Fairfield University School of Nursing

Cultural Diversity

Healthcare Disparities

Session 5

Objectives:

At the end of this session, the participants will be able to:

1. Define ethnocentrism and the implications cultural differences have on healthcare.

2. Identify factors that contribute to health disparities.

3. Examine the demographics of these disparities in the local and state area.

4. Identify cultural competence as an effective strategy to address health disparities.

Food Presentation…………………………………………….………………5-10 minutes

Depending on one or two presenters

Healthcare Disparities…………………………………………………………..40 minutes

A. Introduction:

Every culture:

o defines what health is for its members

o determines etiology of diseases

o establishes parameters within which distress is defined

o signals and prescribes the appropriate means to treat the disorder

Understanding a person’s culture is fundamental to providing medical care.

Contrasting values may result in conflicting expectations of involving others in providing care.

B. Ethnocentrism:

The belief or attitude that one’s own cultural view is the only correct view.

It can cause healthcare providers to misinterpret cross-cultural situations, which can:

o lead to miscommunication, stereotypes and disrespect

o cause a breakdown in the delivery of culturally competent care.

Racial/Ethnic Composition of Fairfield County, Connecticut:

|Group |Percentage of the Population |

| | |

|White |83% |

| | |

|White/Non-Hispanic |68.5% |

| | |

|Hispanic/Latino |16% |

| | |

|Black/African American |11% |

| | |

|Asian |4.5% |

| | |

|American Indian |0.3% |

| | |

|Pacific Islander |0.1% |

Source: Fairfield County Quick Facts from the US Census Bureau

o That of minority racial/ethnic groups will influence the future health of the U.S. substantially.

o Differences in treatment contribute to higher death rates for minorities.

C. Health Disparities:

Those avoidable differences in health among specific population groups that result from cumulative social disadvantages.

Population groups experience:

o reduced healthcare quality and access

o increased rates of disease

o disability

o death

D. Factors that Affect Health Status and Access to Healthcare:

o Socioeconomic position

o Income

o Education:

▪ Education and income are both independently linked to health

▪ Death rates from chronic disease, communicable diseases and injuries are inversely related to education.

▪ Education is a benchmark for building literacy skill. Limited education causes a large percentage of adults in the US to have great difficulty successfully performing health-related literacy activities.

o Housing

o Employment

o Health barriers

o Individual biological susceptibility

o Early childhood and familial influences

o Access to power/ decision-making/ supportive resources

▪ Racial and ethnic minority Americans are less likely to possess health insurance.

▪ Lack of heath insurance coverage has been identified as the single most important factor in explaining differences between health status of African Americans, Hispanics and Whites.

▪ Minority population groups who are poor, lack resources and have less than a high school education are likely to have limited literacy skills.

E. Health Literacy:

The degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.

F. Healthy People 2010:

People with low health literacy are:

o less likely to report poor health,

o less likely to have a complete understanding of their health problems and treatments,

o at greater risk of hospitalization

G. Facts about Health Disparities:

o Blacks or African Americans suffer worse health outcomes than any other race.

o Blacks or African Americans suffer more from major chronic diseases than whites in the following disease categories:

Heart disease………………………..20% higher

Cancer………………………………..20% higher

Stroke/cardiovascular disease…….30% higher

Diabetes………………………………3 times higher

HIV/AIDS……………………………..16% higher

Unintentional injuries………………..40% higher

o Hispanics or Latinos are the fastest growing population in the nation and the largest ethnic group in Connecticut

o American Indians and Alaska Natives suffer extraordinarily high rates of The following diseases:

TB…………………………………….600% higher

Alcoholism …………………………..510% higher

Motor Vehicle Crashes……………..229% higher

Diabetes ……………………………..189% higher

Unintentional injuries………………..152% higher

H. Target Areas for the Elimination of Health Disparities by the US Department of Health and Human Services:

o Cancer

o Cardiovascular Disease

o Infant Mortality

o Diabetes

o HIV/AIDS

o Child and Adult Immunizations

Connecticut Department of Public Health has added the following to their Surveillance:

o Asthma

o Obesity

o Oral Health

o Infectious Diseases and Sexually Transmitted Diseases

o Environmental Health

|Target Areas |Descriptor |

|U S Department of Heath and Human Services |The Connecticut Health Disparities Project, CT DPH Fall 2007 |

|Cancer |Significant racial differences in appropriate diagnostic testing |

| |and treatment. |

|Cardiovascular Disease |Minorities are less likely to be given appropriate cardiac |

| |medications or to undergo bypass surgery. |

| | |

| |African Americans suffer strokes at a 35% higher rate than whites|

| |and are less likely to receive major diagnostic and therapeutic |

| |interventions. |

|Infant Mortality |Minority women are less likely to undergo Cesarean sections. |

| | |

| |Children are less likely to get prescription medications. |

| | |

| |In Connecticut, women in these groups have the highest percentage|

| |of late or no prenatal care in the first trimester and the |

| |highest rate of low birth weight infants. |

|Diabetes |Minorities have higher death rate and illness from diabetes. |

| | |

| |African Americans are less likely to get key diagnostic tests. |

| | |

| |Minorities are more likely to get less desirable procedures, i.e.|

| |lower leg amputations. |

|HIV/AIDS |Minorities are less likely to receive antiretroviral therapy and |

| |other state-of-the-art treatment. |

| | |

| |In Connecticut, it is more prevalent in Hispanics and Blacks. |

|Child and Adult Immunizations |The following groups receive influenza vaccine: |

| |48% of African Americans |

| |56% of Hispanics |

| |67% of Whites |

| | |

| |The following groups receive the pneumococcal vaccine: |

| |31% African Americans |

| |30% Hispanics |

| |57% Whites |

| | |

| | |

|Connecticut | |

|Asthma |African Americans are less likely to receive appropriate |

| |medications to manage chronic symptoms. |

| | |

| |Highest incident is seen in Hispanic and Black children. |

|Obesity |Seen more in lower income groups (less than 25,000/year). |

| | |

| |Linked to hypertension, high cholesterol and triglyceride levels,|

| |diabetes, heart disease and cancer. |

|Oral Health |The incidence of tooth decay in kindergarteners and third graders|

| |includes: |

| |49.3% Hispanics |

| |43% African Americans |

| |42% Asians |

| |28.9% Whites |

|Infectious Diseases and STDs |The highest incidence of Tb is among Asian residents. |

| | |

| |STDs (Chlamydia, gonorrhea, syphilis) are more prevalent in the |

| |African American community. |

|Environmental Health |Hispanics have 2.4 times more non-fatal work related injuries and|

| |illnesses than whites. |

| | |

| |Blacks and Hispanic residents of all ages have the highest asthma|

| |hospital rates (332 per 100,000 populations) than whites (84.5 |

| |per 100,000 populations). |

| | |

| |Native American children have three times higher lead blood |

| |levels than whites. |

| |Blacks have 2.7 times higher levels than whites. |

Group Activity: “Being a Minority” Exercise……………………………..…15 minutes

Conclusion:

Cultural competence is a strategy to improve quality and address disparities. The goal is to provide the highest quality care to every patient regardless of race, ethnicity and culture or language proficiency.

References:

CT Department of Public Health. (2009). Facts About Health Disparities in Connecticut, 2009. Retrieved October 10, 2010 from dph/lib/dph/hisr/pdf/facts_cthealth_disparities_2009.pdf.

Fairfield County QuickFacts from the US Census Bureau. Retrieved October 16, 2010 from .

Heath Disparities Report. (2009). Retrieved October 16,2010 from dph/lib/dph/multicultural_health/2009/ct_healthdisparitiesreport.pdf.

Stratton, A., Nepaul, A,, and Hynes, M. (2007). Issue Brief-Defining Health Disparities.. Retrieved October 10, 2010 from dph/lib/dph/hisr/pdf/defining_health_disparities.pdf.

Stratton, A., Nepaul, A,, and Hynes, M. (2007). Issue Brief-Race and Ethnicity Matters: concepts and Challenges of racial and Ethnic Classifications in Public Health. Retrieved October 10, 2010 from dph/lib/dph/hisr/pdf/race_and_ethnicity_matters.pdf.

Yeo, G. (2010). Culture Med Ethnogeriatrics Overview Introduction. Retrieved November 6, 2010 from .

Yeo, G. (2010). Culture Med Ethnogeriatrics Overview Patterns of Health Risk. Retrieved November 6, 2010 from

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download