Question

Please discuss in DETAIL the characteristics of certain U.S. population groups that face challenges and barriers in accessing health care services by including groups such as: Racial/ethnic minorities, children and women, persons living in rural areas, those who are homeless, migrant workers, mentally ill individuals and persons with HIV/AIDS.

*Please answer in detail and provide all websites used!!*

Thank you!

Answer 1

The vulnerable populations in the US continue to face significant disparities, including risk factors, access to health care, morbidity, and mortality despite efforts and goals to reduce or eliminate disparities in healthcare by 2010. The health care disparities refers to differences in health and health care between population groups like (vulnerable populations ) the economically disadvantaged, racial and ethnic minorities, the uninsured, low-income children, the elderly, the homeless, those with human immunodeficiency virus (HIV), and those with other chronic health conditions, including severe mental illness. The healthcare disparities occur across many dimensions, including race/ethnicity, socioeconomic status, age, location, gender, disability status, and sexual orientation. It can impose a higher burden of illness, injury, disability, or mortality experienced on one group relative to another. The terms health inequality and inequity also are used to refer to disparities.

The healthcare disparities are commonly viewed through the lens of race and ethnicity, but their dimensions occur across a broad range.

of dimensions. The Federal efforts to minimize the disparities focus on priority populations who are vulnerable to health care disparities, including people of colour, low-income groups, women, children, older adults, individuals with special health care needs, and individuals living in rural and inner-city areas.

The effects of healthcare disparities not only affect the groups facing disparities but also hinders the quality of care and health for the broader population and result in unnecessary costs. It is also important to address the health care disparities as the population becomes more diverse.

The vulnerable population must be able to conveniently and confidently access services such as primary care, dental care, behavioural health, emergency care, and public health services for achieving the goal of Healthy People 2020. Proper access to healthcare can ensure the following aspects:

•        Overall physical, social, and mental health status

•        Prevention of disease

•        Detection and treatment of illnesses

•        Quality of life

•        Preventable death

•        Life expectancy

In order to ensure adequate health care for the vulnerable population, they must have sufficient healthcare access, availability of necessary and appropriate services in a timely manner. In spite of the adequate supply of healthcare services exists in the community some other factors affects the healthcare access like financial means to pay for services - health insurance coverage accepted by the provider, transportation means to reach and use services, medical leave - ability to take paid time off of work to use the services, effective communication with healthcare providers by overcoming the language barriers, confidence in the healthcare services without compromising privacy, trust in the quality of the care that they will receive.

To improve health care access; every barrier must be addressed effectively.

1. Health Insurance Coverage

The problem of lack of health insurance coverage hinder the vulnerable people from seeking proper timely care. The authorities must consider designing and implementation of appropriate programs, especially for the needy community.

2. Shortages of the healthcare workforce

The shortage of healthcare professionals in rural America is a factor for limited access to care by limiting the supply of available services. According to HRSA.gov Preformatted Report -September 2018, 57.27% of Primary Care Health Professional Shortage Areas were located in rural areas. The redistribution and strengthening of the workforce to ensure adequate representation of rural areas must be done promptly.

3. Distance and Transportation

The vulnerable population including rural people has to travel long distances to access health care services, especially the specialist care services. This will add to burden in terms of both time and money. The arrangements of proper transportation by means like public ambulance can help in this situation. The care must be made available in rural areas as far as possible. The periodic health checkups by the healthcare workers also can reduce the transportation barriers.

4. Social Stigma and Privacy Issues

Many vulnerable communities still have a social stigma and privacy concerns and they may act as barriers to healthcare access. The people will have concerns about seeking care for issues related to mental health, substance abuse, sexual health, pregnancy, or even common chronic illnesses due to this issues. Proper health awareness programmes can be helpful in this situation to improve their understanding about confidentiality and the treatment means of a healthcare system.

5. Poor Health Literacy/communication barriers

The people’s ability to understand the health information and instructions from their healthcare providers also must be considered to improve the healthcare access. The healthcare workers with knowledge on the local languages and the use of local leaders to impact the people can reduce this barrier.

The basic healthcare -Primary care is the most important aspect to improve the health status of the community. Effective distribution of primary care along with emergency services can reduce the healthcare gap.

6. Co- morbid conditions

The existence of co-morbid conditions is common in the vulnerable population. The proper management of co-morbid conditions improves the health of the community.

The primary care services to improve health care access:

• Prevention services like improving healthy practices, immunization and early disease detection
• Effective coordination of care
• Lower the mortality rates
• Reduction in low birth weight
• Improved health behaviours
• Ensuring effective obstetric Services with the help of midwives and thereby reducing the maternal and infant mortality and morbidity rates.
• Family-based Mental Health Services and behavioural health aides
• Promoters (or community health workers) with supplemental training in mental health
• Oral Health Services
• Substance Abuse Services offered at the grass root level

The vulnerability of rural people also enhanced by race, ethnicity, age, sex, and factors such as income, insurance coverage, and absence of a care facility. In order to solve the health and health care problems, the intersecting with social factors, including housing, poverty, and inadequate education etc. must be considered.

Unexplained Vulnerability Associated with Race, Ethnicity, Sex

The characteristics of Race, Ethnicity, Sex also have been shown to be associated with differential health care and inferior health status.

Many studies have pointed out significant differences in treatment by race, ethnicity, and sex that is not explained by other demographic differences, insurance status, clinical factors, or provider characteristics. Ball and Elixhauser, 1996 found that African Americans with colorectal cancer have been found to be treated less aggressively than their white counterparts (Ball and Elixhauser, 1996). Hellinger, 1993, showed that even after being diagnosed and having accessed the health system women with AIDS receive fewer services than men with AIDS.

References:

1. https://www.ajmc.com/journals/supplement/2006/2006-11-vol12-n13suppl/nov06-2390ps348-s352?p=2

2. http://govinfo.library.unt.edu/hcquality/meetings/mar12/papch08.htm

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319434/

4. https://www.ruralhealthinfo.org/topics/healthcare-access#barriers

5. https://www.kff.org/disparities-policy/issue-brief/disparities-in-health-and-health-care-five-key-questions-and-answers/

6, https://www.ncbi.nlm.nih.gov/books/NBK425844/