assignment 2

Nezha Elomari

Capella University

Developing a Health Care Perspective

Assessment Two: Applying Research Skills

March 18, 2020

Abstract

Health care disparities have been an ongoing issue within the healthcare system that began long before the industrial age of technology. Reported and documented disparity in healthcare started well before the mid-twentieth century, where prior to the 1940’s, socioeconomic, ethnicity and gender were legal and common factors used in denying not only primary medical care but quality care to patients in the greatest need (Louis A. Penner, 2011). This paper will be discussing health care disparities and any current community health care improvement plans that are currently in place or that will soon be in place to address current health care disparity practices, such as access to primary healthcare but mainly health care disparities.

Keywords: health disparities, community health assessment, community health improvement

plan, strategic planning, local health departments, health inequities

Health Care Disparities

As a Licensed Practical Nurse working towards a Bachelor of Science in nursing, I can attest to the level of quality care and primary care for patients of color being unsatisfactory compared to care provided to Caucasian patients. According to research and past practices, one of the most important factors that contribute to health care disparities is limited access to healthcare (Louis A. Penner, Health Care Disparities, 2011). Incidents of health care disparity occur when a minority of African or non-white individual are assessed through the lenses of stereo types, discrimination, prejudice and racial bias. There is primary care and that is having access to a doctor but not necessarily a doctor that practices equity and quality care for patients. Health care facilities believe that one leading way to reduce disparity is to improve access to medical care for those with limited access. However, based on a study Journal of National Medical Association; “Racial and ethnic disparities in health care exist even when insurance status, income, age, and severity of conditions are comparable, And because death rates from cancer, heart disease, and diabetes are significantly higher in racial and ethnic minorities than in whites, these disparities are unacceptable. These differences in health care occur in the context of broader historic and contemporary social and economic inequality and persistent racial and ethnic discrimination in many sectors of American life (Nelson, 2002).”

A scenario of racial bias that occurred in my field of practice in the years between 2024-2017, dealt with one where the patient was not only African but elderly and a woman. This patient had complained about pains in her lower back to her, who in turn ordered multiple x-rays of her back and stomach. The Primary Care physician was a male of Indian and Caucasian descent, who released her after several visits over a period of 7 years as listed in her file as being a herniated disk and a procedure to have her back operated on and the herniated disk removed. Unfortunately, it was discovered a year after the procedure was performed that the mass that was sitting on the x-ray for the last 7 years causing the patient intense pain was stage 4 cancer and it had been cut into from the lower back and spread to the patients lungs who died within 4 months after the proper diagnosis was discovered. This instance helped me as a woman who is also a minority but not African American, understand how easy it is to dismiss patients concerns simply because they are elderly, a woman or minority. Since that time, I have endeavored to help prevent health care disparity related treatment, sickness or death by assisting very busy Head Physicians and Administrators. I assist then with sorting through cases based on proper diagnosis and patient need by practicing uniformity in my care of patients that I service as well as proactive listening and practicing cultural diversity and sensitivity.

Identifying Academic Peer-Reviewed Journal Articles

Using BSN Program Library Search Guide, Capella University Library’s search engine, I accessed databases relating to health care disparities, such as Sage and ProQuest. I used keywords such as health care disparities, health care inequities, community health improvement plan to search for peer-reviewed literature relevant to health care disparities. Using Capella Library Search, Sage and ProQuest, not limited my search to scholarly and peer-reviewed journals but choosing also articles within books which gave more detailed contexts on the subject such as the book. It was a challenge to find detailed articles that fell within the three to five-year time frame recommendation.

Assessing Credibility and Relevance of Information Sources

All of the articles and journals that were selected for this paper were credible. Some of the articles were a little older than 5 years but the information still as relevant today as when it was written due to the information being foundational and credible because it was built on historical incidences. The writers of each journal, article and book reviewed were from credible publishing companies and medical professionals as well as historians of the field of study.

Using key words such as health care disparities and health inequities, I was able to find enough credible scholarly articles to support my topic choice.

Annotated Bibliography

Louis A. Penner, T. L. (2011). Health and Health Care Disparities. In M. H. John F. Dovidio, The SAGE Handbook of Prejudice, Stereotyping and Discrimination (pp. 472-490). Sage Publishing.

This article speaks in detail about the health care disparities based of biological make up and socioeconomical status. If the biological factors such as gender, age, skin color, nationality, education and living environment are not main variables considered when treating the patient as the driving factors used to make medical decisions, then health care disparities could be eliminated officially or brought down to less incidents that actual result in the death of a minority for a condition that can be treated or that is preventable. This article also discusses how physician bias plays a big part in level of quality care received.

Louis A. Penner, S. M. (2018). Patient Stigma, Medical Interactions, and Health Care Disparities: A Selective Review. The Oxford Handbook of Stigma, Discrimination, and Health.

This article discusses the research that determined the differences in life expectancy between a black male and white male being more than 20 years just by neighborhood location alone. Racial differences in illness and death from many of the leading causes of death (e.g., cardiovascular disease, diabetes, cancer) would be easy to ignore were they not so well documented. The quality in health care received between black patients and white patients have shown a stigma attached to the minority patient where the stigma represents the devaluation of a social identity, often involving the association of stigmatized individuals with certain attributes that are usually negative and undesirable (Link & Phelan, 2001) and a loss of social status or value associated with that social identity(Louis A. Penner S. M., 2018). Cancer incidence rates for all cancers combined are highest for black men compared to all other racial and ethnic groups, and mortality from most major cancers is highest among African Americans (Louis A. Penner S. M., 2018). This brings me back to the patient that was an elderly black woman who was misdiagnosed several times over a 9 year period and didn’t received proper diagnosis until a practicing black male doctor assessed the patient. By this time it was too late and the patient was in stage 4 cancer of the uterus that spread to the lungs after lower back surgery.

Nelson, A. (2002). Unequal treatment: Confronting racial and ethnic disparities in health care. Journal of the National Medical Association, 666-668.

Thomas, S. B. (2019). Racial and Ethnic Disparities as a Public Health Ethics Issue. The Oxford Handbook of Public Health Ethics, 277-91.