Case Study Introduction Healthcare policy, like most policy is not always easy to pass through all the channels and actually come out as law. In fact, it may go….
Racial and Ethnic Disparity in Healthcare
The population of United States of America is quite diverse as there is substantial numbers of African-American, Hipic, Native American or Asian/Pacific Islander living here. The numbers of non whites is enormously increasing in the country. In 1900, one in eight American was non white but at present one in four is non white and it is estimated that by the year 2070, each one of two American will be non white. (US Census Bureau 2005) This changing composition of population is making differences in various sectors but the nation is facing an important challenge with respect to the biasness in healthcare.
The overall healthcare of the country is impressively improving but this improvement is not being equally shared by all the racial and ethnic groups of nation. Non white population is getting divergent and low level medical treatment and care as compared with the white people and this difference has created healthcare disparities among the minorities. There are several causes behind these growing healthcare disparities among the minorities and several strategies have also been designed in order to cope up with this problem.
This paper is proposing to conduct a quantitative research in order to highlight the root causes of healthcare disparities, strategies to overcome this problem and the attitude and role of the nation towards these disparities. The paper provides the background information, statistic data, need, purposes, significance and methodology of research. Introduction Disparity is “the condition or fact of being unequal, as in age, rank, or degree” and healthcare disparity refers to unsatisfactory situation when patients receive unequal medical treatment and care.
When the medical care and treatment become unequal on racial and ethnic grounds, it gives rise to minorities healthcare disparities. Many researches have proved that in United States of America, people belonging to different races are not getting equal healthcare and the healthcare disparities among the minorities is extensively increasing. The quality of medical care and treatment is different for minorities There are some basic factors responsible for this disparity like “differences in socioeconomic level i. e.
income and education, language barriers, differences in health behaviors of consumers, lack of diversity in the health care workforce, lack of multi-cultural knowledge and actual discrimination and stereotyping by health care providers” (American Hospital Association). The death rate of African, South Asian, Hipia American due to severe diseases is considerably higher then that of white Americans. In order to avoid these disparities authentic researches are required that can highlight the problem areas and then design the strategies for improving the healthcare situation of minorities.
A research study is proposed in order to find out the role of healthcare provider in promoting these healthcare disparities. The research will focus on the behaviors of nation especially the healthcare providers and their practice pattern in order to point out their contribution towards amplifying these disparities. It will be a qualitative research; a survey of major healthcare units where the health care providers (doctors and medical staff) and the patients (both White and Non-Whites) will be questioned about the issue.
The research will focus on the points that how the people are responding towards the strategies designed for reducing the healthcare disparities among the minority population, how much the working pattern of healthcare provider has changed for minorities, how the white people are changing their attitude for non whites and weather the victims (minority population) are feeling any difference in their treatment and care or not. The data will be access to get the key findings which will be use in order to develop future strategies for preventing and minimizing the minorities healthcare disparities.
The research will contain an introduction, background information, Statistical Data, Finding of the survey, Analysis and results, discussion, proposed strategies and conclusion. The problems statement or hypothesis for the research will be “Is our nation doing enough to reduce racial and ethnic disparity in healthcare? ” Background Information There is great rise in healthcare discrimination for minorities in United States. Despite the improved national healthcare situation, the minority population is facing more problems regarding their health.
Following is the background information about the health condition of African Americans, Hipics, South Indian and Native Americans, and islanders. The infant mortality rate is going down in America but the African American still have a high infant mortality rate which is almost double than the white Americans. “Heart disease death rates are more than 40 percent higher for African Americans than for whites. The death rate for all cancers is 30 percent higher for African Americans than for whites; for prostate cancer, it is more than double that for whites.
African American women have a higher death rate from breast cancer despite having a mammography screening rate that is nearly the same as the rate for white women. The death rate from HIV/AIDS for African Americans is more than seven times that for whites; the rate of homicide is six times that for whites. During 2001-2004, 68% of all women reported with AIDS were African American; among men, just under half (44%) of the new cases of HIV and AIDS were in African Americans. Lupus is three times more common in African American women than in white women.
African American women tend to develop symptoms at an earlier age than other women, and have more severe organ problems, especially with their kidneys. ” (Health People 2010) The Hipic population is also facing low level medical care which has resulted in their poor health conditions. Among the new cases of tuberculosis registered in America during 1996, almost 20% were Hipic. The number of Hipic Americans dieing from diabetes is almost double then the non Hipics.
They also have high blood pressure and obesity rate as compared with non Hipics. “Only 18% of Hipics with high blood pressure have this condition under control, compared with 30% of whites. Type 2 diabetes is being diagnosed more often in Hipic children and adolescents than in the past. Only 42% of Hipics aged 65 years or older receive a pneumonia or annual flu shot, compared with 63% of whites. Only 28% receive the pneumonia shot, compared with 61% of whites.
Hipics have the second highest rate of HIV/AIDS diagnoses and account for 18% of all HIV/AIDS cases. In 2004, non-Hipic black persons were less likely than non-Hipic white persons to have received a flu shot during the past 12 months (Non-Hipic black: 32. 9%; Non-Hipic white: 50. 9%), and were also less likely to have ever received a pneumococcal vaccination (Non-Hipic black: 38. 6%; Non-Hipic white: 60. 9%)”. (CDC, 2007) The American Indians and Alaska natives are also the minority nations having bad health conditions.
The diabetes and infant mortality rate is almost double among them as compared with the white Americans. “The Pima of Arizona have one of the highest rates of diabetes in the world. American Indians and Alaska Natives also have disproportionately high death rates from unintentional injuries and suicide. ” (CDC) The health condition of Asians and Pacific Islanders is considered as “one of the healthiest population groups in the United States” but there are still data that proves that this population is also facing healthcare diversities.
For example “the women of Vietnamese origin suffer from cervical cancer at nearly five times the rate for white women. New cases of hepatitis and tuberculosis also are higher in Asians and Pacific Islanders living in the United States than in whites. Pacific Islanders are more than twice as likely as whites to receive a diagnosis of diabetes. Although the estimated HIV/AIDS rate among Pacific Islanders is the lowest in the United States compared with all other racial and ethnic groups, the rate increased an average of 9% each year during 2001–2004.
” (Healthy People 2010) There are many diseases which are very common among the minorities and causing high death rates among them. These diseases include Infant Mortality, Hepatitis, Tuberculosis, Mental Problems, Cancer, Heart Diseases, Diabetes, Immunizations and HIV AIDS. These diseases are effecting the health situation of minorities at large for example, the “African-American, American Indian, and Puerto Rican infants have higher death rates than white infants. In 2000, the black-to-white ratio in infant mortality was 2. 5 (up from 2. 4 in 1998).
African-American women are more than twice as likely to die of cervical cancer as are white women and are more likely to die of breast cancer than are women of any other racial or ethnic group. In 2000, rates of death from diseases of the heart were 29 percent higher among African-American adults than among white adults, and death rates from stroke were 40 percent higher. In 2000, American Indians and Alaska Natives were 2. 6 times more likely to have diagnosed diabetes compared with non-Hipic Whites, African Americans were 2. 0 times more likely, and Hipics were 1.
9 times more likely. African Americans and Hipics accounted for 66 percent of adult AIDS cases and 82 percent of pediatric AIDS cases reported in the first half of that year” (NCHS 2002) whereas In 2001, Hipics and African Americans aged 65 and older were less likely than Non-Hipic whites to report having received influenza and pneumococcal vaccines (MMWR, 2002) The mental problems of the minorities are also an important point of concern as “American Indians and Alaska Natives appear to suffer disproportionately from depression and substance abuse.
Minorities have less access to, and availability of, mental health services. Minorities are less likely to receive needed mental health services. Minorities in treatment often receive a poorer quality of mental health care. Minorities are underrepresented in mental health research. ” (Mental Health Report 1999) In 2002, 50 percent of those infected with Hepatitis B was Asian Americans and Pacific Islanders. Black teenagers and young adults become infected with Hepatitis B three to four times more often than those who are white.
One recent study has found that black people have a higher incidence of Hepatitis C infection than white people. (Department of Health and Human Services) Of all the TB cases reported from 1991-2001, almost 80 percent were in racial and ethnic minorities. Asian Americans and Pacific Islanders accounted for 22 percent of those cases, even though they made up less than four percent of the U. S. population. (NCHSTP Division of TB Elimination) Medical Care and Treatment of Minorities
The poor health condition of the minorities is caused by unequal medical treatment and care. The minority people are in great need for better medical facilities because they are suffering from severe diseases at higher rates but there is not proper access of minorities to the healthcare facilities. Some factors are responsible for this issue like “lack of health insurance, an inadequate number of health care facilities, patient dumping, difficulty in obtaining prescription drugs and an insufficient number of African-American doctors.
” (Cara A. Fauci, 1996) There is lack of medical facilities availability to the minority population for example, the “African Americans are 13 percent less likely to undergo coronary angioplasty and one-third less likely to undergo bypass surgery than are whites, Among preschool children hospitalized for asthma, only 7 percent of black and 2 percent of Hipic children, compared with 21 percent of white children, are prescribed routine medications to prevent future asthma-related hospitalizations.
The length of time between an abnormal screening mammogram and the follow up diagnostic test to determine whether a woman has breast cancer is more than twice as long in Asian American, black, and Hipic women as in white women. African Americans with HIV infection are less likely to be on antiretroviral therapy, less likely to receive prophylaxis for Pneumocystis pneumonia, and less likely to be receiving protease inhibitors than other persons with HIV.
An HIV infection data coordinating center, now under development, will allow researchers to compare contemporary data on HIV care to examine whether disparities in care among groups are being addressed and to identify any new patterns in treatment that arise. Asian American, Hipic, and African American residents of nursing homes are all far less likely than white residents to have sensory and communication aids, such as glasses and hearing aids. A new study of nursing home care is developing measures of disparities in this care setting and their relationship to quality of care.
” (AHRQ Fact Sheet 2000) Following is the chart that shows the total number of deaths in America during the year 2001 and the ratio of different minorities’ death due to different diseases. The Need to Conduct the Study: The above stated information clearly throws the light on the situation of minorities’ health in United States. The current scenario is not very positive and hopeful for the people living in US, belonging to different races and ethnicity. The situation demands the attention of scholars and social scientists to work for its betterment.
Research studies are greatly needed in the field of healthcare disparities of minorities because the results of the researcher will work for formulating strategies that can reduce the disparities and make the situation better. To eliminate the racial and ethnic discrimination in healthcare sectors it is very necessary to have a research support so that there could be a better understanding of healthcare disparities among the government, healthcare providers, insurers, employers, hospital staff, physicians, patients and general public.
Several researches have been conducted with the aim to minimize the healthcare disparity. These researches worked out for authentic data and strategic plans but despite all that there is no significant improvement in this field. Now a research is much needed to know the impact of previously taken steps so that the new plans can be designed. There is a great need to know weather those steps and strategies are working or not. It is required to find out the response of public towards the strategies and steps that have been taken in order to create awareness among people about the healthcare disparities of minorities.
The change in the working pattern of healthcare providers and their behaviors towards the minorities is also need to be found out. All these requirements can be fulfilled by this proposed study as it is intended to focus upon the nation’s role in minimizing minorities’ healthcare disparities. It is also required to measure the differences in the medical treatment given to the people of different races so that a clear picture of the issue could be achieved.
The report of the proposed research will also provide authentic data and detailed background information of the issue that will aid in formulating policies for the betterment of the sector. The Purpose and Objective of Research The research study is aimed at improving the healthcare conditions of minorities in United States by expanding the information about the minorities’ healthcare with reference to particular diseases like heart problem, cancer, AIDS and infant mortality etc.
It will point out the main diseases and their relative medical care conditions for the minority people. This data will help in the formulation of health policy for the minorities also it will throw the light on the main health problems among minorities that could make them conscious about their health. The study will be directed by the objective of enhancing the understanding of issue at national and governmental level and to underline the negative consequences of the issues so that there could be great awareness about reducing the disparities.
Through the study people will be insisted to change their thinking about the minorities and changing their behaviors. The healthcare providers who discriminates the minority people will be accessed and they were asked to analyze their attitude towards minorities. Their personal analysis of their attitude could be helpful in making changes in their way of thinking and as a result there could be betterment in situation for the non white and low income people who are not getting proper medical care from them.
The purpose of the study is also to investigate people about their troubles and to point out the major problem areas like language barrier or other so that the monitory population will also get some idea to overcome this discrimination. The survey could be a great opportunity for the minorities to express their thinking and to share their experiences. It will develop a communication link among different people of the society. The principle factors responsible for the disparities among the racial and ethnic groups will also come in front of people, as a result of this study.
In short the purpose of the study is to get a better understanding of the minorities healthcare disparities and to find out the ways for the reduction of this disparity. It will be a systematic approach and managed effort for minimizing the minorities healthcare disparities. Significance of the Research The research will focus on the purpose of eliminating the healthcare disparities among minorities. The study will work to collect the data related to the issue from all possible sources then its analysis and interpretation for digging out some points that can help in making situation better.
This effort will result in the gathering of complete authentic background information about the issue that will be helpful for the other scholars intended to work in the field. The data will also provide the students of this field a deep and detailed view of the issue. The systematically gathered data about the health condition and medical care will facilitate the policy making people and while formulating the health policy for minorities, it will be significant to know their health condition with respect to several diseases and their treatment.
The major problems area will be identified easily. The research is proposed to done in quantities method and the data gathered through the survey from different people will provide a picture about the thinking and interpretation of the issue. The social scientists and psychologists can also dig out some solutions from the thinking style of people and they can also work for changing people behaviors and their perception of the issue.
Some researches have been done by different organizations that focused on minority healthcare disparities and strategic plan for their reduction. Many of the researches are done under the supervision of credible organizations. A research was conducted by the “Agency for Healthcare Research and Quality – AHRQ” in the year 2003, under the name of “National Healthcare Disparities Report”. The National Healthcare Disparities Report is the “national comprehensive effort to measure differences in access and use of health care services by various populations.
The report includes a broad set of performance measures that can serve as baseline views of differences in the use of services. The report presents data on differences in the use of services, access to health care, and impressions of quality for seven clinical conditions, including cancer, diabetes, end-stage renal disease, heart disease, HIV and AIDS, mental health, and respiratory disease as well as data on maternal and child health, nursing home and home health care, and patient safety.
It also examines differences in use of services by priority populations. ” (AHRQ) The 2003 report is also available online at http://www. qualitytools. ahrq. gov/disparitiesreport/2003/download/download_report. aspx. Another research “Racism and Health Care in America: Legal Responses to Racial Disparities in the Allocation of Kidneys” was conducted by Cara A.
Fauci in the year 1996 which “proposes and analyzes various responses to disparities in kidney allocation on the basis of race including public education, organ donation publicity campaigns, presumed consent to donation laws, the creation of criteria for placement on an United Network for Organ Sharing kidney allocation waiting list, alteration of kidney allocation guidelines, and litigation under both the Equal Protection Clause of the United States Constitution and Title VI of the Civil Rights of 1964. ” This report is also available online at http://www. bc. edu/bc_org/avp/law/lwsch/journals/bctwj/21_1/02_TXT.
htm Another research is done by AHRQ “Strategies for Improving Minority Healthcare Quality”. The research is focused at developing scientific information for other agencies and organizations on which to base clinical guidelines, performance measures, and other quality improvement tools. Contractor institutions review all relevant scientific literature on assigned clinical care topics and produce evidence reports and technology assessments, conduct research on methodologies and the effectiveness of their implementation, and participate in technical assistance activities (AHRQ Fact Sheet)
The Hypothesis or Problem Statement and Introduction of Research The research study will focus on the nation’s awareness about the minorities’ healthcare disparities and will focus on the attitude and thinking ways of general public and healthcare providers. The problems statement or hypothesis for the research will be “Is our nation doing enough to reduce racial and ethnic disparity in healthcare? The problem statement will be expresses in the questionnaire.
A survey will be done among the healthcare providers, white Americans and non white Americans in which they will be asked to express their views about the role of nation for reducing the disparities of health care. It will be evaluated weather there is complete awareness among the people about the issue or not. The strategies designed by different research organizations are successful in changing nation’s way of thinking or not. The general public also has discrimination with each other and do the white people think it is justify carrying on the discrimination with non whites.
Method and Introduction of the Research Study The research study will be quantitative. It will be a survey which is to be conducted among the healthcare providers and general public. Keeping in view the problem statement, a survey questionnaire would be designed. The questionnaire will consists of more then 5 questions which will be aimed at finding out the people opinions and thinking about the issue. Most of the questions will be multiple choices and in some there would be open field for people to express their views.
The main question would be the same; the problem statement with sub questions i. e. “Is our Nation Doing enough to Reduce Racial and Ethnic Disparity in Healthcare? ” a) The behavior of healthcare providers varies for people of different races and ethnicity or not? b) Is there any impact of strategies planned reducing the minorities’ healthcare disparities? After the making of questionnaire, the universe for the survey would be decided; the number of people to be questioned, their geography, demography, age, sex, profession, race etc.
Survey sampling is an important part of research in which it would be decided that what would be the criteria for selecting the people from different groups either they will be picked randomly or every 10th or 20th listed in the telephone directory or other population statistical data catalog. The data gathering could be through telephone, through internet and preferably by meeting them personally. The people can be accessed in the hospitals, clinics, offices or homes.
After getting the entire questionnaire filled by the decided number of people, the next step would be finding out the results. Once the results came out they can be analyze in different ways, with respect to race and ethnicity, with respect to age, with respect to gender or with respect to profession or locality. After analyzing the key findings of the results will be use to presenting result summary of the research. The key finding will help in formulating the strategies for the betterment of situation.
there would be a discussion on the finding and proposed strategies as well as the impact of previous strategies. A conclusion would windup the research report. Contents of Research Thesis with Proposed References List In the beginning there would be an Abstract and Acknowledgement. The theses will be consisting of main chapters including Introduction, Background information and Statistical Data, Research Methodology, Research Findings or Results of the Study, Discussion, Proposed Strategies, Conclusion and Appendix.
The “Introduction” will throw light on the whole theses. It will contain basic information about the issue, the need and purpose of research study, its significance, and the outcome. The introduction is an important part of the thesis. It should be compact and comprehensive. In the next section “Back ground Information and Statistical Data” there would be complete factual information about the situation of healthcare disparities related to minorities. There would be history indicating that the problem is not very new but it has deep roots inside history.
After history there will be present picture of the issue; the ratio of different racial and ethnic groups in the population of United States and their health condition. The situation of present healthcare of minorities with regard to major diseases and their respective treatment will also be including in the background information. The quality of medical care available for different ethnic and racial groups would be an important point to focus upon. The statistical data will comprise of charts and tables indicating different diseases among minorities and death rates compared with white people.
The thirds section “Research Methodology” will describe the entire method of conducting research. It will include the problem statement, questionnaire, survey sampling, data gathering tools and methods. It will also inform about demography and geography of the people included in the study, the number of people questioned, the number of questions asked, the method of conducting survey either through telephone, internet, post or personal meetings. After the methodology, the next section will be the “Research findings” or “Results of the Survey”.
In this section there would be included the statistical data that came out from the survey questionnaires. The opinion of people would be included in percentages with respect to their race, age, geography and profession or income group. The results will clarify the study finding and highlight the public opinion. The next section i. e. “Discussion” will contain the analysis of the findings of the survey. This is the main part of the theses where the result finding will be use to analyze the current situation and the impact of previously formulated strategies.
The discussion will throw the light on the current condition of minority healthcare disparities. The discussion will be followed by the “Proposed Strategies” where there will be suggestions about the steps that could be taken in order to reduce the disparities in minority healthcare and to create better awareness in nation about the problem. In the “Conclusion” the whole thesis would be windup. It will be the end of research report which will sum up all the information, data, findings, discussion and proposals made within the theses.