When we think of equity, or equality, we often think of voting rights, equal opportunities at school and work, and the right to express yourself freely, to name a few. But what about the right to equal healthcare, no matter your socioeconomic status? As frontline healthcare providers, nurses need to be aware of the inequities in not only access to care but to the differing levels of care available to certain marginalized populations. Gaining awareness of health disparities can better prepare nurses to improve health conditions for their patients and their communities. Not all Americans are born into conditions that support their best health. Barriers to quality healthcare lead to health disparities according to the American Public Health Association. For example, some rural populations lack access to necessary medical treatment, including regular wellness visits and preventive care. Other people may have language barriers that prevent them from seeking necessary care or understanding health recommendations. Without this care, no matter the cause, health outcomes for these populations are likely to be worse than for those with easy access to care. Healthy People 2020 defines health disparity as a particular type of health difference that is linked to a disadvantage. Disadvantages include, but are not limited to, socioeconomic status, geographic location (rural or urban), sexual identity or orientation, ethnicity, race, age and disability. Dr. Susan Hassmiller, featured in a Nurse.com article, says, "Research has shown that social determinants of health such as education status, access to healthcare, social connectedness and food and housing insecurity can all affect an individual's health and well-being." Making improvements where possible can improve the chances of better health. Health equity means all people can achieve their optimal health. Identifying disparities and working to change them can help bring about health equity. And nurses are perfectly placed to do just that. Some factors that contribute to illness and chronic disease, like genetic predisposition and family medical history, cannot be mitigated. Health promotion seeks to put patients in the driver's seat for the things they can control, helping provide access where it might otherwise be limited or non-existent. Optimizing conditions for patients can help manifest health equity. For example, access to clean, uncontaminated drinking water can prevent illness and promote wellness. Safe shelter impacts the ability to sleep and protect one's health from the elements. Public parks and recreation areas make it easier for communities to engage in outdoor exercise to manage weight and support heart health. Education is a large component of health equity. Understanding how nutrition and exercise can stave off potential chronic disease benefits the population. Knowing how to select nutritious foods to build healthy bodies and having access to such foods can improve lives. People can also learn about exposure to toxic chemicals and take actions to reduce their risk. Because nurses are often more accessible than physicians, they are a valuable asset in improving health equity. Nurses understand the benefits of health promotion and disease prevention, and they have the opportunity to educate each patient who crosses their path. They are also at a particular advantage to learn more about disparities in the communities they serve. Nursing Outlook notes that additional training can improve the ability to provide patient-centered care. Nurses who are familiar with the particular challenges faced by the specific races, ethnicities and socio-economic classes under their care can improve patient outcomes. Learning about cultures in the area may provide insight that can guide treatment and help them gain more patient compliance with treatments and healthy life choices. The availability of smartphones to people at almost any economic level or location is expanding the possibilities for health equity through technology at an increasing rate. NCBI points out that mobile applications can provide some widely available health management tools to cell phone users. Educating patients about these apps can help improve health equity. Nurses can encourage patients to use mindfulness, fitness and nutrition apps, as well, to start making health changes. Technology also enables nurses to better connect with patients to assess any disparities and issues. Translation apps and photographs help patients and nurses better understand one another. A photograph of a rash, for instance, can help the nurse make recommendations for treatment or further consultation with a physician. Coletta Barrett, RN, recommends nurses serve as advocates for policy change to improve health in underserved populations. Because nurses are on the frontlines of patient care, they can provide informed insight into existing health disparities in communities. This information can help shape policies and guide community advocacy. By cultivating health equity, nurses can shape patient health on individual and community levels. Through greater comprehension of health disparities, better training on cultural health, the use of technology where possible, and advocacy for health equity, nurses can help ensure the end result of better health for all. Learn more about the University of North Carolina Wilmington's online RN to BSN program. Sources: American Public Health Association: Health Equity HealthyPeople.gov: Disparities Nurse.com: Nurses Target Health Disparities to Enact Social Change Nursing Outlook: Culturally Competent Nursing to Reduce Health Disparities The National Academies Press: The Promises and Perils of Digital Strategies in Achieving Health Equity: Workshop Summary Have a question or concern about this article? Please contact us. You are seeing this page because you are using an unsupported browser. We recommend using huddle.florence-health.com with one of the following browsers:
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Healthcare should be equally accessible to all, regardless of race, ethnicity and other factors. Unfortunately, statistics show that minority groups are more likely to experience significant health conditions such as heart disease, cancer, stroke and diabetes, and die from these conditions. Great effort is ongoing nationally to better understand and address health disparities to promote health equity. Nurses have a key role in understanding, identifying and responding to barriers that prevent people from having the opportunity to be as healthy as possible. Although health disparities (or inequalities) are often viewed in terms of race or ethnicity, other factors to consider include disability, gender, geographic location, income and education level. Additionally, living conditions, healthcare coverage, diet, stress, environment, lifestyle choices and even genetics can impact health equity. The reasons for health disparity are complex, and not all of them are easy to measure or even talk about. The term "health disparity" includes anything that creates inequality in healthcare. Domino Effect: There is often a "domino effect" where one factor impacts another aspect of a person's health journey. It is easy to see the connection between low income and a lack of health insurance, but it may be less obvious that a low income may limit access to healthy fresh fruits and vegetables to reduce or manage diabetes, cancer and heart disease. Beyond the Bricks: Accessibility is about more than just a brick-and-mortar health center. Having access to care means that a patient also has transportation (and in some cases a driver), a support system, a job that permits time off and the financial ability to cover transportation and medical costs — either for prevention or treatment. Medical information must be appropriate, both linguistically and at the patient's health literacy level. Genetic Differences: Genetically, conditions and risk factors vary for each person as their unique DNA structure impacts their overall health and often their treatment plan. For example, one study showed that African Americans with lung cancer are missing a cell signal, meaning that one form of targeted therapy that tries to block that signal does not work in this population, although it works in Caucasians. Unfortunately, minority groups are underrepresented in clinical trials making drug efficacy unknown in different ethnic groups. Certain groups may be at higher risk for other illnesses like hypertension, which may impact the availability of certain treatment options (e.g., cancer drugs that block blood vessel formation). In addition, cancer screening guidelines prescribe some tests a few years earlier for certain groups (e.g., prostate screening in African American males) due to the higher risk. Nurses are at the forefront of making meaningful changes toward health equity. Holistic care that accounts for social, cultural and economic factors improves outcomes. One of the most powerful things nurses can do to reduce health disparities is to advocate for their patients. This may include advocating for patient rights, appropriate resources, interpreters, distress screening or even cultural-competence training in your workplace. Opportunities to make impactful change are not limited to the workplace. Many community-based projects and events can improve health equality for all. For example, the Centers for Disease Control and Prevention's successful Traditional Foods Project recognized the almost-double likelihood of receiving a diabetes diagnosis in Native American populations as a major health disparity. In cooperation with tribal leaders, dietitians and local nurses, this project focused on providing access to healthy foods and promoting physical activity in these populations. The nurses' contributions to community outreach, educational video production and even policy advocacy made this project extremely successful. Diversity in nursing can also bring diversity in language and cultural awareness. Nurses who are able to provide care in their patient's native language or suggest appropriate resources help fill the gap for better health literacy and often access to care. Multiple studies have shown that racial and ethnic minority nurses are more likely to work in underserved areas, providing healthcare to those who experience health disparities. Nurses can better address preventable health issues with consideration of social and environmental factors. Nurses with diverse backgrounds may be more sensitive to these factors. The idea of health disparities is not new, but there has been some progress in righting this inequality. As our nation becomes increasingly diverse, it is important to identify health disparities and take steps to reduce and ultimately eliminate them. Not surprisingly, nurses are often leading the way in building healthy communities often starting in their own neighborhoods and workplaces. An RN to BSN program can help you gain the leadership skills required for such initiatives. Learn more about UNM's online RN to BSN program. Sources: Office of Disease Prevention and Health Promotion: Disparities Mayo Clinic: Office of Health Disparities Research OIJN: Disparities in Health and Health Care: Focusing Efforts to Eliminate Unequal Burdens Nutrition Today: Low-Income Shoppers and Fruit and Vegetables: What Do They Think? NCBI: Racial Differences in Cancer Susceptibility and Survival: More Than the Color of the Skin? CDC: Traditional Foods Project, 2008-2014 U.S. Department of Health & Human Services: HHS Action Plan to Reduce Racial and Ethnic Health Disparities Have a question or concern about this article? Please contact us. |
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