Summary NR_222 Study Guide, Exam Inclined

NR_222 Study Guide, Exam Inclined NR_222 Study Guide, Exam Inclined Health Disparity A particular type of health difference that is closely linked with social, economic, and environmental disadvantage. Health disparity  The second goal, eliminating health disparities, addressed the continuing problems of access to care; differences in treatment based on race, gender, and ability to pay; and related issues such as urban versus rural health, insurance coverage, Medicare and Medicaid reimbursement for care, and satisfaction with service delivery. (Edelman text book Unit 1 Foundations for Health Promotion Ch. 1 Objectives for Promotion and Prevention pg. 6)  Health disparities is an umbrella term that includes disparities in health care. It was defined by Healthy People 2020 as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage, and “health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender, age, mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion (U.S. Department of Health and Human Services, 2011)  Addressing health literacy and providing culturally sensitive health education are critical to reducing health disparities and achieving health equity. Health disparities are systematic, potentially avoidable health differences that adversely affect socially disadvantaged groups. Groups affected are those with characteristics such as race/ethnicity, skin color, religion, language, or nationality; socioeconomic resources or position; gender, sexual orientation, or gender identity; age; physical, mental, or emotional disability or illness; geography; political or other affiliation; or other characteristics that have been linked historically to discrimination or marginalization [(Braverman et al., 2011) Edelman text book Ch. 10 Health Education pg. 217]  Health Disparities and Health Care: Health disparities are the differences among populations in the incidence, prevalence, and outcomes of health conditions, diseases, and related complications. On the other hand, health care disparities are differences among populations in the availability, accessibility, and quality of health care services (e.g., screening, diagnostic, treatment, management and rehabilitation) aimed at prevention, treatment, and management of diseases and their complications. [Fundamentals Ch. 9 Cultural Awareness Pg. 102]  Poor access to health care is one social determinant of health that contributes to health disparities. Access to primary care is an important indicator of broader access to health care services. A patient who regularly visits a primary care provider is more likely to receive adequate preventive care than a patient who lacks such access. The 2013 National Healthcare Disparities Report (AHRQ, 2013a) revealed that African Americans, Asians, and Hispanics are less likely than non-Hispanic Whites to see a primary care provider regularly.  A similar disparity in access to care exists in other disadvantaged groups. Less care is available or accessible to people in low and middle- income groups compared with people in high-income groups. Uninsured people ages 0 to 64 are less likely to have a regular primary care provider than those with private or public insurance (AHRQ, 2013a). Research suggests that some subgroups of the LGBT community have more chronic health conditions & a higher prevalence & earlier onset of disabilities than heterosexuals  In addition to the poor access to health care, a large body of research shows that health care systems and health care providers can contribute significantly to the problem of health disparities. More than a decade ago, reports by the Institute of Medicine (IOM 2001, 2010) defined quality health care as care that is safe, effective, patient centered, timely, efficient, and equitable or without variation in outcomes as determined by stratified outcomes data. Although the U.S. health care system has improved in most of these areas since the IOM reports were published, the focus on the equity has lagged behind (Mutha et al., 2012). Inadequate resources, poor patient-provider communication, a lack of culturally competent care, fragmented delivery of care, and inadequate access to language services all compromise patient outcomes (NQF, 2012). As a result, many disparities in health care and health outcomes remain.  Disparities in access to care, quality of care, preventive health, health education, and available resources to enable self-management when patients are outside of the health care setting contribute to poor population health. Health disparities are also very costly. Recent analysis estimates that 30% of direct medical costs for Blacks, Hispanics, and Asian Americans are excess because of health inequities and that overall the economy loses an estimated $309 billion per year because of the direct and indirect costs of disparities