There is no secret about the fact that the population is not homogeneous in the United States. There are differences in welfare, education, origin, lifestyle and a range of other aspects. It goes without saying that any of these factors can be interrelated with health factors and as a result create health disparities among different groups of population. Hence, such kinds of disparities exist as frequency of certain diseases, quality of medical care provided and overall health level. As the statistics are quite illustrative of significant gaps between groups, it is clear that measures should be taken on governmental level to reduce or eliminate these disparities. It is natural that it should be done by improving the situation of those groups that are doing worse rather than discriminating more successful ones.
To make a thorough analysis of the issue, it is worth considering the major factors that cause disparities of all sorts, as well as the main aspects that are different between the considered groups of people. First of all, the level of income is one of the factors that determine people’s access to healthcare and the quality of service they receive. It is obvious that groups with welfare below average and especially the poorest part of population tend to be exposed to more issues with getting the best health assistance. These can include subjective factors, like for instance, biased treatment, and objective ones, like uneven funding and unequal access to proper medical service. Hence, the issue lies in the field of the state’s responsibility for providing free medical care of high quality, compared to the one that is provided in private clinics. In many cases, income stratification intersects with the racial and ethnical differences, as statistically there are economic differences between them. Thus, African American and Latino population are stated to have overall lower income that their Caucasian counterparts. Furthermore, low income and ethnicity are closely related to social, cultural and lifestyle differences that might cause health disparities. Thus, such factors as nutrition, environment, circle of communication, criminality level, drugs taking, etc., are the ones that can change the whole situation.
There are some major areas, which are statistically the most striking in terms of health disparities. Thus, despite the fact that the United States is the country which is the world leader in healthcare expenditures, this money is not spread evenly among different social and ethnic groups. Hence, conditions of living and healthcare are the factors that cause the following breaches, though they are not the only factors. As an example, even if not discussing particular diseases, statistics does not speak in favor of African Americans. It is stated that “one of the most glaring disparities is apparent in the African American community, where 48% of adults suffer from a chronic disease compared to 39% of the general population” (Health Disparities: A Case for Closing the Gap). When considering the issue in a more detail, the gaps with such diseases as AIDS, cancer, obesity and diabetes are declared. In all cases the average figures are at least 15 per cent higher than for the whites, while for AIDS the difference is more striking: it is stated to be two and a half times as frequent as for Caucasian population. At the same time, except black Americans, such ethnic minorities as Hispanics and Native Americans suffer from health disparities. Speaking about cancer, statistics is quite illustrative, too: “Black men are diagnosed with cancer and die of the disease at higher rates than other racial, ethnic or gender groups, the CDC said. The incidence of cancer is 599.2 per 100,000 black men compared with 523.6 per 100,000 white men”( 2012). The same is true of cancer death ratios, which are higher for Hispanicas and African Americans. This cannot be explained by gender specifics, as statistics are similar for females of different races.
When considering the major healthcare issues, which lead to these gaps, researchers name several of them. Thus, it is a well-known fact that a high ratio of the above mentioned racial groups does not have health insurance. As a result, many of them avoid addressing doctors because their income does not allow covering their health expenses. Alternatively, they turn to medical institutions only in extreme situations when some serious diseases like cancer might be too late to cure effectively. Hence, the major consequence of insurance absence is lack of routine tracking of health, which allows to discover minor or major health issues on time. Furthermore, treatment and drugs can be costly at all stages, so underprivileged groups tend to avoid using medicine even if they are aware of minor health problems. As a result, these issues accumulate and might work as triggers to more serious illnesses at a certain stage. The statistics confirms the striking disparities: “Four in 10 low-income Americans do not have health insurance, and half of the nearly 46 million uninsured people in the United States are poor. About one-third of the uninsured have a chronic disease, and they are six times less likely to receive care for a health problem than the insured.12 In contrast, 94% of upper-income Americans have health insurance.” (Health Disparities: A Case for Closing the Gap). Other issues stated by experts include the absence of a customary place of medical care that a person addresses regularly. Instead, such groups of population tend to have occasional care and change doctors more frequently. Besides, communication between them and clinical institutions is poorer than it could be.
Taken above said as a record of bottlenecks in healthcare and public welfare in general, measures are to be taken to reduce health disparities. First of all, low income families are to be provided with opportunity to receive regular medical service, including routine meetings with a therapist. It can be stated that most steps taken by the authorities in this direction, work more effectively for emergency situations. It is clear, though, that having equal access to 911 rescue is far not enough for bridging the differences that make opportunities unequal. The necessity to ensure routine health tracking is vital, as the trend of lifestyle is quite shocking for some ethnic groups. As Dr. Chin, who is a head of Disparities Research for Change National Program Office states, “African-Americans tend to present with later-stage cancer…That suggests a problem with access to care that people aren’t presenting until the cancer is advanced.”( Krupa, 2012). Social experts suggest the approach that does not stem from healthcare directly but rather originates from cultural awareness and counseling skills that a good therapist has to have. Psychologists say that while changes at a global scale are necessary, one-to-one communication is still priceless resource that should be used. It is a duty of authorities to change the system, while it is an opportunity of a human to change another individual’s mind.
The authorities are quite optimistic about the results of the efforts in reducing healthcare disparities that have been taken in recent years. The medical statistic report that tracks progress between the years 2002 and 2008 says that the gaps are becoming narrow in many areas, although they are far from being totally eliminated. In fact, the research demonstrates that the quality of medical service is improving in the United States, yet the underprivileged groups still have to tolerate a lower quality care than the more socially comfortable groups. There is yet another factor, a human one, which Donald Barr explores in his research. This aspect concerns physicians’ attitude to patients based on their ethnicity and race. In this respect, biased treatment is possible, which affects both interpersonal and healing processes in a negative way. As it stated by the author, “bias, stereotyping, prejudice and clinical uncertainty on the part of healthcare providers may contribute to racial and ethnic disparities in healthcare” ( Barr, p. 201). Hence, this issue lies not so much in healthcare system but in the overall cultural and social paradigm that is still to be changed. However, proper education of physicians in terms of professional ethics can work favorably to resolve the issue.
To conclude, it is worth saying that health disparities are an issue that lies beyond purely medical scope. These gaps can be explained by a whole range of historical, economic and cultural factors, all of which are closely interrelated. However, when analyzing these factors, there are major trends, which cannot be left unnoticed. It is obvious that white population still have better statistics in all areas of health and healthcare than African Americans, Hispanics and Native Americans. Research demonstrates that this is first of all explained by their lower social status and lower income that restrict them from receiving quality service. The major issues include lack of routine medical care, which results in late diagnoses. Besides, although not a major factor, but still there is bias on part of physicians towards their patients, which tends to reveal in different care and recommendations. Thus, although healthcare system is to be reformed to improve the situation, the changes are not to be confined to this narrow area but need a broader public discussion.