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Health disparities are referred to as population-specific gaps in (4):
- 1. Quality of Health
- 2. Presence of Disease
- 3. Health Outcomes
- 4. Access to Healthcare
Give examples of populations that can suffer from health disparities.
- Socioeconomic status
- Geographic location (i.e. rural)
- Sexual orientation
- Physical or mental disability
- Global health disparities
Racial and ethnic groups:
1. African americans have a (higher or lower) incidence of cancer compared to caucasians?
2. African americans and latino adults have approximately ___ times the risk of developing diabetes compared to caucasians.
3. Ethnic and racial underrepresented minority groups have a (higher or lower) rates of immunization and cancer screening?
- 1. higher incidence (10%)
- 2. 2 times the risk
- 3. lower rates
What is the single most important factor predicting a person's access to and quality of care?
Socioeconomic status: "the relative position of a family or individual on a hierarchical social structure, based on their access to or control over wealth, prestige and power." [this is actually a good thing, because at least it is something we can change...]
Rural populations are (more or less) likely to seek preventative care than urban populations?
Less likely [also, there are less physicians in rural areas]
Members of the LGBT (lesbian, gay, bisexual, transgender) populations are (more or less) likely to have health insurance?
Members of the LGBT population are (more or less) likely to resort to visiting emergency rooms for healthcare?
LGBT individuals have (higher or lower) rate of:
1. some diseases
2. testing and screening for certain illnesses like heart disease
3. engagement in risky behaviors that can compromise overall health or well-being, such as alcohol and tobacco use.
- 1. higher
- 2. lower
- 3. higher
(T/F) According to the National Health Interview Survey, women are less likely to have health insurance the more disabilities/limitations they have. (i.e. a woman with 3 limitations is less likely to have health insurance than a woman with 2 limitations)
(T/F) Since some physicians refuse to treat patients who are covered only by Medicaid or Medicare, persons with disabilities have access to a smaller pool of physicians, who may lack experience treating their disabilities.
(Majority, minority, 50/50) Number of those with functional limitations who live in the community that rely exclusive on family, friends, volunteers for personal assistance services.
What are some key health disparities in the US?
- Mortality rates: includes overall mortality, infant mortality and life expectancy
- Infant mortality: used as a marker of the general health status of a population, nationally and internationally [african americans, even in higher SES groups, have higher rates]
- Life expectancy: has improved for all Americans over the 20th century
- Mortality crossover: at 80 years old, African americans have a longer life expectancy than Caucasians
- Morbidity: chronic conditions like diabetes, cancer, HIV/AIDS
Which groups have the longest and shortest life expectancy?
- Longest: Caucasian Women
- Shortest: African American Men
- Caucasian Men and African American Women have about the same life expectancy.
- Gender disparity surpassed the racial disparity in the 1960s.
Breast cancer DEATH rates are about 2.7 times higher among _______ women than among _______ women.
African american women (highest rates) higher than asian/pacific islander women (lowest rates)
(T/F) Prevalence of HIV/AIDS is increasing among African americans, particularly women.
How can doctors help reduce the disease burden and health disparities?
Raise awareness of Social Determinants of Health among your patients.
Key causes of health disparities.
- Lack of insurance coverage
- Lack of regular source of care
- Lack of financial resources
- Legal barriers (i.e. immigrants...federal law bans immigrants from being covered by Medicaid during their first 5 years in the country)
- Structural barriers (i.e. transportation, time spent in waiting room)
- Healthcare financing system: health insurance plans limit covered services and number of providers
- Scarcity of providers
- Linguistic barriers
- Health literacy: patients may not know when to seek care for certain symptoms or accidentally be noncompliant with treatment
- Lack of diversity in the healthcare workforce
- Age: fewer than 15% of patients of 65 have access to the internet; impaired mobility; lower budget
(T/F) In 2003, the proportion of Asians registered for transplantation was higher than caucasians.
True (27.9% compared with 16.9%)
(T/F) There are minimal disparities in the care of minorities in the military, while there are some disparities in preventative care.
Name the 8 techniques for improving healthcare systems.
- **Interpreter Services: for foreign languages and the hearing impaired
- Recruitment and Retention: of minority health care providers
- Coordinating with traditional healers
- Use of community health workers: these people should bring in people who rarely seek out healthcare
- Culturally competent health promotion
- Immersion into another culture
- Administrative and organization accommodations
Quality of care is usually related on four primary measures. Which of the following is NOT one of the measures used to rate the quality of health care?
B. Physician consideration
C. Patient safety
E. Patient centeredness
Individuals in some groups rely on health care services more than individuals in other groups. Unfortunately, research shows that the quality of care is disparate across groups. Based on the info provided and what you know of disparities in access to, and use of, and quality of health care among groups that differ in SES, sexual orientation, and mental and physical health status, which of the following patients is BEST matched with the quality of care he/she is likely to receive?
A. Daisy, a caucasian woman who identifies herself as a homosexual: Excellent
B. Luke, a latin-american man with low SES: Excellent
C. Stephen, an african american man with a physical and mental disability living in a rural area: Poor
D. Belinda, a middle-class african american heterosexual woman living in an urban suburb with a mental health disorder: Excellent
E. Anthony, a highly education african american man with high SES living in an urban area: Poor
All of the following health disparities occur among lesbian, gay, bisexual transgender (LGBT) populations compared to heterosexual populations EXCEPT:
A. Lower engagement in risky behaviors, such as alcohol and tobacco use
B. Lower rates of health insurance
C. Higher rates of emergency room visits
D. Lower rates of testing and screening for CVD
E. Higher likelihood of delaying getting prescription medications