Gregory Galloway Health Care Inequality Presentation

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Gregory Galloway Health Care Inequality Presentation

  1. 1. Why do Racial and Ethnic Disparities Exist in Health Care? By: Greg Galloway
  2. 2.  Racial Disparities in the Treatment of Pain:  Whites are given more opiod pain relievers than blacks (klonoff, 2009)  Minorities were given non-opiod analgesic (Klonoff, 2009)  In emergency room Native Americans were perceived to be exaggerating their symptoms and pain in order to get pain medications (Klonoff, 2009) Why do Racial and Ethnic Disparities Exist in Health Care 2
  3. 3.  Racial Disparities in Cardio Vascular Disease andTreatment:  Blacks and Whites in the 1950’s had identical mortality rates from heart disease, by the year 2000 blacks had a 30% higher rate (Williams & Jackson 2005)  African Americans are more likely to receive older treatments and less likely to receive newer cardiac treatments (Klonoff, 2009)  Blacks are less likely to receive cardiac catheterization, revascularization and smoking cessation counseling (Klonoff, 2009) Why do Racial and Ethnic Disparities Exist in Health Care 3
  4. 4.  Role of Income on SES and Race and Health:  SES is a strong predictor of health. Americans with a low SES have levels of illness in their 30’s & 40’s that are not seen with higher SES until three decades later  Death rates form heart disease are 3 times higher in low income blacks & whites than their middle income equivalents  Blacks at all income levels have a higher heart disease death rate than whites  Mortality form heart disease in black women of low income is 65% higher than comparable white women * (Williams & Jackson, 2005) Why do Racial and Ethnic Disparities Exist in Health Care 4
  5. 5.  Race and SES and Health Practices:  Ethnic adolescents in lower SES more likely to have a sedentary lifestyle (Braveman et al, 2010)  Disadvantaged racial groups and those from a low SES less likely to reduce high-risk behavior or to initiate new healthier practices (Williams & Jackson, 2005)  Blacks and individuals in low SES less likely to stop smoking (Braveman et al, 2010)  Positive or negative changes in heath practices are shaped by race and SES (Braveman et al, 2010) Why do Racial and Ethnic Disparities Exist in Health Care 5
  6. 6.  Geographical and Racial Differences in Health Care:  Neighborhoods can influence healthy or unhealthy behaviors  Neighborhoods lack healthier food options which result in poor diets and high rates in obesity  Residents of these neighborhoods are typically minorities *(Center for Medicare Advocacy, Inc, n.d) Why do Racial and Ethnic Disparities Exist in Health Care 6
  7. 7.  Neighborhood Quality:  Neighborhood quality contributes to racial disparities  Poor environmental conditions and exposure to toxin can cause health problems  Ethnic minorities and are often exposed harmful pollutants because of the neighborhoods they live in  Blacks tend to live in poorer neighborhoods that whites in the same SES *(Williams & Jackson, 2005) Why do Racial and Ethnic Disparities Exist in Health Care 7
  8. 8.  Geographical Location and Disparities in Providers:  More affluent areas contain more providers with higher quality of care (KFF, 2008)  Areas that are poor and have a large minority population are medically underserved (KFF, 2008)  Blacks and whites typically have different providers, those that treat minorities are often less clinically trained (Chandra, 2009)  Clinics and providers in these locations often have fewer resources (Chandra, 2009) Why do Racial and Ethnic Disparities Exist in Health Care 8
  9. 9.  What are the Options: Increasing the Knowledge Base: Increasing the knowledge base will require investing in routinely collecting and analyzing data on health care use across racial/ethnic groups. Data from national surveys, health insurers, and different health settings are needed to better understand the problems and impact of interventions. One reason we know so little about patterns of health care use for many racial/ethnic groups is that we have not collected the data or have insufficient sample sizes in publicly available data sources (KFF, 2008) Why do Racial and Ethnic Disparities Exist in Health Care 9
  10. 10.  What are the Options: Raising Public and Provider Awareness: Perceptions of a problem often influence the actions taken (or not taken) to change policy and practices. If the public or providers are unaware that a problem exists, or misunderstands the nature of the problem, it can be difficult to direct resources to address that problem. Efforts to raise the public’s awareness of racial/ethnic health care disparities have achieved modest success (KFF, 2008) Why do racial and Ethnic Disparities Exist in Health Care 10
  11. 11.  What are the Options: Improving the Number and Capacity of Providers in UnderservedCommunities: Despite efforts since the 1970s to increase the number of health professionals in medically underserved areas, members of racial/ethnic minority groups are still underrepresented in the health care workforce and are more likely than Whites to live in neighborhoods that lack adequate health resources… African Americans and Latinos are also twice as likely as Whites to rely upon a hospital outpatient department as their regular source of care, rather than a doctor’s office where opportunities for continuity of care and patient-centered care are greater. This is a result of many factors, including the higher rates of uninsured and the limited availability of primary care physicians in some communities of color (KFF, 2008) Why do racial and Ethnic Disparities Exist in Health Care 11
  12. 12.  Racial Disparities Exist in Treatment of Pain and Cardio Vascular disease. Socioeconomic status and income is a strong predictor of health. SES andrace predict health or unhealthy health practices. Geographical location and neighborhoods influence health behaviors.Access to quality providers is determined by race and geographical location. Options in eliminating disparities:  Increasing the Knowledge Base  Raising Public and Provider Awareness  Improving the Number and Capacity of Providers in Underserved Communities Why do Racial and Ethnic Disparities Exist in Health Care 12
  13. 13.  Agency for Healthcare Research and Quality (2011, March). National healthcare disparities reports2010. Agency for Healthcare Research and Quality. Retrieved November 3, 2011, fromhttp://www.ahrq.gov/qual/nhdr10/nhdr10.pdf Apter, A. J., & Casillas, A. M. (2009). Eliminating heath disparities: What have we done and whatdo we do next. Journal of Allergy and Clinical Immunology, 123, 1237-9. doi:10.1016/j.jcai.2009.04.028 Braveman, P. A., Cubbin, C., Egerter, S., Williams, D. R., & Pamuck, E. (2010). Socioeconomicdisparities in health in the United States: What the patterns tell us. American Journal of PublicHealth, 100(S1), s186-196. doi:10.2105/ajph.2009.166082 Center for Medicare Advocacy, Inc. (n.d.). Racial and ethnic health care disparities. Center forMedicare Advocacy, Inc.. Retrieved November 11, 2011, fromhttp://www.medicareadvocacy.org/medicare-info/health-care-disparities/ Chandra, A. (2009). Who you are and where you live race and the geography of healthcare.Medical Care, 47(2), 135-7. Kaiser Family Foundation (2008, October 24). Eliminating Racial/Ethnic Disparities in Health Care:What are the Options?. Kaiser Family Foundation. Retrieved November 13, 2011, fromhttp://www.kff.org/minorityhealth/h08_7830.cfm Klonoff, E. A. (2009). Disparities in the provision of medical care: an outcome in search of anexplanation. Journal of Medicine, (32), 48-63. doi:10.1007/s10865-008-9192-1 Williams, D. R., & Jackson, P. B. (2005). Social sources of racial disparities in health. Heath Affairs, 24(2), 325-334. doi:10.1377/hlthaff.24.2.325 Why do racial and Ethnic Disparities Exist in Health Care 13

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