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Cultural competence has acquired attention as a potential strategy for the purpose of improving and eliminating racial and ethnic disparities in health care sector. At the time of treating the patients, consideration should not be given to person’s race or ethnicity because that might increase risk of having other diseases (Baquet, 2002). It is essential to bridge the gap prevailing in health disparities because that not only hampers the health aspects; but also it changes the efficiency of health care standards. In order to build bridge to bring communities together, it is essential to put collaborative and dedicated efforts. Further, it also requires great understanding of the natural and manmade forces that interact over time.
In most of the ways, bridging and eliminating the gaps in health disparities takes the same efforts in which health care practitioners should give equal importance to all the health aspects. Social, cultural and religious beliefs are considered in health care sector; but at the same time it also develops gaps in the same domain (Bridget Booske, Stephanie Robert and Angela Rohan, 2011). Thus, regarding this several research papers have been used in the part of discussion so that to highlight their area of concerns. Moreover, in the study, information has been included regarding the areas where differences occur while delivering health care and medical services.
In order to complete the section, researcher has utilized several journals that depicts different aspects related to health care disparities. The study done by Kirkwood (2016), emphasizes on health disparities that persist in the U.S for a variety of reasons (which includes lack of proper access to care, cost and caregiver biases). In the study, discussion has been laid on role of clinical laboratories in reducing health care disparities (Kirkwoodm, 2016).
However, apart from this, other study conducted by Chin (2007) (pp. 78-228), is also utilized in the present study because it gives information about a conceptual model for intervention that aims to reduce disparities (Chin and et. al., and 2007) (pp. 78-228). Using this model as a framework, researcher has also focused on other interventions through using cultural leverage and pay per performance measures. Thus, in the study global conclusion (regarding the current state of health disparities interventions) have been stated.
In addition to this, the present research paper also includes Brady’s (2007) (pp. 53-6), study which shows the concept of evidence based practice (EBP) to gain credibility and acceptance in health professional community (Brady, 2007) (pp. 53-6).
Besides this, information has been included from Lopez and et.al. (2011), which mentions that racial and ethnic disparities in health care have been continuously documented in the areas of diagnosis and treatment both. Besides an uneven level of implementation, researcher has also demonstrated that health information technology is useful in improving quality of care and patient’s safety aspects (Lopez and et. al., 2011).
The study of Ferguson (2005) (pp. 46-54), states that from past several decades, many international development agencies have broadened their activities and portfolios for the purpose of facilitating more development in health care sector (Ferguson, 2005) (pp. 46-54). However, the study also denotes that many efforts are build up by the health care communities to bridge the gap and most of them have failed to meet the objectives.
The study of Betancourt (2005), is also considered for the present research work which states that health care stakeholders are developing initiatives to manage cultural competence. In this study, interview has been conducted with experts in cultural competence from managed care, government for the purpose of ascertaining the perspective of health care. Along with this, it also includes recent trends in cultural competence in health care policy, practice and education (Betancourt and et al., 2005).
On the contrary, study conducted by Egede (2006), is also utilized in the present research report which provides new insight to the sources that contributes to the racial and ethnic disparities in health care sector. Hence, in this study cross sectional analysis has been conducted regarding 54,968 respondents for the purpose of assessing relationship between perception of health care discrimination and use of health services (Egede, 2006).
Moving on to the research work of Booske (2011), it can be articulated that health care entities should improve public awareness regarding health disparities. In the research work, little research has been done regarding awareness of racial and ethnic disparities prevailing US public. In this study, survey has been conducted to get responses from 2,791 US adults (Bridget Booske, Stephanie Robert and Angela Rohan, 2011). Moreover, researcher also used χ2 tests and logistic regression to compare the correlation of respondent’s awareness about health care disparities.
Moreover, researcher has also utilized the research work of Olivia Carter and Claudia Baquet (2002), which focuses on several approaches for measuring disparities in health care sector. It states that health care disparities can be measured by comparing the health of one group with other groups. The study seems to be highly useful for the present research work because that gives answers for several research questions (Olivia Carter and Claudia Baquet, 2002). Along with that, policy implications are also discussed in the study from several health perspectives.
In the section of discussion, chief importance needs to be given on cultural values and dimensions that creates major differences in health care sector. There are various reasons that generates health disparities in US and it also increases risk factors for patient’s health. It has been observed that health disparities extracts financial cost which also enhances financial burden on those families who are unable to afford it (Dubiel et al., 2010). It is essential for medical health care practitioners to pay attention towards health disparities because that aids in enhancing the standard of medical services. Minority patients have lower process of care setting and they also have lower utilization of major medical procedures. In this regard, the Agency for Healthcare Research and Quality has published an annual disparities report which provides brief overview and data about both quality of care and its access. Racial and ethnic minorities experience poor quality of care as compared to whites in several care measures.
On the contrary, Hispanics receive poorer quality of care when it is compares to non-Hispanic whites in 77% of these measures which also includes 73% African Americans, 41% American Indians and Alaska natives and 32% of Asian Pacific Islanders. Health care disparities have a multi-dimensional etiology which also depicts health system, challenges in service delivery and beliefs of patients. Henceforth, in this respect quality improvement has been regarded as an important strategy which reduces or eradicates health care differences. There are several causes of health disparities in which socio economic status plays major role. Income as well as education attainment on average are lower for ethnic and minority groups; hence this restricts them to avail better medical services (Olivia Carter and Claudia Baquet, 2002). There is a direct link between poverty, low education attainment with poorer health outcomes (with increased mortality). People who do not have high income attainment experiences more issues while availing health care services. Additionally, higher socio economic groups have recently achieved greater improvements in managing health status as compared to lower socioeconomic groups.
Equitable healthcare means elimination of biasness and it also means creation of patient cantered systems of care that aims to support and health the diseases. Further, it also assists in developing proper relationships with the patients. In order to develop equality in health care sector, it is essential for the practitioners to align health care resources and capabilities with needs of patients especially those who have been historically underserved (Egede, 2006). There are several health care practitioners who give importance to social and cultural values and this sometimes restricts them to deliver prominent services to the care providers. The term disparity reflects availability of differences in the context of public health and social care and most often it is also viewed as a chain of events that shows differences between quality of care, environment, health status and access to health care resources (Ferguson, 2005) (pp. 46-54).
Various studies have been conducted wherein it is measured that racial differences exist among people due to changing attitude towards innovative medical technology. Patient centred care and cultural competence is essential in improving and eliminating racial and ethnic health care differences (Brady, 2007) (pp. 53-6). Cultural competence is also driven by both quality and business imperatives wherein it is mainly included because it helps in controlling costs aspects. Hence, looking towards this aspect, health care practitioners should use quality improvement technique for the purpose of eliminating the prevailing differences (Betancourt and et al., 2005). Health Information Technology is an association of technologies which aids in developing several new tools for the purpose of enhancing the efficiency of health care services. Thus, the study done by Lopez and et.al. (2011), contends that HIT has the potential to improve quality of care and patient safety; however for that appropriate implementation plan is required to be developed.
From patient level, HIT plays major role in improving health communication and the quality of service care. There is also an evidence that electronic health record functions improves the efficiency of the delivered care, especially at the time when systems interact with one another (Chin and et. al., and 2007) (pp. 78-228). This also shows increased adherence to clinical guidelines and protocols and along with that, it also amends adherence to all the preventive measures that can be taken in the hospitals. Socioeconomic position is also considered a stronger determinant of health related outcomes than race and this is also the chief reason that depicts why people are unable to access better medical services. In the present study, various research works have been utilized which shows the effects of race and ethnicity on health outcomes; however specifically it tends to diminish the significantly when socioeconomic position is controlled in a few cases (Ferguson, 2005) (46-54).
On the other hand, research work of Booske (2011) contends that it is essential to develop awareness among people regarding the health care disparities for the purpose of enhancing the standard of health care services. Further, providing appropriate services to all the patients not only enhances service capability; but also it motivates people towards equality and diversity. Both the terms are required to be followed in health care sector so that people can avail better health care amenities. Moreover, it is also essential for the purpose of reducing mortality ratio prevailing in the economy. Along with that, varied health care changes should be made so that people facing major problems could get the opportunity to get better treatment (Kirkwoodm, 2016). Further, in the study it is also discussed that awareness of health care disparities amid African Americans and whites ranges from a low of 32% to a high of 65%. In order to bridge the gap prevailing in health care sector, it is essential for the social care practitioners to remove all the disparities which can also aid in spreading equality in all domains.
Further, the research work of Olivia Carter and Claudia Baquet (2002), contends that patterns of inequality differ by type of measure and it is also dependent on the baseline level of variables wherein differences occur. In this term, policy recommendation may be affected by several measures that can be used to reveal the magnitude of inequalities that exists among people. Therefore, in order to reduce and eliminate differences in health care sector, policy makers should go beyond to the discussion of inequality and they should consider what is equitable in the same domain. Further, there should be better standardization and quality of educational programs wherein health care practitioners should get training in all the areas so that they can manage their service provision through unified conceptual teaching framework (Booske, 2011).
Apart from this, there should be greater concern from government; hence focus should be laid on increasing key capacities of cultural competence wherein respect and dignity should be given to the people regardless of their social and cultural dimensions. It is also essential to remove disparities through organizing events that shows the importance of quality and diversity. Most of the experts agree that health care practitioners (working in both private and public sector) should stimulate several changes so that they can ascertain the impact of disparities on cost and quality facets of health care services (Lopez and et. al., 2011). This is also essential in terms of analysing what is required to maintain cultural competence in the health and social care sector.
Summing up the entire research work, considering all the studies, it is vital for the health care community to adopt new practices and methods to improve the health and social values. There are several approaches through which health care disparities can be measured; however the one prominent factor is through comparing health beliefs and aspects of different groups.
I would like to extend my special thanks and gratitude to all my mentors who supported me in preparing the study within stipulated time period. Also, I would like to thank all the respondents who have given immense support in data collection process. I would like to confront that assistance from all the associated people helped me to work prominently in this research work. I am really thankful to my family members as well because of the support they have given to me.
- Brady Noreen, “Evidence- Based Practice in Nursing- Brdiging the Gap Between Research and practice”. 21,1 (2007): 53-6.
- Bridget Booske, Stephanie Robert and Angela Rohan, “Awareness of racial and socioeconomic Health Disparities in the United States: The National Opinion Survey on Health and Health Disparities 2008 – 2009”. 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136972/. Accessed 22nd, Dec 2016.
- Chin. Marshall and et. al., “Interventions to Reduce Racial and Ethnic Disparitis in Health Care.” Med Care Res Rev 64,6 (2007): 78-228.
- Ferguson, Jullie Bridging the gap between research and practice 1, 3 (2005): 46-54.
- Heather Dubiel et al, “The Connection between Health Disparities and the Social Determinants of Health in Early Childhood”. 2010, http://www.chd.dphe.state.co.us/Resources/pubs/ECHealthDisparities2.pdf. Accessed 22nd, Dec 2016.
- Joseph Betancourt et al, “Cultural Competence and healthcare Disparities: Key Perspectives and Trends”. 2005, http://content.healthaffairs.org/content/24/2/499.full. Accessed 22nd, Dec 2016.