Diversity in health care management has different dimensions. It may be a matter of practices and policies in service delivery or may even take the form of work-force composition. This implies that diversity is not just a question of law only, as it is commonly viewed (McDonough et al, 2004, p. 10). In the U.S, the aspect of racial and ethnic diversity is an issue in medical care that the government needs to address since it has created disparities in healthcare. Knowing how to serve people with different values, health beliefs and alternative perspectives about health and wellness is a business imperative in the most diverse regions of the U.S (McDonough et al, 2004, p. 8). In this paper, we will look at the contemporary issue of minority disparities in health care provision. According to Goldberg et al report, eliminating racial and minority disparities should be made a national priority (2004, p. 8). For this reason, I will discuss the factor of racial and minority diversity, which has resulted to healthcare disparities.
The core issue
Diversity in the population has of late yielded disparities in the service delivery to different groups. These disparities may include among others; the presence of disease, health outcomes, or access to health care across racial, ethnic, sexual orientation and socioeconomic groups (Goldberg, 2004, p. 3). When speaking of disparities we refer to the differences in access to health care between populations. These differences have resulted to the violation of health equity in which case, different groups of people receive different extents of medical care. Despite the current situation and the projections that the situation may worsen, the American health care system has not taken significant measures to meet the current need of eliminating healthcare disparities leave alone anticipating future challenges concerning this problem.
Cause and implications
Disparities in healthcare provision have resulted from various indirectly related factors. First, these disparities may result from communication breakdown between patient and service provider (Goldberg et al, 2004, p. 8). This communication is important for the appropriate and effective treatment and care. Breakdown of this communication will mean wrong diagnosis, improper use of medications, and failure to receive follow-up care. This implies that health care management should ensure that this aspect of breakdown is eliminated by formulating policies and strategies that reflect this interest (McDonough et al, 2004, p. 16).
Disparities can also arise when the service provider is either consciously or otherwise discriminative toward the patient either by race or by ethnic group. Some people argue that ethnic minorities are less likely than whites to receive a kidney transplant once on dialysis or to receive pain medication for bone fractures (Smedley et al, 2004, p. 132). Another factor may be lack of preventive care. This disparity is common along social-economic groups as opposed to racial groups. Researchers have found that uninsured Americans receive less or no preventive medical care when compared to those that are insured (McDonough et al, 2004, p. 24)
The above-discussed factors majorly affect the quality of health services rendered to the beneficiaries. In addition to these, other factors affect the access of health care services among diverse groups of patients. The first on the line is lack of insurance cover. Without health insurance cover, it is more likely that patients will go without appropriate medical care and or necessary medical prescriptions, as is the case with minority groups in the U.S who cannot afford insurance coverage at higher rates (KCMU, 2003, p. 32). The lack of health insurance can be because of legal requirements. For instance, the Federal law prohibits states to issue insurance cover to immigrants who have resided in the U.S for a period of less than five years. This means that new immigrants have limited access to medical care in the U.S.A.
Lack of financial resources is another cause for disparities. Though it is a challenge to the greater majority of Americans, its impact is more on the minority group. This means that many patients will not access regular medical attention, which implies that they will face difficulties in obtaining prescriptions, visiting the doctor and accessing health care facilities (Goldberg et al, 2004, p. 10). Demographic factors can also be a source of disparities. Aged people may not be able to access health information via the internet (Brodie, et al, 2000. p 19) and may not be able access medical facilities due to physical impairment. Furthermore, they may find it difficult to fund their medical bills because they experience fixed income levels.
Another major cause of these disparities is lack of diversity in the health care work force. The fact that African Americans are represented by 4% and Hispanic by 5% of the work force in America compared to their population would suggest that the expected prevalence of these disparities should be high (Goldberg et al, 2004, p. 13). This factor also promotes other causes like communication breakdown and racial discrimination. The healthcare system has to eliminate these disparities to achieve national targets in health provision and therefore, researchers, the government and the population as a whole should assist in the elimination of the disparities. This will help in achieving health equity.
Strategies and policies for improving the situation
To improve healthcare among minority groups, several strategies are being proposed in this discussion which when put in place can help handle these disparities and therefore ultimately attaining health equity. In a report on how to end health disparities, common wealth fund proposed several steps in formulating policies to eliminate these disparities (McDonough et al, 2004, p. 28). The first step involves consistent data collection by health care providers concerning racial and minority disparities. Second is effective evaluation of the implemented disparity reduction programs and then setting Minimum standards for culturally and logistically competent health services. The fourth step is to ensure that the minority group has greater representation within the health care workforce. Another proposal was that the government establishes minority health offices and Involvement of all other health system representatives in minority-health improvement efforts. Last on the list was that the government was to expand services access for all minority and racial groups (McDonough et al, 2004, p. 30).
In addition to these proposals, there are other means by of addressing the problem at hand in both the short and long-term periods. Collins et al proposed several other strategies that health practitioners can employ to control the situation (2002). In the report, some of the proposed strategies were that medical facilities should take an initiative of hiring professional interpreters for foreign languages besides training their staff to co-ordinate when working with those interpreters. It also proposed a high minority representation in the workforce of the medical facilities.
Another proposal was the incorporation of traditions and cultural beliefs in the treatment and health practices that in some cases would involve incorporating traditional healers. In addition, medical facilities are to engage culturally competent health promotions, which would involve taking necessary early detection and treatment measures and outlining the good and risky health behaviors to all patients. Furthermore, medics can involve community health workers who will be responsible for bringing people who rarely seek medical care. This can involve family members to ensure adherence to cultural norms when administering treatment. According to Brach et al, some aspects of health care offices should be considered (2000). For instance, public transportation availability, clinic hours, the physical environment of the clinic, and the rapport built with the patients. In addition, immersion into other cultures should be encouraged. This is set to improve the service providers’ awareness to new ideas and believes and his tolerance for other peoples’ culture.
In conclusion, the issue of cultural diversity in health care management needs to be addressed more seriously than it has been today. The current challenges are overwhelming but the prospective challenges in the future might be more serious. For this reason, there is an urgent need to respond to these challenges now and more there is the need for forward planning both by health agencies and by the government to anticipate what the future holds for the nation. This will call for joint efforts from all parties involved and will require more research on prospective demographic changes. This will ensure that all patients in American hospitals receive quality health care.
Brach, C. & Fraser, I. (2000). Can Cultural Competency Reduce Racial and Ethnic Health Disparities. Berkeley School of Public Health: Henry Publishers
Brodie, M., Flournoy R.E., & Altman D.E. (2000). Health information, the Internet, and the digital divide. Millwood: Associates press.
Collins, K., Hughes, D., Doty, M., Ives, B., Edwards, J., & Tenney, K. ( 2002). Diverse Communities, Common Concerns: Assessing Health Care Quality for Minority Americans. Herndon VA: Stylus publishing LLC.
Goldberg, J., Hayes, W., & Huntley, J. (2004) Understanding Health Disparities. Health Policy Institute of Ohio: Health Policy Institute of Ohio press.
Kaiser Commission on Medicaid and the Uninsured (KCMU), (2003). The Uninsured and Their Access to Health Care. California: KCMU.
McDonough, J., Gibbs, B., Scott-Harris, J., Kronebusch, K., Navarro, A., &. Taylor, K. A. (2004). State Policy Agenda to Eliminate Racial and Ethnic Health Disparities. Herndon VA: Stylus publishing LLC
Smedley, B., Stith, A., & Nelson, A. (2002). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington DC: Institute of Medicine.