An Integrated Health System

According to the U.S Department of Health and Human Services (Kassandra, A., 2015), the issue of health disparities have impacted many people’s lives in the community where the minority groups do not have equal access to the quality health care. These

Barriers in health care can lead to disparities in meeting health needs and receiving appropriate care, including preventive services and the prevention of unnecessary hospitalizations (HealthyPeople.gov, 2012). In their 2008 annual report, the Agency for Healthcare Research and Quality lists several disparities’ in health care. They report that racial and ethnic minorities in the United States

The answer is no simple or a single solution. Rather, the answers must address the range of causes of disparities (inequalities in education, housing, and health insurance) and empower multiple levels of change ( patients, providers, health systems, policymakers, communities). These levels of change are most commonly found in the fundamental public health Socio-Ecological model. In this model, there are 5 levels, intrapersonal, interpersonal, community, institutions and policy, that could be focused on when implementing solutions to public health concerns, which health disparities would be considered. One method that should be looked at very closely in the institutional level of the model is reorganizing the curriculum of physician education in order to incorporate cultural competency. Such training can improve provider knowledge, attitudes and skills, which may be an important precursor to addressing unconscious provider bias. Drawing upon evidence in social cognitive psychology, Van Rhys Burgess have outlined strategies and skills for healthcare providers to prevent unconscious racial biases from influencing the clinical encounter. Their framework includes: 1) Enhancing internal motivation and avoiding external pressure to reduce bias, 2) Enhancing understanding of the psychosocial basis of bias, 3) Enhancing providers’ confidence in their

The United States is a melting pot of cultural diversity. For a country that was founded by individuals fleeing persecution, it has taken us many years to grant African-Americans equal rights, and even longer for those rights to be recognized. Despite all the effort to eliminate inequality in this country, health disparity among this minority group remains a significant issue. Research in this area has pointed to several key reasons for this gap that center on differences in culture, socioeconomics, and lack of health literacy.

Across the country, a steady increase has been noted in the number of patients presenting to emergency departments for psychiatric complaints (Zun, 2014). Patients also attempt to use their primary care doctors to treat their mental illnesses. The mental health care options for these patients are extremely limited, especially for minority populations such as African Americans and Hispanics. One out of four adults in America suffers from some form of mental illness, yet only one out of three of those affected receives treatment (Safran, 2009). Furthermore, patients are routinely misdiagnosed, receive poor quality of care, receive care from providers who have no understanding of their cultures and values, or are not even able to receive care in the first place (Sanchez, 2012).

When it comes to healthcare racial disparities continue to be an ongoing issue. In fact racial disparities have been a topic of discussion since desegregation. The US Department of Health and Human Services, in 1984 published a report that called attention to the healthcare disparities. The report was called Heath, United States 1983(Dougher, 2015). Within the context of the report there lies a passage that describes the major disparities that are within the burden of illness and death that is experienced by African Americans and other minorities, “despite significant progress in the overall health of the nation” (Dougher, 2015). It was evident that there was a serious lack of health care minorities.

The vision of The National Institute on Minority Health and Health Disparities (NIMHD) to help provide the American people have a healthy life equally. By increasing awareness throughout the nation on the prevalence rates and impact of health disparities on individuals and communities The National Institute on Minority Health and Health Disparities (NIMHD) helps reduce and encourage elimination of health disparities. The National Institute on Minority Health and Health Disparities (NIMHD) has a direction on developing and conducting research, publication of findings, train and public education to better minority health and minimize health disparities. In achieving those goals The National Institute on Minority Health and Health Disparities (NIMHD) must enhance its research and create a culturally knowledgeable workforce, develop researches on factors that influence health disparities and must reach out to communities to provide any new information that was identified in the recent researches and lastly educate the public.

With a growing and diverse United States population, pursuing the goal of cultural competence in the workforce and health-care system emerges as a leading strategy in reducing disparities. Cultural competency, is defined as the ability of health-care providers to function effectively in the context of cultural differences (IOM, 2001). As a healthcare administrator it is important to employ several initiatives to increase the cultural competency within the workforce including the recruitment and retention of minority staff as well as providing training to increase cultural awareness, knowledge and skills. Another strategy to employ in strengthening the relationship between the patient and provider is to create buy-in from community leaders and stakeholders when launching initiatives geared toward the reduction of health disparities. One example of this type of approach is the Racial and Ethnic Approaches to Community Health (REACH) projects funded by the Centers for Disease Control and Prevention (CDC). REACH projects aim to reduce racial and ethnic health disparities in minority communities. For example, a 2010 study by Liao et. al., documented overall decreasing trends in the prevalence of smoking among men in Asian communities served by the REACH project. By engaging the communities that they serve and forming community partnerships, projects such as REACH can be been successful in targeting health behaviors and consequently reducing health disparities in communities of

Vertically integrated health care system that I have chosen is the Veterans Administration (VA) it's accountable for a large patient population for military veterans. As stated, The Veterans Health Administration is America’s largest integrated health care system with over 1,700 sites of care, serving 8.76 million Veterans each year (VA.GOV). The services that's provided to veterans is health care, rehabilitation, employment, education, home loan guaranties, and life insurance coverage. VA control costs by buying in bulk and control costs by engaging in a deep, single-source relationship with each patient. The Assistant Secretary for Management oversees all resource requirements, development and implementation of agency performance measures,

There are several disparities where health care is deprive between minorities African American, Hispanic and low-income communities. Healthcare quality and access to care are unequal among racial and low-income groups. Black American and Hispanic have face with poor access to health care among any other race, and the low- income family who have been offers low stander of care according to the American Medical Association eventually suffer from” higher mortality rates, higher incidence of major diseases, and lower availability and utilization of medical services” (50-I-95).

In the United States, we believe that health care should not differ by race, ethnicity, socioeconomic status or geographic location. When these differences do exist, they are referred to as disparities. We see this when racial and ethnic minorities receive lower quality healthcare than whites, when age is a determinant of quality of care, when level of education or sexual orientation are taken into consideration or when a person is uninsured or must rely on government issued health coverage for care. It is important to understand that differences in

Problem Multicultural disparities serve as a gap within the health care system. However, all remarkable leaders and or administrator share commonalities to try and bring about a resolution for multicultural disparities. In fact, an integral part of multicultural disparities stems from attitudes, no access to resources, health behaviors, and organization not validating a change is needed. More importantly, health disparities, continue to plague the population. Multicultural Health Care: A Quality Improvement Guide.

Health care providers receive little or no training on issues of race and racism. As a result, awareness of racism and its impact on health care delivery is low. Until racial issues are honestly addressed by members of the health care team, it is unlikely that we will see significant improvements in racial health care disparities for Americans. Barriers to racial health care equity therefore includes the health care system (insurance, funding), the patient (poor health literacy, fear, mistrust), the community (awareness, advocacy), and the health care providers (bias, attitudes, expectations, stereotyping). Nelson, (2016).

Diversification continues to rise in the United States which results in an increase in poverty level living and lower levels of educational achievement. The mixture of low education and an increase in poverty effects individual and population health. Additionally, health disparities are growing and impacting the health care field. Cultural competency and communication across language barriers are influential in producing quality care for socioeconomically challenged minorities. However, educational attainment and health literacy are the most influential factors for minorities’ well-being. Better quality of care for minorities ultimately results in an improvement in population health.

In summary, the text elaborates on the issues at hand with both the business and social aspects of the inconsistencies in reaching fair and equitable healthcare within the United States. The aim is to reduce these discrepancies of racial/ethnic or socioeconomic disparities within the healthcare system by implementing interventions. A vital intervention is escalating responsibility and taking a closer look to polish up the quality of clinical care given for individual patients and communities. While working on these health imbalances, the healthcare organizations want to know that there will be a return on investment.