Ischemic Stroke Environmental Analysis

As an oncologist at Grady Memorial, an inner-city hospital located in Atlanta, Dr. Brawley witnesses the disastrous effects of healthcare disparity first-hand. Healthcare disparities are vast differences in quality and access to care between socioeconomic classes. "health care disparities refer to differences in health and health care between population groups. Disparities occur across many dimensions, including race, ethnicity, socioeconomic status, age, location, gender, disability status, and sexual orientation "(KFF, 2016). As Brawley describes to us, Grady is a hospital that demonstrates health disparity at its worst. Brawley describes Grady as " a monument to racism, Racism is built into it, as is poverty, as is despair." (Brawley, 2011).

The disparities are around us every day and unless we educate ourselves and our communities these disparities will continue to wreak havoc on our neighborhoods and in the future, we will just be putting our kids and their kids in a continuing cycle of ignorance when we could have done more if it’s just educating the community we leave in, that alone could be enough to turn the tides in our people favor. In turn, I would hope this paper enlighten you on what is going on in our neighborhood and what we can do to correct this issue to preserve our autonomy. Racial and ethnic health disparities undermine what a healthcare system should stand for. Although the top three causes and seven of the 10 leading causes of death are the same for African Americans and whites, the risk factors and incidence, morbidity, and mortality rates for these diseases and injuries often are greater among blacks than whites (MMWR, 2005). Health disparities refer to differences in disease risks, incidence, morbidity, and mortality but most of all for the sake of this paper unequal access to quality health insurance amongst African American in the United States, which will also go hand and hand with the social and economic disadvantages. The disadvantages of health disparities usually affect people of African American descent who have systemically experienced a greater social and economic obstacle to health care.

Health disparities among African-Americans is a continuing problem that has been seen over many years. African-Americans have higher poverty rates, have lower rates of insurance coverage, and are more likely to be covered by Medicaid, than the White population (Copeland, 2005). This lack of insurance has led many of these individuals, to not seek treatment for illness, due to problem accessing health care (Kennedy, 2013). This leaves African-Americans with little to no treatment, which causes an increase of medical care that will be needed further on in their life or a sooner than expected death, caused by illness (Copeland, 2005).

For decades, a person’s socioeconomic status or SES has affected the healthcare that people receive due to race and “wealth”. This problem has plagued American society because of these factors leading to many receiving inadequate healthcare. All of these factors for someone’s SES has changed a lot in the healthcare domain that is unfair to many who are not the “ideal”. Due to this the perception, experiences with healthcare waver and are different between the stages of these SES’s. No matter the status of a person they should receive the same amount of care, treatment, and closer.

The United States is plagued with stark health disparities across its communities (Institute of Medicine, 2013). Defined as the “variation in rates of disease occurrence and disabilities between socioeconomic and/or geographically defined population groups,” disparities describe the inequality of access to basic health services in America (HSRIC, 2016). Over the past decade, health reform has attempted to address this issue of health inequality by strategizing to insure more people and provide increased access to care.

As Americans, we are all equal, right? Well, why are there differences (or disparities) rampant throughout our nation’s health care system. These disparities can sometimes indicate that there is unequal treatment of Americans in our nation. In 2002, The Institute of Medicine (IOM) published the leading report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. The report proved there is in-fact, racial and ethnic disparities in American health care, and amid the many health care services available. Disparities in health care are of-course, not only prevalent across racial demarcations, but also across one’s sexual orientation, social class, socioeconomic position, sex, and geographic location (U.S.). Medical organizations like the AHRQ and the Health & Human Services Dept. are dedicated to bringing about equal health care to all Americans. These organizations have invested a lot of time and money into studies, making it possible for all Americans to research this issue in greater depth. This report is an attempt to provide some insight on the issue of ethnic/racial inequity in health care treatment in America. First, we’ll look at the stats that prove there are discernible ethnic/racial disparities in our health care system, and then we’ll examine why racial and ethnic disparities may exist and what methods can be employed to solve them.

According to the Census Bureau approximately 49 million Americans didn’t have coverage in 2011. The Patient Protection Affordable Care Act has only been extended to cover 32 million uninsured individuals mandates. The main issue of access to affordable care will be to exacerbated by limited community- based resources that provide preventive services, primary care access and the continuum care for patients with chronic conditions. There is a need to increase capacity to serve more patients, while improving outcomes and reducing cost. Health disparities in the U.S. range from HIV/ Aids to obesity. The minority population typically has a disproportional burden of the HIV/ Aids epidemic ( Wetle & Scanlan 2013). Disparities in healthcare are among the lines of access to care, treatment, preventive measures, and medicine. Several research projects were used to examine how ones race, neighborhood, or social classes affect their quality of care, and health outcomes ( Wetle & Scanlan , 2013). It was found that people who lived in lower income urban areas were found to have a lower quality of care. The study also found that these people were also prescribed stronger more dangerous medicine, and also paid higher co- pays. The Affordable Care Act was created to target, and eliminate health disparities (Adepoju , Gonzales , and Preston 2015). The ACA planned to improve health disparities by increasing access to care for minorities. In addition to improving access to care the ACA

Mitchell (2015) discovered that, compared to white Americans, those who are uninsured or underinsured tend to lack regular sources and access to care and receive poor quality of care. About 50% of these individuals are “in lower socioeconomic brackets [with] limited education in historically underrepresented racial and ethnic groups, who have . . . experienced oppression, discrimination, and social and economic inequalities. [Consequently,] they experience higher rates of disease,

Disparities in access to health services affect people and lead to unmet health needs, preventive medical services, and poor health. Low-income people are less able to afford the out-of-pocket costs of care, even if they have health insurance coverage. Public health insurance programs have expanded coverage for the poor and not enough to close the disparity gap. In order to improve health care services, we must make sure that the District 17 communities have usual and ongoing source of care as people with a usual source of care have better health outcomes. District Council 17 needs increased access to quality care regardless of their ability to pay, insurance status, or other potential barriers to

Mason, Gardner, Outlaw, & OGrady, (2016) explains cost, quality, access and racial disparity complications persist throughout the health care system. Healthcare policies work to alleviate these problems associated with the healthcare system. The purpose of this discussion is to identify healthcare policies related to access, equity, quality, and cost. Next, I'll explain what the healthcare reform means to uninsured and underinsured individuals. Following I will identify the implication of limited access to the vulnerable population. Finally, I will describe what nurses can do to help increase awareness of the civil rights in healthcare.

Despite efforts and goals in the United States to reduce or eliminate disparities in healthcare by 2010, significant disparities, including risk factors, access to healthcare, morbidity, and mortality, continues in vulnerable populations. For example, studies find that Americans living in poverty are much more likely to be in fair or poor health and have disabling conditions, and are less likely to have used many types of healthcare. I believe that more effort should be made to bring affordable healthcare to vulnerable population

The Heart and Stroke foundation fails to acknowledge that low income and poor living conditions are major leading causes of CVD and that living a “healthy lifestyle” has very little to do with preventing heart disease. From my own personal experience, when I was in elementary school , every single year a representative from the Heart and Stroke foundation would come to my school and talk about heart disease and how to prevent it. They put major emphasis on eating healthy and engaging in regular exercise. They would hand out jumping ropes and healthy eating charts to every student. For years I was under the impression that heart disease could be prevented if I ate my fruits and veggies, exercise regularly, and didn’t smoke, it wasn’t until I read these articles how far off the Heart and Stroke foundation is regarding the leading causes of CVD. These traditional disease associations unfortunately don’t even acknowledge the effects of adverse social determinants of health, and more often than not lessen how social determinants of health even acknowledge “healthy lifestyle choices” to be formed by those who are most vulnerable to these diseases (Raphael, 2014a). The Majority of people are under the impression that if they were

The World Health Organization (WHO) has defined particulate matter (PM2.5), as an outdoor air pollutant. Also known as air pollution, aerosols, and “fine” particulate matter, PM2.5 has emerged as one of the most significant environmental and public health concerns over the past several decades. PM2.5 has revealed to hold detrimental affects on human health and is attributable to over 130,0000 deaths annually according to 2005 air quality levels (Hoek et al. 2013; CDC). The processes of economic development, urbanization, energy production, and consumption, and transportation have been the primary driving forces of PM2.5. (EPA; Huang et al, 2014)

Particulate matter is particle air pollution that consists of both organic and inorganic molecules (Blomberg 2012). This particle pollution, also known as PM, is constructed of inhalable coarse particles as well as fine course particles. These particles consist of various sizes, which are unequivocally connected to causations of health ailments. The inhalable course particles (PM10) have

Small particulate matter (PM) is the prominent air pollutant responsible for the grey sky in Beijing while other forme such as sulphur dioxide, carbon monoxide and nitrogen dioxide emissions has also been reported concurrent increase over the time (Gang, 2009). Beijing PM2.5 figure is reported repeatedly showing more than 100 µg/m3 average mass concentrations. This figure exceeds twice the safety standard limit imposed by the US Environmental Protection Agency (Wang et al., 2005).