The Low Country Healthy Start Program

Discuss disparities related to ethnic and cultural groups relative to low birth weight infants and preterm births. Describe the impact of extremely low birth weight babies on the family and on the community (short-term and long-term, including economic considerations, on-going care considerations, and co-morbidities associated with prematurity). Identify at least one support service within your community for preterm infants and their family. Provide the link for your colleagues to view. Does the service adequately address needs of this population? Explain your answer.

There are many factors that contribute to the current health status of Black Americans, but “Poverty may be the most profound and pervasive determinant of health status” (Edelman & Mandle, 2010, p. 39). Health care is expensive and can only be purchased by those who can afford to pay, so those below the poverty level are those who lack insurance. Without insurance their access to healthcare is limited, especially preventative care. No preventative care means more expensive care that comes with illness.

The health of a nation plays an integral part in the overall success and economic well being of a particular country. The United Stated, while pouring more money into the healthcare system than any other country, still stands as a broken system with inadequate care for many citizens. One of the most marginalized groups of people, African American women, continually score alarmingly low on basic measures of overall health. The healthcare discrepancies between white and black women in the United States are alarming, and they reveal flaws in the American health care system as a whole.

With this increased research and effort, Americans would be able to intervene and make positive impacts with the state, tribal, and local levels to best address health disparities and inequalities. In efforts to thwart ethnic and minority disparities, The Department of Health and Human Services (HHS) passed the HHS Disparities Action Plan in order to establish “a nation free of disparities in health and health care, (Cooper 97)” and to implement a series of priorities, strategies, actions, and goals to achieve this vision. States, local communities, private organizations, and providers have additionally engaged in efforts to reduce health disparities. With the HHS Disparities Action Plan, the Department continuously assess policies and programs on racial and ethnic health disparities, watching to see which policies make an impact on the level of health care received by minorities. Similarly, The Affordable Care Act (ACA) health coverage expansions significantly increase coverage options for low and moderate income populations and particularly benefit the “vulnerable populations.” The ACA also includes provisions to strengthen the safety-net delivery system, improve

Infant mortality rate constitutes the death of a baby before their first birthday. Mortality rates around the world differ tremendously with America leading the first world countries at an alarming rate of 6.1 deaths per 1,000 births. Conversely, Finland and Japan secure the last, most desirable position, with deaths totaling 2.3 per 1,000 births, as of 2010. (Ovaska-Few, 2015) In 2014, over 23,000 babies died in the United States. (CDC, 2016) Exploring the mortality rates in America brings light to a dire need for additional interventions and research as to why this developing nation has the highest rate of infant deaths before the age of 1 year old. African Americans face the worst outcomes of infant death compared to whites, Latino, and their Native American peers in North Carolina. (Ovaska-Few, 2015) This paper will explore why African American are the leading race for infant mortality and the steps that health communities need to take to address this devastating occurrence.

I assume that in today’s world, there is a lot of information and scholarly research available that shows factors such as economic status, income, social situations, education, ethnicity, employment, availability of affordable housing and geographical (place where one was born and lives) conditions have a tremendous impact on the health and well-being of individuals, countries and communities (Amaro, 2014). Inequalities in health and well-being are created by social determinants and economic conditions for many in our community (Brannigan &Boss). The people that are affected the most are people with low income and minority groups here in the United States. This creates health disparities and unequal care (Brannigan &Boss). In many developing and under-developed countries, the situation is dire: lack of modern health services, illiteracy, poor economic conditions has created a cultural situation of desperation and unhealthy behaviors. Corruption by African governments is rampant. To improve the health and wellbeing of communities, we need to start thinking of how we can create a culture of health.

For this paper, Ms. Minister Melishia Bansa MPH was interviewed. She is a thirty year old African-American woman. Her occupation is the director of community outreach and provider Relations for “Coordination of Health Care for Complex Kids” (CHECK) Program and Project Coordinator of “Promoting Adolescent Health” (PATH) Study. She was interviewed about her work with the CHECK Program. The Coordination of Health Care for Complex Kids program aims to improve overall health and quality of life for underserved populations. This programs aims to fight the social injustice of unequal health systems for low socioeconomic communities. The CHECK program aims to increase doctor appointments and improve communication between the patient and the patient’s health provider. However, the program is focusing on young individuals with chronic illnesses within low socioeconomic communities.

“Compared with European Americans, African American infants experience disproportionately high rates of low birth weight (LBW) and preterm delivery and are more than twice as likely to die during their 1st year of life”(Giscombé, C. L., & Lobel, M., 2005). The infant mortality rate for African Americans is 13.7 deaths per 1000 live births, more than twice the rate (5.7) for White Americans in the U.S. (Kung, Hoyert, Xu, & Murphy, 2008). A lot of the racial disparity in infant mortality can be explained by low birthweight and preterm delivery, which are also disproportionately and often experienced by African Americans (Martin et al., 2007).

Despite improvements, differences persist in health care quality among racial and ethnic minority groups. People in low-income families also experience poorer quality care (U.S. Department of Health and Human Services, 2013). Access to care measures include facilitators and barriers to care and health care utilization experiences of subgroups defined by race and ethnicity, income, education, availability of health insurance, limited English proficiency, and availability of a usual source of care (Mandal, 2014).

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.

One important health disparity is the lack of prenatal care amongst women in socially disadvantaged populations. These predominately include women of minorities, women who have a low income, and the location these women live in. This health disparity is important to address because research has shown that women who receive prenatal care are more likely to conceive babies of a healthy birth weight and have low infant mortality rates than those women who do not receive this prenatal care ("Putting Women 's Health Disparities on the Map," 2009). Therefore, health disparities amongst women in need of prenatal care have lead to preventable infant mortalities amongst women in vulnerable populations. Three reasons why this health disparity is important to address include the following: health disparities in prenatal care lead to lack of access to prenatal care to women in vulnerable populations, there are increased adverse health outcomes for both the infant and mother, and there are excess medical expenses that could otherwise have been prevented. Because “prematurity is the leading cause of newborn death in the United States” (“Healthy Mothers and Healthy babies,” 2013), finding and developing a solution will be extremely beneficial and needs to begin with addressing prenatal care.

Major disparities continue to exist in spite of America’s “Affordable Care Act”, Although minorities suffer disease five times greater than the rest of the nation, minorities represent the majority of the disparity. Infant Mortality has always been America’s indicator as to the state of the countries health status. America is one of the wealthiest and most powerful nations in the world, However, America ranks number 24th in the world for infant mortality. Puerto Rican and Indian women rank highest among ethnic classes with low infant mortality rates. Some researchers have found lack of prenatal access as the key contributing factor to low mortality and birth weights among these two ethnic classes.

healthcare system (Elchoufani, 2018). Attaining a good health is the ultimate goal for all people and the overall population, so it is important that people study the interactions between race, gender, and socioeconomic status in this matter (ASPPH, n.d.). People in communities with lower socioeconomic status typically encounter fewer options for healthy food and a lack of health education as well as health care. All in all, studying minority health allows us to find methods in making health care more accessible for under-resourced populations, along with determining methods out services and resources can be dispersed to the populations which are more prone to certain illnesses (ASPPH, n.d.). The studying which results in better methods all benefit towards guiding the U.S. population to overall health

In the United States, there are disparities between the different racial groups when it comes to low birth weights and premature births. Evidence of this can be seen with information collected Reichman (2005). She found that African Americans have the highest rate with this accounting for 13.0%. While whites are reporting 6.5% and Hispanics are seeing figures of 6.5%. However, inside the Hispanic demographic there are differences in these numbers as Puerto Ricans have 9.4%. These disparities are not tied to economic status with many educated African American women having children of low birth weight. Whereas, there are differences between select segments of the Hispanic population in contrast with other sub groups. (Reichman, 2005)

One issue with underserved populations is an increase in health disparities, not only race and ethnicity, but also gender and age. The Centers of Disease Control and Prevention (2014) list a number of key findings from a report on underserved populations and health care. Mortality rates from certain diseases and different types of death were higher in different racial groups than Caucasians (Centers for Disease Control and Prevention, 2014). Morbidity of asthma, oral disease, tuberculosis, obesity, and diabetes were also higher in minority groups (Centers for Disease Control and Prevention, 2014). Preventive screening for the over-50 population was just over 60%