Unwittingly Perpetuate Health Care Disparities

The increasing population of immigrants in the United States has contributed to health disparities in the health care system. Cultural competence can remove health disparities by eliminating personal biases, and treating every person with respect. Simply recognizing and accepting different cultures is not enough, one must be able to consistently recognize and understand the differences in order to be culturally competent. Knowledge and culturally competent practices are a must for nurses to deliver quality care in our rapidly changing multicultural world (Edelman, 2014 p. 25).

The main purpose of this article was to unexamined biases, to see how much they contribute as well as to address ethnic and racial in health care disparities. Biases can be referred to as favoritism, a favor of one and against another, very systematic and differing by racial and ethnic groups. Many psychologist has turned their focus and studies on common biases, which biases influence medical decisions and interaction.

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 term culture is defined as “the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups” (Potter & Perry, 2013). With the increase of culturally diverse populations in the United States, it is important for nurses to practice cultural competence. Cultural competence is the ability to acquire specific behaviors, skills, attitudes, and policies in a system that permits “effective work in a cross-cultural setting” (OMH, 2013). Being culturally competent is essential because nurses who acknowledges and respects a patient’s health beliefs and practices are more likely to have positive health outcomes (OMH, 2012). Every culture has certain views and attitudes concerning

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

Since the publication of the Institute of Medicine’s “Unequal Treatment Report” in 2002, highlighting the startling but harsh truths behind these health care differences, there has been a renewed interest in understanding the sources of these inconsistencies, with any seeking to identify contributing factors in hopes of creating an effective solution in reducing or eliminating racial and ethnic disparities in health care

Barriers to healthcare include factors that restrict or hinder people from receiving adequate and quality health care service. Health care disparities are those differences that negatively affects less advantaged group (Mehta, 2014). Health care barriers play a significant role in comprehending causes of disparities. This paper will discuss the obstacles and disparities that exist and affects healthcare.

Critically analyse one of the main challenges, barriers, and enablers for cultural competence in health care when working in a cross-cultural environment.

Although the United States is a leader in healthcare innovation and spends more money on health care than any other industrialized nation, not all people in the United State benefit equally from this progress as a health care disparity exists between racial and ethnic minorities and white Americans. Health care disparity is defined as “a particular type of health difference that is closely linked with social or economic disadvantage…adversely affecting groups of people who have systematically experienced greater social and/or economic obstacles to health and/or clean environment based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion” (National Partnership for Action to End Health Disparities [NPAEHD], 2011, p. 3). Overwhelming evidence shows that racial and ethnic minorities receive inferior quality health care compared to white Americans, and multiple factors contribute to these disparities, including geography, lack of access to adequate health coverage, communication difficulties between patients and providers, cultural barriers, and lack of access to providers (American College of Physicians,

Chang, M., & Kelly, A. (2007). Patient Education: Addressing Cultural Diversity and Health Literacy Issues. 27(5), 411-417. Retrieved from http://www.medscape.com/viewarticle/564667

Sally Satel on the other hand is a supporter of the fact that racism is not a serious problem in the health care system. Even though she agrees with IOM about health care disparity, she thinks racism is not a cause. That is what she shows the reader in her article. She argues that the health care system is colorblind. Satel she mentions the causes of health care disparities as well as ways to correct the disparities. In her opinion, “racism isn't to blame for health disparities, but rather race itself” (Satel 2). Satel identifies two possible reasons to counter the notion that racism is the cause of health care disparities. First, she quotes that, “white and black patients, on average, do not even visit the same population of physicians—making the idea of preferential treatment by individual doctors a far less compelling explanation for disparities in health” (Satel 2). Another reason is “that a higher proportion of the doctors that black patients tend to see may not be in a position to provide optimal care” (Satel 1).

Gordon Moskowitz and his co-authors’ (2012) expands on this discussion of unconscious bias by associating it with stereotyping certain racial groups. The providers’ unconscious biases are referred to as implicit biases, and demonstrate usefulness if correctly used to identify groups more readily susceptible to a health condition than others (996). When used correctly to identify these individuals, patient outcomes have a positive outcome. However, a hasty assumption that leads to an incorrect stereotype results in severe negative outcomes from a resulting incomplete or inaccurate diagnosis by the physician (1000). These implicit biases also tie back to the previous theme

Oliver et al. (2014), exemplifies how some physicians may not be aware of their implicit bias that could be causing healthcare disparities. This study determines whether physicians’ implicit racial views of African Americans affect their decision making, regarding total knee replacement (TKR) as a treatment option for OA. They also assessed whether not, if the Racial Implicit Association test would impact TKR recommendations. In the study implicit bias was determined by the racial implicit association test (IAT) and explicit bias was tested using a questionnaire that asked physicians which race they preferred (black or white) using a 5-point Likert scale and 10-point thermometer scaled to grade physician’s feelings.

Knowing, understanding, and being aware of personal biases is the first step in the development of plans or strategies overcoming biases. As nurses we must recognize and be more sensitive to the care provided to patients and understand that differences do exist in and between the differing races, cultures, and ethnic groups (Giger, 2013, p. 3). The Implicit Association Test (IAT) is used to identify and provide an awareness to biases that are consciously or unconsciously present in an individuals actions and beliefs (Project Implicit, 2011). After completing the Race IAT, Gender-Career IAT and Religion IAT, I will discuss the prejudices, biases, and stereotypical thinking present in my life and share what steps can be taken to reduce or eliminate

In the article, Effectiveness of Cultural Immersion and Culture Classes for Enhancing Nursing Students’ Transcultural Self-Efficacy, a quasi-experimental research design is performed as nursing students run pretest and posttest studies. The study assesses students’ self-efficacy while dealing with patients from various cultures. Cultural competence in the medical profession is important and is encouraged by the Joint Commission to ensure students in the medical field are taught culture competency as well as health promotion. This is imperative to learn so that nurses implement fair treatment regardless of patients’ cultural differences.