Abstract
This paper discusses health disparities affecting Kentucky citizens, along with barriers, and roles of leaders. It shows that Kentucky is one of the unhealthiest states with high rates of drastic health disparities in the United States. There are high rates of chronic diseases, poor physical health, mental health, obesity, and premature deaths in Kentucky. Rural communities, particularly in Appalachia experience most of these health disparities due to several contributing factors, such as cultural belief systems; lower socioeconomic status, income and education attainment; inaccessibility of healthcare facilities; a large number of uninsured people; and poor utilization of the available healthcare services. Leaders and stakeholders in the healthcare sector must address the high rate of health disparities in Kentucky by focusing on minorities and rural communities. The process requires thorough assessments and effective allocation of resources.
Health disparities in Kentucky
According to Baretta Casey, Kentucky is one of the “unhealthiest states in the US, ranking in the lowest ten out of the fifty states in total mortality, cancer deaths, percentage of smokers, poor physical health, cardiovascular deaths, percentage of obese adults, and premature deaths” (Casey, 2012, p. 130-131). This implies that there are widespread health disparities that affect Kentucky citizens. Specifically, excessively high rates of health disparities were noted in heart diseases, adult obesity, diabetes, heart conditions, high blood pressure, and poor spending on mental health. Rural areas of Kentucky, particularly Appalachia region and others have experienced high rates of health disparities. While metropolitan areas are mainly in Bluegrass region with largest healthcare facilities in the state, rural residents must travel there to receive healthcare services. Rural communities of Appalachia suffer from most disparities perhaps because of working in the coal mining, farms, and the timber industry. These occupations result into ill health such as musculoskeletal degenerative disease, coal miners’ pneumoconiosis, and work related injuries. Other studies have also that “Appalachians experience increased rates of cancer incidence and mortality and high risk health behaviors” (Vanderpool and Huang, 2010).
Barriers
There are several barriers to effective provisions of healthcare in Kentucky. Culture plays a critical part in influencing health related beliefs and practices among different ethnic groups. Apart from lower socioeconomic status and geographic isolation, Appalachians have cultural beliefs like fatalism (Vanderpool and Huang, 2010). These researchers found that Appalachians were likely to relate cancer with death, could know their cancer status before a diagnosis, everything could cause cancer, and they did not like to visit care facilities (Vanderpool and Huang, 2010). One can conclude that rural communities in Kentucky have mistaken cultural beliefs about cancer and its treatment, particularly because of abundant information about cancer treatment. Therefore, Appalachians require specific communication strategies, education to create cancer awareness, address depressing cancer beliefs, and promote relationships with healthcare providers. In addition, effective healthcare provision in a geographically isolated region requires local knowledge on relationships between culture and ill health, practices, beliefs, and risks.
Socioeconomic status of many Kentucky residents has also contributed to health disparities. People in rural areas of Kentucky tend to have lower incomes and educational achievements. There are relationships among poverty, poor health, and levels of education, which relate to high rates of morbidity and mortality. In fact, Casey shows that Kentucky residents in rural areas are mainly coal miners, farmers, and loggers, who experience high rates of different forms of ill health (Casey, 2012).
Several rural communities in Kentucky experience challenges with gaining access to and utilizing available healthcare services. Rural residents have to commute to Bluegrass region to get such services. Financial and other factors create barriers to accessing and using healthcare services among minority groups in rural regions of Kentucky. Studies have shown the association between inequalities and poor utilization of preventive and primary healthcare services. Rural communities or minorities do not have equal chances for screening and utilizing healthcare equipment.
Another barrier is health insurance. A significant percentage of Kentucky citizens do not have health insurance. These are mainly minorities and rural communities. Moreover, they cannot get private coverage like other groups. Any minority citizens who had health insurance were mostly using public ones. Lower incomes and education achievements hampered rural communities from getting health insurance.
Healthcare disparities also result from failure to utilize preventive healthcare services. Many uninsured rural communities in Kentucky are not likely to have nearby healthcare facilities, doctors and nurses for consultation.
Roles of leaders
Given the disproportionately high rates of health disparities in Kentucky, leaders and other stakeholders in the healthcare sector have take initiatives to address Kentucky’s health disparities. As a result, they have conducted various assessments on health risk factors, population characteristics, health access, outcomes, and mortality rates associated with chronic diseases. The evaluation should provide a framework for decision-making among healthcare leaders and other stakeholders to provide healthcare services for minorities and rural communities.
While the state has made some achievements with regard to several public health areas, Kentucky has many health issues, particularly with regard to drastic health disparities, yet the minorities know little about several specific contributing factors and their associated risks (Reiter et al., 2013). It must focus on addressing these health disparities among its citizens to improve their health status.
References
Casey, B. R. (2012). Rural Public Health Systems: A View from Kentucky. In R. Crosby, M. Wendel, R. Vanderpool, & B. Casey (Eds.), Rural Populations and Health: Determinants, Disparities, and Solutions (pp. 115-132). San Francisco, CA: Jossey-Bass.
Reiter, P. L., Fisher, J. L., Hudson, A. G., Tucker, T. C., Plascak, J. J., and Paskett, E. D. (2013). Assessing the burden of HPV-related cancers in Appalachia. Human Vaccine and Immunotherapeutic, 9(1), 90-6. Web.
Vanderpool, R. C., and Huang, B. (2010). Cancer risk perceptions, beliefs, and physician avoidance in Appalachia: results from the 2008 HINTS Survey. Journal of Health Communication, 15(Suppl 3), 78-91. Web.