Healthcare Disparities of Impoverished Americans


The availability of affordable quality healthcare is one of the basic needs that every American should have. The country has made significant progress to ensure that every American, irrespective of the social status or any other demographical classifications, have access to quality healthcare. However, a report by DeLong (2014) shows that many impoverished Americans still struggle to have access to these services. The report further indicates that the Native Americans and other minority groups are the worst affected by this problem. Their limited financial capacity to purchase quality healthcare products is worsened by institutional racism that is common in various healthcare institutions across the country. According to Institute for Research on Poverty (2015), about 8.6% of American children from poor families lack health insurance coverage. It means that they cannot get the services when they visit hospitals if they cannot pay in cash. The trend is worrying because the number of uninsured Americans is high despite the creation of Affordable Care Act and other legislations meant to make these services affordable (Nash, 2017). It is a sign that urgent measures are needed to address this problem. The availability of quality health care in the United States is still a preserve of the rich despite the government’s effort to make it available to all Americans.

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According to a recent report by Nash (2017), the life expectancy of the natives in the United States (American Indians and Alaska Natives) is about 20 years shorter than that of the national average. The report attributes this condition to health disparities in the country. The poor, majority of who are the natives and other minorities such as African Americans, are unable to afford some of the expensive health insurance coverage that can enable them to have access to the best medical facilities in the country. The situation is worse among the American Indians living in the reservations. The Congress has chronically underfunded healthcare institutions within these reservations, which means that they can only provide sub-standard services. These institutions are understaffed and sometimes lack important medicine needed by the patients. The limited healthcare services available in these regions can only be accessed by those who have the capacity to pay. However, DeLong (2014) notes that about 19.3% of the poor Americans do not have health insurance coverage.

The poor minorities are the worst by this issue. Their inability to afford healthcare services is worsened by the racism, which is still a major problem in the country. A poor American Indian without health insurance coverage is five times less likely to have access to healthcare services than a white under the same conditions (Nash, 2017). The Hispanics also face the same problem and are sometimes dismissed from hospitals without treatment because of the general perception that most of them are illegal immigrants. A report that was released by the National Health Interview Survey in 2014 shows that the poor in the United States are 4.2 times more likely to delay or forgo necessary medical care compared to those above the poverty line (Nash, 2017). They have other pressing needs such as food and shelter. They only consider going to the hospital when the health problem is at or nearing a crisis level. The trend causes a situation where a diagnosis of major diseases such as cancer among the poor is done at advanced stages when treatment is very expensive. It compounds their problem, a fact that causes a shorter life expectancy among the affected population. Figure 1 below summaries the health disparities in the United States by poverty status.

Health disparities by poverty status (Institute for Research on Poverty, 2015).
Fig. 1. Health disparities by poverty status (Institute for Research on Poverty, 2015).

Nursing Response

According to Nash (2017), the availability of quality healthcare services is a basic need. The socio-economic status of an individual should not be a barrier to accessibility of these services. As the world’s leading economy, it is very unfortunate that the United States is unable to provide quality healthcare to all its citizens. The impoverished find themselves in situations where they can only afford substandard healthcare services. Some of them are forced to forego regular medical check-ups that can help in identifying major illnesses for early intervention. Although the real power to address the problem lies with the political class, nurses can help improve the current condition.

Nursing Plan to Reduce Illness and Improve Wellness

Nurses are always expected to work under strict guidelines provided by the Nursing Administrators and the management of the hospitals. However, the nursing union can champion for a nursing framework where all patients who visit the hospitals are given proper initial care irrespective of the nature of identification that they present. Nurses should be allowed to attend to the patients, especially those who need urgent care, before the documentation process can begin. Nurses should also commit to fighting racism and any other form of discrimination that may limit accessibility of healthcare services.

Socio-Political Measures for Which Nurses Can Advocate

Nurses can advocate for a comprehensive healthcare insurance cover for all Americans irrespective of their capacity pay for such services. As DeLong (2014) observes, major national discourse about the appropriate healthcare cover for Americans should involve nurses. They should provide expert opinion on these issues based on their daily experiences with desperate patients who are in dire need of healthcare services but lack the capacity to pay. They should be the voice of the poor Americans because they regularly see how they suffer whenever they visit healthcare institutions. DeLong (2014) believes that nurses are in the best position to convince the American society that quality healthcare is a basic need that should not be denied to anyone because of the inability to pay.


The availability of health care services in the United States is still a preserve of the rich despite the effort put in place by the past and current regimes to make it available to all Americans. The poor find themselves in situations where they have to forego important medical check-ups and treatments because of their limited financial capacities. Some of the healthcare facilities meant to serve the poor, such as those in the reservations, are understaffed, making it difficult for them to offer quality services. From this study, the researcher has learned that racism is another issue that compounds the problem of inaccessibility of healthcare services to the poor Americans. The poor minorities not only suffer because of their unfortunate social status, but also because of their race. The findings of this study should be applied in the future practice. Nurses are strongly encouraged to be the champions for the poor Americans in terms of fighting for comprehensive healthcare cover for all irrespective of the social and economic status.

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DeLong, B. (2014). How US healthcare affects inequality. Web.

Institute for Research on Poverty. (2015). Reducing health disparities by poverty status. Web.

Nash, D. (2017). Health inequities in America. American Health & Drug Benefits, 10(6), 279-280.

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