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Racial and Ethnic Disparities in Healthcare

Introduction

Racial and ethnic disparities affect the provision of quality healthcare in managing chronic conditions for minorities. With a significant portion of the American population consisting of minority groups, their plight in the matter concerning healthcare is a national issue. These disparities are mainly caused by implicit biases by providers, social stratification, financial burdens, and the lack of clinical preventative services resulting in poor health outcomes. As a result, the mortality rates in ethnically dense areas are significantly higher while treatment costs for minorities that are socially disadvantaged become larger when compared to other sections of the population. Therefore, to adequately mitigate the issues caused by racial and ethnic disparities in the healthcare system that affect the well-being of minority populations, there is a need for improvement measures that cater to their specific problems.

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Racial disparities involve the issues of treatment imbalances of people based on their skin color while ethnic disparities refer to different handling of people based on specific shared cultural values. In such cases, access-related factors such as the patient’s preferences and clinical needs do not pose a significant challenge to their treatment (National Academies of Sciences, Engineering, and Medicine, 2017). However, other factors such as geography, stereotypes, communication barriers, and lack of access to healthcare providers pose a significant challenge when treating minorities (National Academies of Sciences, Engineering, and Medicine, 2017). Consequently, these challenges lead to health inequities between minorities and non-minorities, causing adverse health outcomes. Furthermore, with cardiovascular disease and cancer being the leading causes of death in America, the inequities brought about by race and ethnicity affect the provision of quality healthcare in managing these chronic conditions. Consequently, minorities suffer extreme effects of chronic illnesses due to the inequality faced in service provision when seeking medical assistance in predominantly white countries.

The incidence of chronic conditions in American populations has increased over time, with more people affected each year. With cancer being a leading killer among chronic illnesses, its occurrence in American patients is significantly higher. Zavala et al. (2021) highlight that prostate cancer is prevalent in Black males and that it constitutes one of the most significant disparities compared to other types of cancer. More so, such individuals have a higher risk of developing the disease while also suffering from its aggressive forms. Apart from that, minority populations further have the highest incidence of colorectal cancer and pancreatic cancer (Zavala et al., 2021). Consequently, such significant incidence rates show a trend of chronic illnesses in minority populations, indicating a higher disease burden. Thus, the severity of these conditions requires a thorough analysis of healthcare providers to ensure that all citizens can access quality care. The presence of racial and ethnic disparities, therefore, complicates the issue, further putting the lives of minorities at risk due to poor health outcomes.

Causes of Racial and Ethnic Disparities in Healthcare

Health care providers possess implicit biases when dealing with patients from minority groups that lead to a higher possibility of lower quality services. Wheeler and Bryant (2017) state that health care providers are predisposed to bias in providing services and that they are, hence, more likely to discriminate against minorities. Racial and ethnic disparities are experienced across the various healthcare levels. These levels include the patient, the healthcare provider, and the overall health system, each with the individual factors that affect the outcomes. Racial and ethnic biases in healthcare providers lead to longer wait times, poor reception, and lower quality of care among minorities seeking services in such institutions. Apart from that, systemic biases in the health sector make it difficult for minority groups to receive quality care since some people are treated better than others. For instance, hospitals that may require a cash deposit to admit patients to receive treatment may make it difficult for disadvantaged groups to access health care (Wheeler & Bryant, 2017). The presence of such unrecognized instances of discrimination in the interactions with people from minority races ultimately leads to the prevalence of racial and ethnic disparities.

Additionally, health care providers in the local native populations of a country tend to give preferential treatment to individuals perceived to be from the same community. Such perceptions lead to an increase in cases of discrimination against people seen to be from other countries or regions. The National Academies of Sciences, Engineering, and Medicine (2017) states that “unconscious racialized perceptions contribute to differences in how various individual actors, including health care providers, perceive others and treat them” (p. 109). Negative perceptions of minority groups from foreign countries lead to stereotypes and racial profiling, suggesting that these groups may perform poorly in treatments or behave differently. These unfair variances lead to unjust and avoidable health outcomes for members of such populations because they are evaluated differently when visiting health institutions. Therefore, with foreign-born minority populations increasing across America, an increase in the aforementioned disparities poses a great danger to the well-being of these communities.

Furthermore, the financial impacts of chronic conditions disadvantage minority populations seeking medical assistance, who mostly are from poor backgrounds. Due to the persistent nature of such conditions, treatment and management cost significantly higher. While the occurrences of chronic diseases appear to affect all races, minority groups tend to feel the burden imposed by the rigorous treatments required to manage them. Therefore, the effects of such chronic conditions on the well-being of disadvantaged populations result in poor health outcomes. Quiñones et al. (2019) state that “black middle-aged adults had significantly higher initial levels of chronic disease burden compared with white counterparts” (p. 9). Therefore, the inability to get the requisite finances to meet the cost of health care increases the potential for negative health outcomes for minorities. As a result, minority populations may receive lower-quality care, leading to higher mortality rates in their population. Minorities, thus, face negative financial challenges due to racial and ethnic disparities, leading to poor health outcomes.

Effects of Racial and Ethnic Disparities in Healthcare on Minorities

Racial and ethnic disparities occur during the end-of-life care process involving the management of chronic illnesses which can be intensive and expensive for patients. Therefore, such treatment of the conditions in patients at this stage requires moderation to enhance the quality of their life. More white patients tend to enroll in hospice care with less intensive care during their last months of life, based on physician diagnosis. However, minority patients pay significantly higher costs for treatment despite little to no changes in their overall health outcomes. Chen et al. (2020) assert that “insufficient communication could cause providers do not fully understand patients’ needs and order unnecessary treatments or tests” (p. e128). These misunderstandings, thus, lead to an increased number of inpatient costs, laboratory tests, and medication for minorities. Consequently, the enormous cost disparities in patients with chronic illnesses highlight the higher likelihood of minorities having a lower quality of life due to less palliative care. The lack of advanced care planning due to inequality in the healthcare system, thus, negatively affects the health outcomes of minorities diagnosed with chronic conditions.

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Apart from that, the mortality rates of minorities with chronic conditions were significantly higher in populations with a higher ethnic density caused by segregation. Areas with a higher number of Asian and Black communities had worse cancer outcomes compared to White neighborhoods. Fang and Tseng (2018) state that “blacks were more likely than whites to undergo surgery at low-quality hospitals, and this disparity was greatest among blacks residing in the most segregated areas” (p. 1898). From these findings, factors such as lack of healthcare resources, cultural norms, and social factors in ethnically dense areas consisting of minorities are the major causes of poor health outcomes. Therefore, segregation causes lower early-detection rates and unsuitable treatment regimens, ultimately resulting in higher mortality rates in minority communities.

The prevalence of racial and ethnic disparities affects the mental well-being of minority populations exposed to such experiences. Chronic conditions require a significant amount of strength to overcome for both patients and their family members. Consequently, exposure to racial and ethnic disparities at critical stages of treatment and disease management may create mental issues, especially in cases where adverse outcomes occur due to such disparities. According to the National Academies of Sciences, Engineering, and Medicine (2017), “a variety of both general and disease-specific mechanisms have been identified; they link racism to outcomes in mental health, cardiovascular disease, birth defects, and other outcomes” (p.107). The loss of a loved one in instances where it could have been avoidable can create negative perceptions and feelings that may overwhelm affected individuals. In the long run, racial and ethnic disparities have far-reaching implications on the mental well-being of patients and their caregivers who depend on health care providers as a last resort.

Improving Health Outcomes of Minorities Affected by Racial and Ethnic Disparities

The study of chronic conditions requires constant research that includes a variety of samples and data to develop treatments comprehensively. Human genetic variations contribute significantly to the difference in outcomes for patients related to race and ethnicity. Therefore, data must be collected from a diverse pool of population to actively develop new criteria for the treatment of conditions such as cancer. However, the inclusion of racial and ethnic minorities in oncological research has been minimal, with White participants being overrepresented. Guerrero et al. (2018) state that “samples collected by the aforementioned strategies should be predominantly included in basic aspects of oncological research, such as patient-derived oncological models, initial drug screening, and cancer genomics” (p. 4). Consequently, increasing minority representation in such studies improves the patient-derived models based on genomics and populations. Accurate approaches ensure that racial and ethnic minorities can have equal treatments that ultimately improve their health outcomes.

Apart from that, improving access to frequent checkups and vaccinations for minorities can form a critical part of identifying and preventing any chronic illness from spreading. For instance, continuous cancer screening can identify potential lumps that may pose a risk to the patient, thus enabling early interventions to prevent its development. Additionally, vaccinations for specific forms of cancer can significantly reduce the chances of its development. Quiñones et al. (2019) highlight that “poor access to good quality health care and low socioeconomic status may exacerbate and accelerate additional chronic disease development” (p. 9). However, access to these services is nearly impossible due to cost implications and access to health facilities that offer them. Consequently, this finding shows that access to good health services, including preventative care, forms an essential part of improving the health outcomes of minority populations. Therefore, when individuals lack basic access to quality care, pre-existing conditions become more challenging to manage hence increasing disparities.

Furthermore, understanding the basis of the factors associated with racial and ethnic disparities can lead to better decision-making on their health issues. Minorities are susceptible to social disadvantages due to marginalization, poverty, and low literacy levels. As a result, such cumulative disadvantages lead to poor health outcomes for such individuals. Additionally, system failures that lack responsiveness increase the racial and ethnic disparities in the healthcare system. However, to tackle these problems, a method of quality improvement (QI) is required to address the core issues causing inequalities. For instance, Fiscella and Sanders (2016) suggest that “routine monitoring of health care disparities as a core element of organizational QI where monitoring requires the routine, standardized collection of patient race and ethnicity data with linkage to quality measures” (p. 385). In this case, QI requires a deeper analysis of racial and ethnic disparities in healthcare to ensure that each health institution can identify emerging issues to be addressed. Ensuring responsiveness can create a robust healthcare system that can accommodate the needs of the entire population, ultimately eliminating disparities.

Community health initiatives can further assist in fostering collaborative measures to eliminate racial and ethnic disparities in healthcare. For instance, in cases where state and federal interventions fail to have the desired impact, advocacy in terms of policy changes can help achieve the objective of improved health outcomes. By focusing on aspects such as housing and urban development, taxation, income distribution, and education, communities can empower their populations to improve standards of living that can guarantee better healthcare (National Academies of Sciences, Engineering, and Medicine, 2017). Community-based organizations can, thus, function as a watchdog that highlights problems facing minority communities. These movements can ultimately make significant changes in policy and law concerning systemic challenges that significantly impact the ability of minority groups to receive quality healthcare.

Conclusion

The differences in the treatment of minorities in the healthcare sector affect their overall health provision. Racial and ethnic inequities have, thus, played a role in the deteriorating health sector despite the various efforts put in place. Chronic illnesses continue to impact the lives of minority groups, with their situation further affected by racial and ethnic disparities in healthcare provision that ultimately leads to adverse outcomes. Identifying the underlying social, political, and economic challenges that minority groups face can ensure that health services can improve and, thus, lower morbidities and mortality rates among such populations. Eliminating racial and ethnic disparities in their entirety requires explicit measures by all involved parties, including the use of community-based organizations for advocacy that can guide the change process. Through such interventions, the government can improve health outcomes by ensuring equitable access to diagnosis, treatment, and management of chronic illnesses for marginalized populations.

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References

Chen, Y., Criss, S. D., Watson, T. R., Eckel, A., Palazzo, L., Tramontano, A. C., Wang, Y., Mercaldo, N. D., & Kong, C. Y. (2020). Cost and utilization of lung cancer end-of-life care among racial-ethnic minority groups in the United States. The Oncologist, 25(1), e120–e129. Web.

Fang, C. Y., & Tseng, M. (2018). Ethnic density and cancer: A review of the evidence. Cancer, 124(9), 1877-1903. Web.

Fiscella, K. & Sanders, M. R. (2016). Racial and ethnic disparities in the quality of health care. Annual Review of Public Health, 37(1), 375-394. Web.

Guerrero, S., López-Cortés, A., Indacochea, A., García-Cárdenas, J. M., Zambrano, A. K., Cabrera-Andrade, A., Guevara-Ramírez, P., González, D. A., Leone, P. E., & Paz-Y-Miño, C. (2018). Analysis of racial/ethnic representation in select basic and applied cancer research studies. Scientific Reports, 8(1), 13978. Web.

National Academies of Sciences, Engineering, and Medicine. (2017). Communities in action: Pathways to health equity. The National Academies Press.

Quiñones, A. R., Botoseneanu, A., Markwardt, S., Nagel, C. L., Newsom, J. T., Dorr, D. A., & Allore, H. G. (2019). Racial/ethnic differences in multimorbidity development and chronic disease accumulation for middle-aged adults. PloS One, 14(6), 1-13. Web.

Wheeler, S. M., & Bryant, A. S. (2017). Racial and ethnic disparities in health and health care. Obstetrics and Gynecology Clinics of North America, 44(1), 1-11. Web.

Zavala, V. A., Bracci, P. M., Carethers, J. M., Carvajal-Carmona, L., Coggins, N. B., Cruz-Correa, M. R., Davis, M., de Smith, A. J., Dutil, J., Figueiredo, J. C., Fox, R., Graves, K. D., Gomez, S. L., Llera, A., Neuhausen, S. L., Newman, L., Nguyen, T., Palmer, J. R., Palmer, N. R., Pérez-Stable, E. J., … Fejerman, L. (2021). Cancer health disparities in racial/ethnic minorities in the United States. British Journal of Cancer, 124(2), 315-332. Web.

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