Background and Significance of the Problem
“The Health Gap: The Challenge of an Unequal World,” written by Marmot (2015), examines social health inequality. The significance of the problem is underscored by the fact that countries have varied socio-economic situations, meaning that medicine is not as advanced or readily available in some countries as in others. The central thesis of the book is that until social factors related to the disease have been addressed, implementing standard practices and guidelines to improve a population’s health may be ineffective.
The history of this issue dates back to the first missionary travels and attempts to bring medicine and education to individuals, in accordance with contemporary standards, only to discover that the socio-economic and cultural dimensions work for or against the proposed measures. Depending on the situation, it can be beneficial or detrimental to patients. However, more often than not, it works against healthcare practitioners, whose solutions run contrary to the situation on the ground.
There is literature that substantiates the significance of the problem and supports Marmot’s (2015) claims. KC et al. (2020) highlight how exposure to the products of burning cow dung as fuel in Africa contributes to higher rates of lung cancer and other diseases. At the same time, there are few alternatives to these crude fossil fuels for the population, meaning that any means used against them would only reduce, not eliminate, the problem (KC et al., 2020).
Another example is provided by Odgerz and Olivas-Hernandez (2019), who highlight that efforts to promote evidence-based medicine in Mexico are often undermined by strong religious opposition. As can be seen, these are among the many factors that can exacerbate health inequality worldwide.
Issue in Relation to Nursing and Patients
The issue concerns nursing and the populations nurses care for. These specialists are typically those with the most contact with patients and are especially affected by the adverse effects of socio-economic and cultural factors. A nurse cannot administer effective treatment for depression to a woman who is frequently being beaten up by her husband (Marmot, 2015).
Policy-Based Solutions
The issues can be addressed utilizing policies, as they are large-scale and typically endemic to the community in question. In the specific examples provided by KC et al. (2020) and Odgers and Olivas-Hernandez (2019), these solutions would involve providing alternative, cleaner fuels to the population and establishing dialogue with leaders of local religious communities to prevent them from sabotaging health efforts. Murshed and Ozturk (2023) claim that the electrification of the African continent has significantly reduced African communities’ reliance on fossil fuels. Likewise, Odgers and Olivas-Hernandez (2019) state that the relationship between religion and state is ambivalent, with the latter being able to push some initiatives through.
The non-government sector can play a significant role in improving the situation in these cases. Businesses can offer stoves that enable more efficient, cleaner burning of fossil fuels. At the same time, nursing organizations can connect with religious communities and find common ground to expand treatments. Understanding this issue has significantly influenced my perspective on healthcare.
I can now see that my role as both a healthcare provider and a leader is not just to provide high-quality care, but also to advocate and establish bridges to help overcome the social determinants that work against patients. I will focus on treatments that work within the confines of the existing situation, rather than on perfect white-room scenarios. I expect that the outcomes of such treatments would improve.
Potential Outcomes
If the issue is not addressed, the situation will remain unchanged or possibly worsen. More money will be spent needlessly on solutions that have no chance of working in the existing socio-economic and cultural climate (Marmot, 2015). As a result, people will suffer, valuable time and resources will be lost, and trust in the public healthcare community will fade. How can we, as nurses, address the multitude of issues that plague many countries and communities worldwide?
References
KC, R., Hyland, I. K., Smith, J. A., Shukla, S. D., Hansbro, P. M., Zosky, G. R.,… & O’Toole, R. F. (2020). Cow dung biomass smoke exposure increases adherence of respiratory pathogen nontypeable Haemophilus influenzae to human bronchial epithelial cells. Exposure and Health, 12, 883-895.
Marmot, M. (2015). The health gap: The challenge of an unequal world. New York, NY: Bloomsbury.
Murshed, M., & Ozturk, I. (2023). Rethinking energy poverty reduction through improving electricity accessibility: A regional analysis on selected African nations. Energy, 267, 126547.
Odgers Ortiz, O., & Olivas-Hernández, O. L. (2019). Productive misunderstandings: The ambivalent relationship between religious-based treatments and the lay state in Mexico. International Journal of Latin American Religions, 3(2), 356-369.