Discussion Racial Disparities

Discussion Racial Disparities

Discussion Racial Disparities

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Racial disparities in medical care should be understood within the context of racial inequities in societal institutions. Systematic discrimination is not the aberrant behavior of a few but is often supported by institutional policies and unconscious bias based on negative stereotypes. Effectively addressing disparities in the quality of care requires improved data systems, increased regulatory vigilance, and new initiatives to appropriately train medical professionals and recruit more providers from disadvantaged minority backgrounds. Identifying and implementing effective strategies to eliminate racial inequities in health status and medical care should be made a national priority.

My spirituality is molded by my Christian worldview, which encompasses not just inner peace but also strength and compassion. Knowing one’s intentions also helps people figure out their “own inner motivations, truths, and wishes to be involved in activities that add meaning to his or her personal existence and the lives of others.” Understanding the personal relevance of a patient-centered approach and one’s motives for choosing a care-centered career will help to increase client contentment and service quality. My approach to caring for my customers becomes more personal and helpful as I have a better grasp of my position in their well-being. As a result, I believe that my view of spirituality as a soothing moral compass is essential in developing a relationship with my patients. Within the healthcare industry, religion isn’t the only opportunity to discover a sense of purpose and solid external support. Patients’ well-being is dependent on their physicians’ and nurses’ physical and emotional endurance, thus finding a source of comfort is necessary for effective health. As a result, spirituality, regardless of religion or lack thereof, keeps all of the necessary features for personal peace and longevity, which are critical in the health sector.

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National data reveal that over the past 50 years, the health of both black and white persons has improved in the United States as evidenced by increases in life expectancy and declines in infant and adult mortality (National Center for Health Statistics, 1998). However, black persons continue to have higher rates of morbidity and mortality than white persons for most indicators of physical health. Hispanics and American Indians also have elevated disease and death rates for multiple conditions. Although the role of medical care as a determinant of health is somewhat limited, medical care (especially preventive care, early intervention and the appropriate management of chronic disease) can play an important role in health (Bunker, Frazier, and Mosteller, 1995). Thus, racial and ethnic differentials in the quantity and quality of care are a likely contributor to racial disparities in health status. Compared with white persons, black persons and other minorities have lower levels of access to medical care in the United States due to their higher rates of unemployment and under-representation in good-paying jobs that include health insurance as part of the benefit package (Blendon et al., 1989; Trevino et al., 1991).

More striking, and disconcerting to many is the large and growing number of studies that find racial differences in the receipt of major therapeutic procedures for a broad range of conditions even after adjustment for insurance status and severity of disease (Harris, Andrews, and Elixhauser, 1997; Wenneker and Epstein,1989). Especially surprising to many are the racial disparities in contexts where differences in economic status and insurance coverage are minimized such as the Veterans Health Administration System (Whittle et al., 1993) and the Medicare program (McBean and Gornick, 1994). Other research indicates that, although physicians’ ability to detect the severity of pain does not differ for Hispanic versus non-Hispanic white patients (Todd, Lee, and Hoffman, 1994), Hispanic patients are markedly less likely than non-Hispanic white patients to receive adequate analgesia (Todd et al., 1993; Cleeland et al., 1997). Recent studies document that these differences in the receipt of therapeutic procedures have adverse effects on the health of minority group members (Peterson et al., 1997; Hannan, van Ryn, and Burke, 1999). How do we make sense of these differences and how do we move forward with an effective policy and research agenda to eliminate these disparities?

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Race, Racism, and Discrimination
Many observers are surprised and perplexed by these findings. However, we can only regard these findings as surprising if we take an ahistorical and decontextualized view of the data. In compliance with Article 1, Section 2, and Paragraph 3 of the Constitution of the United States, the very first Census in 1790 enumerated three racial groups: whites, blacks as three-fifths of a person, and only “civilized Indians”—those who paid taxes (Anderson, 1988). New racial categories were added in the late 19th Century and beyond (Chinese in 1870, Japanese in 1890, Mexican in 1930) as the need arose to track new marginalized immigrant groups (Anderson and Feinberg, 1995). Race was and is a social category that captures differential access to power and desirable resources in society (Williams, 1997). Throughout the history of the United States, non-dominant racial groups have, either by law or custom, received inferior treatment in major societal institutions. Medical care is no exception.

Thus, understanding racial disparities in medical care requires an appreciation of the ways in which racism has operated and continues to operate in society. The term “racism” refers to an organized system, rooted in an ideology of inferiority that categorizes, ranks and differentially allocates societal resources to human population groups (Bonilla-Silva, 1996). It may or may not be accompanied by prejudice at the individual level. We will illustrate the complex nature of race, racism, and discrimination in society by considering access to housing and employment.

First, Table 1 indicates that there have been important positive changes in the racial attitudes of white persons towards black persons in recent decades and broad current support for the principle of equality in housing and employment (Schuman et al., 1997). In 1963, 60 percent of white persons agreed with the statement that “White people have a right to keep Negroes out of their neighborhoods if they want to, and Negroes should respect that right.” In 1996, only 13 percent of white persons agreed with that statement, documenting a substantial positive attitudinal shift within the white population. Similarly, in 1944, a majority of white persons (55 percent) indicated that white people should have the first chance at any kind of job but, by 1972, only 3 percent of white persons endorsed that view with 97 percent indicating that black persons should have as good a chance as white persons to get any kind of job.

Topic 1 DQ 1

Oct 3-5, 2022

What would spirituality be according to your own worldview? How do you believe that your conception of spirituality would influence the way in which you care for patients?

In essence, spirituality is the quest for the meaning of life (Bogue and Hogan, 2020). This vague term takes on many meanings depending on who is asked. Worldviews have a large impact on what path spirituality takes for someone. Personally, my worldview aligns with realism and optimism. Realism in the fact that what I can perceive and what is tangible in this world is what creates the majority of my experience. My optimistic worldview allows me to rely on such ideas as faith in order to maintain a positive view of my future. These play into my spirituality by allowing me to stay grounded in the present and accepting that the future is still unknown but has so much potential to be better than what I can comprehend now. My worldview allows my spirituality to be fluid and less of a daily burden mentally. The combination of my worldview and spirituality allow me to be present for my patients in their times of need, maintain positivity, be open to external experiences and worldviews, all while maintaining a tangible awareness of the physical ailments they are experiencing. Faith without realism does not benefit the patient because even if a grim prognosis exists, realism allows us to deal with the now and continue to move forward. Even if moving forward towards a terminal diagnosis, solace can be found in working through the physical realm to eventually be at peace in faith; knowing all that can be done in the now has been addressed.


Bogue, D. W. and Hogan, M. (2020). Foundational Issues in Christian Spirituality and Ethics. Practicing dignity: An introduction to Christian values and decision making in health care. Retrieved from https://lc.gcumedia.com/phi413v/practicing-dignity-an-introduction-to-christian-values-and-decision-making-in-health-care/v1.1/#/chapter/1

Racial and ethnic disparities are common in the healthcare systems. The inequality is attributed to different social economic status, level of education, occupation, cultural practices, and lack of comprehensive insurance coverage to some groups of people. In the United States, more people from the minority groups are less likely to get quality healthcare services due to discrimination and lack of enough income compared to the individuals from the majority groups. Racial and ethnic disparities may also arise as a result in differences in geographic locations. In some regions, people are less likely to get effective medical care due to poor accessibility. Racial and ethnic disparities in the healthcare system are a reflection of the societal problems. Therefore, the transformation of the entire healthcare system views and belief may lead to the significant reduction in the disparities experienced in the healthcare systems. Given that disparity in healthcare is sometimes attributed to the poor income from the minorities, it is always necessary for the healthcare actors to consider providing effective comprehensive insurance coverage to minority groups. Ethnicity and racism in the healthcare systems often leads to poor quality in the delivery of healthcare even though the factors such as insurance status may be under control.




Racial and Ethnic Disparities in Health Care


Healthcare system is meant to provide quality services to all citizens irrespective of their race, family background, and level of education, ethnicity, religion, and age. However, due to the cases of racism and inequality in some regions, the population cannot equally enjoy the provision of quality medical services that should be provided. Today, more Whites are more likely to get quality healthcare compared to the black minority. Even though there are significant advances in the treatment and diagnosis of most of the chronic diseases, there is still evidence that ethnic and racial minorities continue to receive low quality of care compared to the nonminority. As a result, patients from the minority groups often tend to experience mortality and morbidity from different chronic diseases as compared to the non-minorities (Goodman et al., 2017). According to the Institute of Medicine, racial and ethnic inequalities in healthcare continues to worsen, and since they are associated to the worst outcomes in many cases, the situation has become unacceptable and most healthcare professionals and policymakers are on the verge of determining the best strategies to reduce the cases of discrimination in the treatment processes (Norton et al., 2016).  Also, the Institute of Medicine define healthcare disparities as the ethnic or racial differences when it comes to the delivery of quality healthcare system that are not due to access clinical needs, appropriateness of interventions, and preferences. From the Institute of Medicine reports, there has been interest for the healthcare actors to understand the sources of disparities through the identification of the contributing factors, as well as the designing and evaluation of the effective interventions to eliminate the ethnic disparities in the healthcare system.

Whereas there are several sources of racial and ethnic disparity in healthcare, studies have identified the lack of insurance as the major contributing factor. The IOM report on health disparities in healthcare based on race demonstrates that one in eight Latinos did not have health insurance coverage. The report further revealed that Whites were more likely to have employer facilitate insurance while the Latinos would only do so via Medicaid. Moreover, a 2017 report revealed that the life expectancy of African-Americans was shortest during birth in comparison to other ethnicities (Mitchell, Williams, Li, & Tarraf, 2020). Indeed, the life expectancy amongst the blacks was eleven years’ shorter compared to Caucasian. The report attributed the presence of such life expectancies to health disparities caused by lack of access to insurance coverage and access to healthcare services, which reduce the quality of care hence life of African-Americans. Ethnic minorities also registered  twice the death rates of their Caucasians counterparts while their statistics on access to usual source of care was grim compared to their white colleagues in the United States (Mitchell, Williams, Li, & Tarraf, 2020). Therefore, some examples of racial and ethnic differences in healthcare include lack of access of effective or appropriate insurance cover, geography, language barrier or communication differences between the healthcare providers and the patients, cultural barriers, stereotyping on the part of the healthcare workers, and lack of healthcare access due to inadequate facilities in some regions.

Impacts of Racial and Ethnic Disparities in Healthcare

Different research outcomes indicate that ethnicity and racism in the healthcare systems often leads to poor quality in the delivery of healthcare even though factors such as insurance status may be under control. In the United States and in other countries where there are levels of racisms, Caucasian people are more likely to obtain quality care compared to people of color. Racism and ethnicity is a common phenomenon in the society, as a result it has always been translated into different sectors from healthcare systems, businesses and education. Also, it is a vice that continues to threaten the healthcare system despite the progress or advances that has been made in medicine for many years (Jain et al., 2018). Different hospitals and healthcare centers have effective models that should favor everyone despite their races; however, due to persistent disparities in race and ethnicities that continue to affect the American society, these models cannot be employed. As such, the minority populations continue to suffer in terms of healthcare quality and access.

The sources of ethnic and racial disparities are not only rooted in the nation’s dysfunctional healthcare system but also in different societal determinants that have become threats to the country’s social order. A person’s environment, level of education, income and other related factors has major impacts on individual healthcare status (Clementz et al., 2020). If the disparities as well as the racial differences are to be effectively addressed, the government must always make efforts towards improving the stressors that exist both within and out of the healthcare system.

Some other sources of racial and ethnic differences in healthcare include lack of access of effective or appropriate insurance cover, geography, language barrier or communication differences between the healthcare providers and the patients, cultural barriers, stereotyping on the part of the healthcare workers, and lack of healthcare access due to inadequate facilities in some regions. Plans to control disparities in healthcare may become a very difficult and multifaceted task. While some studies suggest that reducing the disparities in healthcare is possible through the provision of inclusive insurance coverage as well as better medical plans, higher incomes, adequate communication skills, and continuous healthcare assistance, there is still a lot that needs to be done including transformation of the perception of people in the society and providing education on the need for social integration (Admon et al., 2018). Factors such as stereotyping, uncertainty, and biases need to be continuously explored.

Literature Search

Chen, J., Vargas-Bustamante, A., Mortensen, K., & Ortega, A. N. (2016). Racial and ethnic disparities in health care access and utilization under the Affordable Care Act. Medical care54(2), 140. The article addresses racial and ethical disparities in the healthcare system and how the utilization of the Affordable Care policy can be used to reduce the cases of disparities especially among minorities.

Buchmueller, T. C., Levinson, Z. M., Levy, H. G., & Wolfe, B. L. (2016). Effect of the Affordable Care Act on Racial and Ethnic Disparities in Health Insurance Coverage. American journal of public health, 106(8), 1416–1421. https://doi.org/10.2105/AJPH.2016.303155. The article reveals that the changing nature of insurance amongst Latinos, Blacks and Whites. The revelation supports the fact that racial inequities still exist in the healthcare insurance sector in the nation.

Howell, E. A., Brown, H., Brumley, J., Bryant, A. S., Caughey, A. B., Cornell, A. M., … & Mhyre, J. M. (2018). Reduction of peripartum racial and ethnic disparities: a conceptual framework and maternal safety consensus bundle. Journal of Obstetric, Gynecologic & Neonatal Nursing47(3), 275-289. The article addresses the existing racially-oriented deaths in maternal care caused by disparities in healthcare. According to the article, more Black women are more likely to die from childbirth compared to white women.

Admon, L. K., Winkelman, T. N., Zivin, K., Terplan, M., Mhyre, J. M., & Dalton, V. K. (2018). Racial and ethnic disparities in the incidence of severe maternal morbidity in the United States, 2012–2015. Obstetrics & Gynecology132(5), 1158-1166. The article addresses the maternal morbidities amongst minority populations as caused by healthcare disparities.

Butts, J. B., & Rich, K. L. (2018). Philosophies and theories for advanced nursing practice. Burlington, MA: Jones & Bartlett Learning. The book addresses, among other things, the competence of nurses regarding healthcare disparities.

Clementz, L., McNamara, M., Burt, N. M., Sparks, M., & Singh, M. K. (2017). Starting with Lucy: Focusing on human similarities rather than differences to address health care disparities. Academic Medicine, 92(9), 1259-1263. The articles provides the strategies that one can use to address healthcare disparities in the minority populations.

Goodman, M. S., Gilbert, K. L., Hudson, D., Milam, L., & Colditz, G. A. (2017). Descriptive analysis of the 2014 race-based healthcare disparities measurement literature. Journal of racial and ethnic health disparities, 4(5), 796-802. The article reveals healthcare disparities by comparing minority and majority populations using statistics.

Jackson, C. S., & Gracia, J. N. (2014). Addressing health and health-care disparities: the role of a diverse workforce and the social determinants of health. Public health reports (Washington, D.C. : 1974), 129 Suppl 2(Suppl 2), 57–61. https://doi.org/10.1177/00333549141291S211. The article addresses the role that nurses and other healthcare workers can play to address disparities.

Jain, J. A., Temming, L. A., D’Alton, M. E., Gyamfi-Bannerman, C., Tuuli, M., Louis, J. M., … & Howell, E. (2018). SMFM special report: putting the “M” back in MFM: reducing racial and ethnic disparities in maternal morbidity and mortality: a call to action. American journal of obstetrics and gynecology218(2), B9-B17. The article specifically targets the reduction of healthcare disparities amongst minority mothers.

Mitchell, J. A., Williams, E. D. G., Li, Y., & Tarraf, W. (2020). Identifying disparities in patient-centered care experiences between non-Latino white and black men: results from the 2008-2016 Medical Expenditure Panel Survey. BMC Health Services Research, 20(1), 1-9. The articles examines the existing patient-centered care, which is an aspect of disparity, amongst white and black men.

Norton, J. M., Moxey-Mims, M. M., Eggers, P. W., Narva, A. S., Star, R. A., Kimmel, P. L., & Rodgers, G. P. (2016). Social determinants of racial disparities in CKD. Journal of the American Society of Nephrology, 27(9), 2576-2595. The social determinants of health are used to reveal the existence of healthcare disparities.

Rumball-Smith, J., & Bates, D. W. (2018). The electronic health record and health it to decrease racial/ethnic disparities in care. Journal of Health Care for the Poor and Underserved29(1), 58-62. The use of technology to address the disparity is addressed in this article.