Health Legacy Partnership

Health Care Disparities

Because of mostly predetermined characteristics such as ethnicity, age, disability, and sexual orientation, millions of Americans are in poorer health, suffer worse health outcomes, and have higher rates of illness than the general United States population.

We are surrounded by purported examples of disparities in health care every day. Many are obvious, others we are completely unaware exist. In 2008, the Circulation journal published a study that revealed women receive different treatment for heart attacks when compared to men. We added this to our previous knowledge from Canada that women receive less orthopedic knee procedures than a comparable male. The emergence of ‘new’ disparities underscores the importance for medical professionals and advocates to be cognizant of not unintentionally abetting gaps in service.

Acknowledging that countless influences coupled by the diversity of humanity contribute to disparities, providing equal heath care is not a realistic possibility. However, it is possible to draw attention to known disparities and help uncover new ones so physicians and others in the medical community do not abet these gaps in health care.

Below is a list of common and frequently overlapping barriers to quality health care:

• Socioeconomic - Lower income individuals often lack health insurance coverage or co-pay abilities and they postpone or go without necessary medical care including prescription drugs

• Geographic - Persons living in rural communities frequently lack convenient access to medical facilities. Whether hindered by few health providers, physical or mental handicaps, or lack of reliable transportation these populations often forgo regular – especially preventative – medical care.

• Education – Medical language is technical and riddled with jargon making interpretation difficult for many people. Some words have different meanings for different people. In addition, jargon changes from time to time (i.e. recreational drugs). Some individuals unsophisticated by current phrases or meanings attach their own meanings to the words they hear and face additional challenges – not being able to fill out required medical forms, read medical or prescription instructions, or apply for medical assistance.

• Linguistics – Linguistical challenges are not limited to those who are non-English-proficient, but also to those individuals who are unable to communicate or understand basic health information which may lead to misdiagnoses or delays in treatment. How many would know that trichomoniasis is a sexually transmitted disease? How many would be able to comprehend that congestive heart failure does not mean that you are in the early stages of death? How many would know that sometimes in attempts to explain conditions to patients physicians use words that are inaccurate, such as “you have a kidney infection” when you actually have a bladder infection?

• Age – Americans on fixed incomes or experiencing mobility issues experience increasing difficulties accessing appropriate medical attention. Both the very young and our population with impaired movement require an assistant to attend sessions, and if they have no family member that can miss work on the day their appointment is scheduled, they do not show.

• Ethnicity – The majority of health care providers are white. Research reveals that certain minorities are treated differently than other patients, even though often unintentional.

• Sexual orientation – Gay, lesbian, bisexual and transgender patients may not fully disclose their sexual activity history with their doctors out of fear related to job security, or discomfiture for various reasons. Regrettably, some medical professionals object to treating GLBT individuals out of lack of knowledge, moral or religious or cultural grounds.

• Religion – Patient treatment options can be significantly restricted by religious or termed spiritual beliefs. Some faiths prohibit specific modern medicine practices or mixing of genders.

While the existence of disparities is well-known, understanding how to effectively and practically minimize them is ongoing. The Agency for Healthcare Research and Quality (AHRQ) has identified multiple ways – in addition to education and public awareness outreach – to remedy commonly experienced disparities, including the following:

• Interpreter services – Contract with foreign language and speaking and hearing impaired translators to remove communication barriers.

• Diversity – Recruit minority and culturally diverse medical professionals to raise awareness to new ideas and beliefs and reflect the patient demographic.

• Strategic accessibility – New medical facilities should be made as accessible as possible and take into consideration public transportation, inner-city and urban communities, and off-peak clinic hours. Efforts should be made to provide regular mobile medical clinics to rural areas.

• Sensitivity training – Teaching medical professionals to and how to ask sensitive questions such as sexual orientation can make help patients be more willing to divulge information that can facilitate patient care.

It is vital that everyone do their part to combat disparities. The Health Legacy Partnership (HELP) established the annual Joseph H Kanter Prize in 2008 to recognize physicians who have developed a method to enhance health care delivery in the United States by minimizing disparities. With this award, we hope to discover innovative ideas and promote their broader usage. The distinction carries with it a $100,000 cash prize. A $10,000 cash prize is awarded to the respective nominating state medical association.

To learn more about or to nominate a physician for the Kanter Prize, click here.