medical advances to control asthma symptoms among health care providers who treat minority children, and the lack of asthma education, as well as difficulties in the Identify patterns of national data on disparities The United States Office of Disease Prevention and Health Promotion (ODPHP) Healthy People 2020 provides a scientifically-based, 10-year national objective for improving the health of all Americans. For three decades, the Healthy People program has established benchmarks and monitored progress over time in order to: ● Encourage collaborations across communities and sectors. ● Empower individuals toward making informed health decisions. ● Measure the impact of prevention activities. With the launch of Healthy People 2020, the elimination of health disparities was firmly placed on the national disease prevention and health promotion agenda. The rejection of health disparities currently remains on the national disease prevention and health promotion agenda. The following goals have been proposed for Healthy People 2020: ● Achieve health equity, eliminate disparities and improve health of all groups. ● Eliminate preventable disease, disability, injury and premature death. ● Create social and physical environments that promote good health for all. ● Attain high-quality, longer lives, free of preventable disease, disability, injury, and premature death. ● Promote quality of life, healthy development and healthy behaviors across every stage of life (Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020). Healthy People 2020 defines health disparity as: A particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion. The scope of the Healthy People program goes beyond the prevention and treatment of disease and illness and addresses health care services. It analyzes the multi-faceted relationships between health, biology, genetics, behavior, socioeconomic factors, environment, discrimination, racism, discrimination, education, and legislation that are identified as determinants of health. The mission of The Commonwealth Fund (CF) was designed to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency - particularly for society’s most vulnerable: low- income individuals, the uninsured, minority Americans, young children, and elderly adults (CF, 2015). Race and culture in the medical interview Subsequent to the socio-cultural definition of race and the earlier discussion about genetics, statements about the race of a client or patient should be documented in the social history or subjective information section - race cannot be considered part of the medical history. Keep in mind that clients or patients are using self-identity when describing
implementation of certain asthma control methods within minority families (Akinbami, 2014).
Based on the findings of the Commonwealth Fund’s 2014 Biennial Health Insurance Survey of working-age adults, higher proportions of people in Florida and Texas had difficulty obtaining needed health care than in California and New York, because of the cost. More than four in ten people in Florida (43%) and in Texas (43%) said they did not see a doctor when sick. It was also reported that they did not fill a prescription, skipped a test, did not schedule a treatment or a follow-up visit, and did not seek needed specialist care in the past twelve months for cost reasons - compared to three of ten in California (31%) and New York (30%). The differences in the ability to put money toward medical bills, debt, or cost-related access problems remained - even when taking demographic variations across the states into account. Studies conducted by the Commonwealth Fund’s Princeton Survey Research Associates (2015) noted that uninsured rates within the working-age population are drastically higher for Blacks and Hispanics than for Whites. In 2013 - the year before the ACA’s major coverage expansions took effect - more than one of five Blacks ages 18 to 64 (22%) and two of five Hispanics (43%) did not have health insurance, compared with one of seven Whites (14%). Before the Affordable Care Act (ACA) coverage expansions, uninsured rates were also highest among adults with low incomes. Black and Hispanic adults also were disproportionately more likely than Whites to have low incomes. Among adults ages 18 to 64, nearly half of Hispanics and half of Blacks had incomes below 200 percent of poverty in 2013 - compared with less than one-quarter of Whites. Blacks and Hispanics are more likely to lack resources for care, and often go without care because of cost. One or more individuals had an established source of care that was identified as a personal doctor or health care provider; this has been shown to be an important link to primary and preventive care services and better health outcomes. Yet in 2012 and 2013, more than one-quarter of Black adults ages 18 to 64 (27%) and more than two-fifths of Hispanics (43%) reported not having an established source for care, compared with just over one-fifth of Whites (21%). Black and Hispanic working-age adults also reported an instance within the past year when they could not see a health care provider when needed because of cost - a rate 1.5 to 2 times more frequent than White adults. Minorities have obtained health insurance at higher rates than White Americans since the creation of the ACA Marketplaces in October 2013. Health and Human Services officials report that 20 million people have gained insurance since 2010 (HHS, 2016). African-American and Latino adults still remain less likely to have health coverage than Whites; although the disparities are declining. Hispanic adults are less likely to have employer-sponsored insurance, and immigrants who are in the country illegally are not eligible to buy insurance through Marketplace plans created by the ACA. their race or races; only they can make that determination. Race should not be associated with social class, genetic variation or other elements of the social history. Therapists must be mindful of the potential influence of racism in the health and wellness environment, including the potential for personal bias.
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Book Code: MMD0724
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