Across the globe, the gaps in healthcare are wide and persistent. Most of these barriers are a product of societal attitudes towards race, gender, and structural conflict. These conditions affect how people work, live, and age. Research suggests that social impairments influence health more than other factors. Furthermore, socially disadvantaged areas have less access to healthcare. They also get more ill and have a higher mortality rate. Hence health status is not only affected by internal factors such as immunity and hereditary factors.
The pandemic has turned a microscope to this issue. The social, racial, and gender inequities have made some sectors of society more vulnerable to COVID-19. According to the latest research, people living in deprived areas are two times more at risk of contracting the virus. Disadvantaged populations have to face a disproportionate burden that has only widened the gap.
Therefore, we must address the inequities in healthcare to improve global health structures and diagnose the issues. Many public health institutions have dedicated departments that monitor health inequities.
What is health inequity?
Health is more than genetics. It is the difference in the access to health resources between different social groups because of systematic and unjust social policies and practices. These policies create barriers due to which everyone cannot acquire the same healthcare services. Therefore, one group may suffer from more illnesses than the other. In an equitable society, everyone has the opportunity to attain their health potential regardless of age, gender, or race.
Why struggle for health equity?
A simple analogy can illustrate why a holistic approach to healthcare is vital for a healthier community. Imagine a fish living in a fishbowl. Suppose the fishbowl is dirty and the glass is leaking water. In that case, the fish can never be healthy unless we improve its environment. While our life is more complicated than that of a fish, the metaphor shows that better healthcare outcomes need to consider environmental factors.
Health equity is not a new concept. It can trace its history to the early 19th Century. In 1848 a German physician, Rudolph Virchow, found that social conditions affect the transmission of diseases. Since then, public health workers have argued for social reforms in healthcare structures. Indeed the higher life expectancy rates and lower transmission rates are due to the sanitation movement and better working conditions.
Who can ensure health equity?
Since health inequities are a result of policy failure, governments must make better policy choices. Healthcare professionals with an online masters in public health can improve policies through innovation to create healthier communities. National issues like low literacy rates, improper housing, neighborhood deterioration, and racial discrimination are directly related to health equity. Therefore inequity can be mitigated by better policymaking and community action.
What are the challenges in ensuring health equity?
Many factors hinder access to healthcare amongst different sections of the community. They are considered in detail below:
- Lack of health insurance coverage: More than 92% of Americans have insurance. Due to the prohibitively high cost of medical treatment in America, most Americans carry health insurance. Furthermore, doctors have the right to refuse treatment to patients who do not have insurance. So, medical insurance is vital for access to healthcare. Sadly, there are significant racial disparities in access to insurance. People of color are more likely to be uninsured compared to Caucasians. However, there is a lot of progress in the insurance sector to address these issues. Even though the Affordable Care Act has decreased uninsurance rates across all racial subsets, some states have refused to expand Medicaid under this Act. That still leaves 30 million people without insurance, and more than half of them are people of color. We need to make health coverage accessible to every citizen to improve health equity.
- Clinician bias: Studies have shown that clinicians are implicitly biased towards some individuals. It affects patient communication and care. Clinicians may consider the patient unreliable and uncooperative. Therefore, bias will complicate treatment, and eventually, patient satisfaction will also decrease. Not only that, they treat women and men differently when it comes to pain. Most women report pain bias as they have to wait longer in emergency departments compared to men. They are also less likely to be prescribed pain medication compared to men. Often women and their pain are ignored and misdiagnosed, which leads to a higher mortality rate. Healthcare professionals have to address this bias and introduce training to improve the healthcare system.
- Residential Segregation: Different groups live separately from each other, which can worsen diseases in a population. Not only does your place of residence limit the resources available, but it also increases exposure to environmental hazards. Some communities are more prone to violence and aggressive policing. So, their healthcare sectors will have to treat worse injuries compared to other locations. And eventually, the healthcare sector will be overburdened. Sometimes, distance hinders access to healthcare. Indeed, research suggests that women living near healthcare structures report more symptoms compared to those who live farther away. Therefore residential segregation can negatively affect healthcare equity.
- Education: Health and education are closely related: According to a 2013 report, educational and income gaps are the worst contributors to health inequities. Research suggests that less educated people live shorter lives compared to people with higher education. As education opens doors to better opportunities, more educated people earn higher incomes. It encourages healthier lifestyles and makes healthcare accessible. Viable localized efforts centered on public-private partnerships can bridge the gap and provide comprehensive services to at-risk populations. Resource centers can also provide support through “cradle to coffin” courses that address specific issues in healthcare.
Healthcare organizations must focus on underprivileged communities and build more hospitals in rural areas. Furthermore, healthcare workers need to commit to help low-income patients and give them the care they need and deserve. The healthcare sector has to focus on policies and confront institutional racism and gender discrimination.