NUR 575 Discussion: Culture Competence in Health Care

NUR 575 Discussion: Culture Competence in Health Care

NUR 575 Discussion: Culture Competence in Health Care

Kellie Crowl

Dr. Crowl

I appreicate your post. Your last paragraph is powerful. As unfortunate as it is, I believe you have very valid points. As you mentioned in your third paragraph, a strategy to make healthcare more equitable is by affordability and access. How does one go about doing this? How does the US healthcare system make healthcare more affordable and accessible for those who have low SES?

Natashia Houfek posted

Within the United States there are many factors that contribute to one’s socioeconomic status (SES). Historically, those outside the European, white race have and continue to experience discrimination, racism, and segregation based on cultural values, race, and ethnicity. These social injustices and racial inequities have been shown to be directly linked to lower levels of SES. In fact, research has reported that race and ethnicity often determine one’s SES (Adedeji et al., 2022).

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Those of lower SES experience adverse social and environmental conditions such as a lack of access to quality healthcare, which predisposes them to poorer health outcomes. Economic stability, as indicated by income, wealth, employment status, and occupational category, are important determinants of healthcare access, safe living environment, and adequate financial resources. When an individual, most likely a person of color, is unable to afford quality healthcare, housing, or medical treatments their overall health and wellbeing will be adversely affected. The stressors of these insecurities also expose them to a multitude of psychological issues (Javed et al., 2022). Therefore, one’s SES is directly linked to their quality of life and overall physical and psychological wellbeing.

One strategy is having hospitals and healthcare clinics to collect and use the data they collect on the patients and populations they serve to better understand what it is their patients needs are. By doing this, resources and providers can be better utilized in serving these patients with the care that they are truly needing. According to the addressing bias in collected health data is needed to reduce and/or prevent inequities in care (AHA Center for Health, n.d.).

If we are striving for universal health care, financial stability and adequate tax revenue are then necessary. However, reforms should concentrate on regulating the financial sector and banking systems. A reform of the pharmaceutical sector would also be needed to achieve universal health care. Limiting the power of pharmaceutical companies and regulating medication prices. It really comes down to who has the political power to vote on such policies. I feel that it will take the majority of the population to understand and have empathy towards unequitable health and well-being.

The national trend for the last four years shows an improvement or reduction in the number of people under 65 who were uninsured. That would show that strategies seeking to improve access to care are working. The state of Nebraska, in which I live, also shows an ‘average to strong’ improvement in its residents’ access to care (Agency for Healthcare Research and Quality, 2022). This, I feel, is directly related to the Medicaid expansion that the state passed a few years ago. The one thing I noticed while looking at trends was that data was not collected every year for both state and national levels. This would relate back to collecting reliable data and then using that data to directly address health inequities and determinants of health.

References

Adedeji, A., Buchcik, J., Akintunde, T. Y., & Idemudia, E. S. (2022). Racial identity as a moderator of the association between socioeconomic status and quality of life. Frontiers in Sociology, 7. https://doi.org/10.3389/fsoc.2022.946653

AHA Center for Health. (n.d.). Leveraging data for health care innovation. American Hospital Association. https://www.aha.org/system/files/media/file/2021/01/MI_Leveraging_Data_Report.pdf

Agency for Healthcare Research and Quality. (2022). National Healthcare Quality and Disparities Reports (NHQDR). Department of Health and Human Services. https://datatools.ahrq.gov/nhqdr/

Javed, Z., Haisum Maqsood, M., Yahya, T., Amin, Z., Acquah, I., Valero-Elizondo, J., Andrieni, J., Dubey, P., Jackson, R. K., Daffin, M. A., Cainzos-Achirica, M., Hyder, A. A., & Nasir, K. (2022). Race, racism, and cardiovascular health: Applying a social determinants of health framework to racial/ethnic disparities in cardiovascular disease. Circulation: Cardiovascular Quality and Outcomes, 15(1). https://doi.org/10.1161/CIRCOUTCOMES.121.007917

Kelsey Martinmaas posted

An individual seeking quality healthcare can sometimes be challenging. There are unfortunately factors such as race/ethnicity/culture that can deter someone from getting equal or proper care as opposed to someone who is of higher or lower socioeconomic status (SES) or a different race/ethnicity/culture. “Socioeconomic status (SES) is a complex variable that is derived primarily from an individual’s education, income, and occupation and is inversely related to outcomes of health conditions” (Minejima & Wong-Beringer, 2021, p.194).

A strong association exists between race/ethnicity/culture and socioeconomic status (SES). According to a study done by Mineijima & Wong-Beringer (2021) on sepsis rates among low socioeconomic status patients and racial groups, sepsis incidences were higher among black individuals compared to white individuals and individuals of lower socioeconomic status had higher re-admission rates. I look at our Native American population here in South Dakota and many of them have chronic illnesses and some will have frequent admissions, for example not being able to make it to dialysis due to not having a ride.

Lower socioeconomic status (SES) is associated with lower health status because the lower class may not have access to transportation, not have health insurance, lack of medical knowledge, may live in an area without healthcare resources nearby, and a low income (Minejima & Wong-Beringer, 2021). If you consider these factors, it can be hard for patients with chronic illnesses to make it to their regular follow-ups or appointments, obtain their prescription medications, and afford their care. Patients of lower socioeconomic status may also not receive or have the same opportunity for care at a hospital as those of higher socioeconomic status, for instance, if someone can’t afford insurance versus someone who can. If a population has a low health literacy that can also be a major barrier to quality health care (Cho et al., 2020).

Strategies that could help would be a universal health system, but I feel even then things may be difficult for those who are in low socioeconomic status. I feel that we have a lot of work to do as a healthcare system. At times hospitals appear to be more business driven and what will make the most revenue. Perhaps the healthcare system could be more of an equitable enterprise if it were more consumerism-driven, but I feel this could have its consequences as well and may lean more towards the higher socioeconomic class, same with capitalism. From what I gathered from my articles the last five years we have continued to struggle with equitability in healthcare.

References

Cho, M., Lee, Y.-M., Lim, S. J., & Lee, H. (2020). Factors Associated with the Health Literacy on Social Determinants of Health: A Focus on Socioeconomic Position and Work Environment. International Journal of Environmental Research and Public Health, 17(18). https://doi.org/10.3390/ijerph17186663

Minejima, E., & Wong-Beringer, A. (2021). Impact of Socioeconomic Status and Race on Sepsis Epidemiology and Outcomes. The Journal of Applied Laboratory Medicine, 6(1), 194–209. https://doi.org/10.1093/jalm/jfaa151