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Addressing Disparities in Healthcare

Despite the strides made to ensure healthcare equity, the COVID-19 pandemic has shined a light on the significant disparities that remain. Although bridging these gaps will require systemic changes to the approach to and delivery of care, nurses possess the insight and knowledge to help facilitate this transition.   

 Patient-centered care and detailed health assessments are key, as is understanding the relationship between small interventions and meaningful change in populations. Nurses enrolled in the University of Rhode Island's Registered Nurse to Bachelor of Science in Nursing online program gain this experience by completing a project in which they develop interventions to meet the needs of a specific community.

What Are Health Disparities and How Do They Affect Overall Health?

According to the Centers for Disease Control and Prevention (CDC), health disparities are "preventable differences in the burden of disease, injury, violence or opportunities to achieve optimal health that are experienced by socially disadvantaged populations."

Individuals in at-risk populations often share social, economic and environmental similarities that limit access to healthcare services and reduce the quality of care when treatment is received. The lack of consistent care or preventive measures increases disease or complications, leading to shorter lifespans and lowered quality of life.

Disparities in healthcare are not new. Government reports in the early 2000s showed that rates of tobacco use and access to mental health services varied by race and ethnicity. Subsequent reports found that similar disparities existed in terms of the quality of care received. In addition to race and ethnicity, individuals may experience inequitable healthcare due to their socioeconomic status, age, gender, sexual orientation, geographic location and disability status.  

How Has the Pandemic Exacerbated Disparities in Healthcare?

While there have been concerted efforts to reduce disparities in healthcare, the pandemic has highlighted many areas where the gaps have not been fully bridged and, in many cases, have only worsened. In general, minority populations are more likely to be socially and economically disadvantaged, work public-facing jobs and live in crowded housing — all factors that increase the difficulty of adhering to social distancing guidelines. They may lack health insurance, access to nutritious foods and have comorbidities, including obesity and diabetes, that make them more susceptible to poorer outcomes if they contract COVID-19. 

Some minority populations have been disproportionately impacted by the pandemic, such as Black and Hispanic Americans, American Indian-Alaska Natives and Pacific Islanders. They have experienced higher rates of infection, risk of serious illness and worse outcomes. According to an August 2020 article published in the American Journal of Nursing, aggregated data from 28 states found that the death rate of black patients was three and a half times that of white patients. In some states, minorities experienced as much as a 10-fold increase in death rates compared to white individuals. Lower socioeconomic status was also associated with higher rates of severe illness.

What Can Nurses Do to Encourage Health Equity?

The disparities certainly pose a challenge to personal and community health, but nurses can help bridge the divide and affect change through two main methods:

Awareness. Nurses should continue to learn about vulnerable populations, including the contributory role of social determinants of health. This information is helpful when identifying patients' challenges and crafting suggestions that work within the confines of each patient's unique circumstances.

Advocacy. Because nurses are aware of disparities and see the impacts in their day-to-day work with patients, they can facilitating change by getting involved in advocacy efforts. They can join a workplace committee, participate in community programs that assist at-risk populations or join professional nursing organizations that introduce policies at the state or national level.

Equitable Healthcare

The COVID-19 pandemic has reiterated the importance of equitable healthcare models, not only for the sake of disadvantaged populations but also for the health of society. Nurses are well positioned to affect change through compassionate patient-centered care, awareness and advocacy initiatives.

Learn more about the University of Rhode Island's RN to BS in Nursing online program.


Sources:

American Journal of Nursing: COVID-19 Exposes Health Disparities

Centers for Disease Control and Prevention: Health Disparities Among Youth

Kaiser Family Foundation: Disparities in Health and Health Care: Five Key Questions and Answers

The Online Journal of Issues in Nursing: Nurse Advocacy: Adopting a Health in All Policies Approach


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