Minimizing Healthcare Disparities

June 27, 2023
6:44 pm

Advancing Health Equity

On April 20th, 2023, the World Health Organization (WHO) launched the Health Inequality Data Repository, “the most comprehensive global collection of publicly available disaggregated data and evidence on population health and its determinants.” According to the Centers for Disease Control and Prevention (CDC), healthcare disparities are “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health experienced by socially disadvantaged populations.” According to Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, the way to advance health equity is by directing services to those in vital need. Although this is simple to say, how can we effectively execute this?

Healthcare Models

Across the globe, there are four primary healthcare models: the Beveridge model, the Bismarck model, the national health insurance model, and the out-of-pocket model. Unfortunately, the healthcare disparities certain groups may face due to their gender, race, ethnicity, income, etc., are not likely to be affected by changing the design of a country’s healthcare system, as each model possesses instances of disparity. The United States healthcare system, which combines all four models mentioned above, reflects the trial and error the government went through to find the best fit for our economy, population size, demographics, etc. However, the disparities present in our system prove that our system is not optimal.

Social Determinants of Health

The way to improve the overall health of a population without adjusting healthcare models is to improve the social determinants of health (SDOH) that affect each individual’s health. According to the CDC, SDOH is “the nonmedical factors influencing health outcomes.” SDOH include the conditions in which a person is born and ages along with the forces and systems that shape their day-to-day life. “These forces and systems include economic policies and systems, development agendas, social norms, social policies, racism, climate change, and political systems.” Some examples of SDOH are convenient access to housing in a good neighborhood, transportation, clean air, clean water, nutritious food, and physical health opportunities. By making policy changes to ensure that all citizens have access to the above, the need for a change in the healthcare system will drastically decrease. models

Housing First approach to equity

World Resources Institute says, “330 million households in cities around the world, equivalent to 1.2 billion people, do not have access to affordable and secure housing.” An eighth of the global population doesn’t have access to one of the most basic needs: affordable housing. The effects of not having stable and affordable housing conditions are innumerable. According to Common Bond Communities, families who lack affordable housing may experience “Reduced access to adequate health insurance, lower quality, and more expensive medical care, difficulty paying bills in full or on time, putting them at risk of eviction or even homelessness, less money for basic necessities, like food and clothing, lack of reliable transportation, and reduced access to quality education opportunities.” Overall, lack of shelter sets up people and their families in various manners; however, specifically regarding health, The National Health Care for the Homeless Council also states that “People who are homeless have higher rates of illness and die on average 12 years sooner than the general U.S. population.”

It is common sense and also scientifically proven that there is a direct correlation between homelessness and poor health. Although we may not be able to make healthcare completely accessible to everyone, by making necessities such as housing more accessible, we can count down the dire need for healthcare. If 1.2 billion people are homeless in the world, a majority of those people are unlikely to be healthy either currently or in the near future. By supporting affordable housing programs, we significantly reduce the number of people requiring professional healthcare attention due to homelessness.

Clean water is essential

Another example is clean water. According to World Vision, 771 million people, or every one in ten people, lack clean drinking water. The effects of consuming unclean water are severe. Drinking contaminated water can lead to many diseases, such as cholera, typhoid, hepatitis A, neurological disorders, cancer, etc. According to the CDC, about 7.2 million Americans get sick from drinking contaminated water annually. Comparatively, America has better access to water than some other countries, and there are still millions of people getting sick due to the consumption of unclean water. Addressing this situation will decrease the number of sick people in hospitals due to an issue that we can solve. This will allow us to redistribute our existing resources to people who are chronically ill from uncontrollable genetic diseases.

Low-income families at risk

Low-income families are majorly associated with the lack of access to the social determinants of health. According to the US Department of Health and Human Services, ”Residents of impoverished communities often have reduced access to resources that are needed to support a healthy quality of life, such as stable housing, healthy foods, and safe neighborhoods. Along with this, residents of low-income or impoverished neighborhoods often don’t have equal access to education or employment, further perpetuating the cycle of poverty. Along with social and environmental factors, “barriers to accessing health care,” such as “difficulty obtaining health insurance or paying for expensive procedures and medications,” negatively impact the overall health of a certain neighborhood. People in low-income communities are often victims of bad air quality, violence, unhealthy food, inaccessible healthcare, a lack of recreation opportunities, and more. For example, in lower-income neighborhoods, the ratio of convenience stores to groceries stores is much higher than in any other setting. Often the existing grocery stores are too far of a commute for a neighborhood’s constituents to buy produce from there. Even in the few supermarkets in those areas, the freshness of the food is questionable and exponentially much more expensive. This often motivates more people to buy cheap, unhealthy foods from convenience stores, leading to bad health. The convenience stores in such areas eventually profit from harming the neighborhoods’ citizens’ health.

Addressing Social Determinants of Health

Although this may not be a simple fix, the only fix to such a problem would be to make policy changes that would increase the accessibility of fresh, healthy food to members of low-income neighborhoods. Such a policy change would bring about more access to the social determinants of health. People’s health can significantly improve by replacing some convenience stores in particular neighborhoods across the country with grocery stores. This fix wouldn’t require as much money or effort as it would to make a more superficial change, such as making hospitals take more pro-bono cases or forcing insurance companies to cover more healthcare costs. Allowing people already set up not to have the best health to get better food for their body will ensure they are healthier for longer. The same applies to the rest of the social determinants of health. These improvements will set up each individual to lead a healthier life. Aside from the fact that this would lead to a healthier country, it would also improve the economy if more of our country’s population is working and if more money is invested elsewhere rather than in healthcare. Healthcare is important, but the immediate solution to limiting healthcare disparities is making daily necessities more accessible.