The Nurse's Role in Transitioning From Health Disparity to Health Equity

Healthcare should be equally accessible to all, regardless of race, ethnicity and other factors. Unfortunately, statistics show that minority groups are more likely to experience significant health conditions such as heart disease, cancer, stroke and diabetes, and die from these conditions. Great effort is ongoing nationally to better understand and address health disparities to promote health equity. Nurses have a key role in understanding, identifying and responding to barriers that prevent people from having the opportunity to be as healthy as possible.

What Is a Health Disparity?

Although health disparities (or inequalities) are often viewed in terms of race or ethnicity, other factors to consider include disability, gender, geographic location, income and education level. Additionally, living conditions, healthcare coverage, diet, stress, environment, lifestyle choices and even genetics can impact health equity.

Why Are There Disparities in Health and Healthcare?

The reasons for health disparity are complex, and not all of them are easy to measure or even talk about. The term "health disparity" includes anything that creates inequality in healthcare.

Domino Effect: There is often a "domino effect" where one factor impacts another aspect of a person's health journey. It is easy to see the connection between low income and a lack of health insurance, but it may be less obvious that a low income may limit access to healthy fresh fruits and vegetables to reduce or manage diabetes, cancer and heart disease.

Beyond the Bricks: Accessibility is about more than just a brick-and-mortar health center. Having access to care means that a patient also has transportation (and in some cases a driver), a support system, a job that permits time off and the financial ability to cover transportation and medical costs — either for prevention or treatment. Medical information must be appropriate, both linguistically and at the patient's health literacy level.

Genetic Differences: Genetically, conditions and risk factors vary for each person as their unique DNA structure impacts their overall health and often their treatment plan. For example, one study showed that African Americans with lung cancer are missing a cell signal, meaning that one form of targeted therapy that tries to block that signal does not work in this population, although it works in Caucasians. Unfortunately, minority groups are underrepresented in clinical trials making drug efficacy unknown in different ethnic groups. Certain groups may be at higher risk for other illnesses like hypertension, which may impact the availability of certain treatment options (e.g., cancer drugs that block blood vessel formation). In addition, cancer screening guidelines prescribe some tests a few years earlier for certain groups (e.g., prostate screening in African American males) due to the higher risk.

What Can Nurses Do to Decrease the Disparities?

Nurses are at the forefront of making meaningful changes toward health equity. Holistic care that accounts for social, cultural and economic factors improves outcomes. One of the most powerful things nurses can do to reduce health disparities is to advocate for their patients. This may include advocating for patient rights, appropriate resources, interpreters, distress screening or even cultural-competence training in your workplace.

Opportunities to make impactful change are not limited to the workplace. Many community-based projects and events can improve health equality for all. For example, the Centers for Disease Control and Prevention's successful Traditional Foods Project recognized the almost-double likelihood of receiving a diabetes diagnosis in Native American populations as a major health disparity. In cooperation with tribal leaders, dietitians and local nurses, this project focused on providing access to healthy foods and promoting physical activity in these populations. The nurses' contributions to community outreach, educational video production and even policy advocacy made this project extremely successful.

How Can a Diverse Nursing Workforce Help?

Diversity in nursing can also bring diversity in language and cultural awareness. Nurses who are able to provide care in their patient's native language or suggest appropriate resources help fill the gap for better health literacy and often access to care.

Multiple studies have shown that racial and ethnic minority nurses are more likely to work in underserved areas, providing healthcare to those who experience health disparities. Nurses can better address preventable health issues with consideration of social and environmental factors. Nurses with diverse backgrounds may be more sensitive to these factors.

The idea of health disparities is not new, but there has been some progress in righting this inequality. As our nation becomes increasingly diverse, it is important to identify health disparities and take steps to reduce and ultimately eliminate them. Not surprisingly, nurses are often leading the way in building healthy communities often starting in their own neighborhoods and workplaces. An RN to BSN program can help you gain the leadership skills required for such initiatives.

Learn more about UNM's online RN to BSN program.


Sources:

Office of Disease Prevention and Health Promotion: Disparities

Mayo Clinic: Office of Health Disparities Research

OIJN: Disparities in Health and Health Care: Focusing Efforts to Eliminate Unequal Burdens

Nutrition Today: Low-Income Shoppers and Fruit and Vegetables: What Do They Think?

NCBI: Racial Differences in Cancer Susceptibility and Survival: More Than the Color of the Skin?

CDC: Traditional Foods Project, 2008-2014

U.S. Department of Health & Human Services: HHS Action Plan to Reduce Racial and Ethnic Health Disparities


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