Annotated Bibliography on Healthcare Disparities

Overview

In 2010, the federal department of human and health service launched the healthy people 2020 goals, which included a goal to eliminate health disparities. Healthy People 2020 defines healthcare disparities as the differences in access to healthcare and health outcomes closely linked with social, economic, and environmental characteristics among different groups of people (Zimmerman & Anderson, 2019). Health disparities unfavorably affect groups of people who have systematically experienced significant obstacles to accessing and utilization of health services based on their racial or ethnic background, religion, socioeconomic orientation, mental health, cognitive, sensory, or physical disability, sexual orientation, or gender identity, geographic location, or other factors historically linked to discrimination or exclusion (Maness et al., 2021).

Healthcare inequalities can manifest in various ways, such as differences in the quality of care received, access to preventive care services and screenings, and access to healthcare facilities and health insurance. These disparities can cause significant differences in health outcomes between different groups of people, with disadvantaged communities often experiencing worse health outcomes than more privileged groups. My interest in the topic is to find a way of addressing healthcare disparities to achieve health equity, where everyone can access and attain their highest level of health regardless of their background or social circumstances. From a professional standpoint, reducing healthcare disparities can be challenging, but employing a multifaceted approach that addresses the root causes of these disparities is an effective strategy.

Identifying Peer-Reviewed Articles

I searched Capella University Library`s databases and accessed articles relevant to my topic through PubMed and Google Scholar in the search for peer-reviewed articles, using keywords such as healthcare disparities, health equality, community health improvement plan, community health assessment, and local healthcare disparities. I identified four peer-reviewed articles published from 2019 to 2023 with information relevant to my topic.

Assessing Credibility and Relevance of Information Sources

Articles found in Capella University`s library are usually credible and maintain the source to ensure credibility. I ensured all four articles were scholarly and published within the last three to five years. I also ensured that the selected articles contained information that is still relevant n addresses healthcare disparities. Each of the four articles defined the study’s purpose and contained crucial information about healthcare disparities, especially in the United States.

First Article

Chunara, R., Zhao, Y., Chen, J., Lawrence, K., Testa, P. A., Nov, O., & Mann, D. M. (2021). Telemedicine and healthcare disparities: a cohort study in a large healthcare system in New York City during COVID-19. Journal of the American Medical Informatics Association, 28(1), 33–41. https://doi.org/10.1093/jamia/ocaa217

The article aimed to assess disparities in those who access healthcare via telemedicine for Covid-19 (Chunara et al., 2021). Electronic health records (EHRs) data of patients that visited New York University Langone Health from 19^th March to 30^th April 2020 were used to conduct the assessment. The type of visit was determined and grouped into telemedicine or in-person. The study results indicated that Blacks were 0.6 times less likely to seek healthcare through telemedicine than White patients. However, more Blacks who sought healthcare through telemedicine were diagnosed with Covid-19 as opposed to Whites. The findings reveal that there could be healthcare disparities based on the racial backgrounds of Whites and Blacks. Also, those with home Zip codes with a lower mean income and larger average household size were less likely to seek healthcare through telemedicine (Chunara et al., 2021). In general, the study identified systemic racism, poor socioeconomic status, and ageism as root causes of both in-person and telemedicine care disparities. I included this article because it is scholarly and contains credible information about healthcare disparities.

Second Article

Abedi, V., Olulana, O., Avula, V., Chaudhary, D., Khan, A., Shahjouei, S., … & Zand, R. (2021). Racial, economic, and health inequality and COVID-19 infection in the United States. Journal of racial and ethnic health disparities, 8, 732–742. https://doi.org/10.1007/s40615-020-00833-4

The article purposed to report the associations of COVID-19 concerning race, health, and economic disparities in the United States. The study indicated that people with healthcare disparities usually experience healthcare challenges and are more affected by chronic conditions and infectious diseases like Covid-19 than the privileged ones. An ecological study was conducted in 369 counties from the seven states (California, Louisiana, Massachusetts, Michigan, New York, New Jersey, and Pennsylvania) that the Covid-19 pandemic had hit the most (Abedi et al., 2021).

The study’s findings showed that morbidity and mortality rates differed across counties. Counties with varied demographics, higher populations, lower literacy, income, and lower disability rates were at a higher risk of contracting COVID-19 infection. Also, counties with a higher percentage of people living with disability and a higher proportion of poverty recorded the highest mortality rates. African Americans, a minority group, were more vulnerable to COVID-19 than other ethnic groups in the counties (Abedi et al., 2021).

The authors concluded that the disparities observed might be due to the workforce of essential services, access to care, and poverty. The lower rate of infection but a higher death rate in counties with higher poverty and disability could be attributed to lower levels of mobility but a higher rate of comorbidities and disparities in healthcare access (Abedi et al., 2021). This article was included because it has current information relevant to the topic under review.

Third Article

Williams, D. R., & Cooper, L. A. (2019). Reducing racial inequities in health: using what we already know to take action. International journal of environmental research and public health, 16(4), 606. https://doi.org/10.3390/ijerph16040606

The study is a review that shows evidence-based steps needed to reduce racial inequalities in health. It was noted that marginalized racial groups like African Americans, Pacific Islanders, and Native Americans have poor health outcomes than Whites despite the efforts to reduce racial inequalities over time. The authors proposed that the communities that provide early childhood development resources adopt policies to reduce childhood poverty, provide work and income support opportunities for adults, and ensure healthy housing and neighborhood conditions should be developed to reduce the negative influence of racism on health (Williams & Cooper, 2019). The authors proposed another strategy of emphasizing healthcare systems to ensure that all persons have access to quality healthcare, including preventive health services, without racial discrimination. Lastly, it was recommended that new research be carried out to identify effective strategies to build political will and support to address social inequities in health (Williams & Cooper, 2019). It was prudent to include this article because the authors propose solutions to health inequalities.

Fourth Article

Rader, B., Astley, C. M., Sy, K. T. L., Sewalk, K., Hswen, Y., Brownstein, J. S., & Kraemer, M. U. (2020). Geographic access to United States SARS-CoV-2 testing sites highlights healthcare disparities and may bias transmission estimates. Journal of travel medicine, 27(7), taaa076. https://doi.org/10.1093/jtm/taaa076

The study aimed to determine how geographic access to Covid-19 testing influences the transmission estimates (Rader et al., 2020). The authors noted that Uniform access to SARS-CoV-2 testing is critical for controlling the COVID-19 epidemic. It is evidence-based that inequalities in geographic accessibility to healthcare in the USA cause adverse health outcomes for seasonal influenza transmission and other diseases. In the case of Covid-19, the geographic disparities in testing were one factor that was highlighted as a possible factor that curtailed the containment of the pandemic. People in rural areas had to travel long distances to get tested, which even increased transmission rates. Travel time was highlighted as a factor that negatively impacts health-seeking behaviors. It was noted that sociodemographic factors to poor access to care and healthcare outcomes (Rader et al., 2020). I included this article because it addresses geographic factors and their contribution to healthcare disparities.

Summary

The review of the four articles shows that health inequality is a significant public health concern in the United States. More efforts should be put into the matter to ensure health equity. Policymakers, including community members, should be held accountable for the health disparities and ensure that all citizens receive quality care without discrimination. Marginalized groups should be educated to attain health literacy and be empowered to advocate for health equity. The research has enhanced my understanding of health disparities, especially the factors that contribute to healthcare inequalities in the country. I now recognize that much must be done to ensure the matter gains prominence among policymakers.

References

Abedi, V., Olulana, O., Avula, V., Chaudhary, D., Khan, A., Shahjouei, S., … & Zand, R. (2021). Racial, economic, and health inequality and COVID-19 infection in the United States. Journal of racial and ethnic health disparities, 8, 732-742. https://doi.org/10.1007/s40615-020-00833-4

Chunara, R., Zhao, Y., Chen, J., Lawrence, K., Testa, P. A., Nov, O., & Mann, D. M. (2021). Telemedicine and healthcare disparities: a cohort study in a large healthcare system in New York City during COVID-19. Journal of the American Medical Informatics Association, 28(1), 33-41. https://doi.org/10.1093/jamia/ocaa217

Rader, B., Astley, C. M., Sy, K. T. L., Sewalk, K., Hswen, Y., Brownstein, J. S., & Kraemer, M. U. (2020). Geographic access to United States SARS-CoV-2 testing sites highlights healthcare disparities and may bias transmission estimates. Journal of travel medicine, 27(7), taaa076. https://doi.org/10.1093/jtm/taaa076

Williams, D. R., & Cooper, L. A. (2019). Reducing racial inequities in health: using what we already know to take action. International journal of environmental research and public health, 16(4), 606. https://doi.org/10.3390/ijerph16040606

Zimmerman, F. J., & Anderson, N. W. (2019). Trends in health equity in the United States by race/ethnicity, sex, and income, 1993-2017. JAMA network open, 2(6), e196386-e196386. https://doi.org/10.1001/jamanetworkopen.2019.6386