Abstract
The focus of this literature review is healthcare disparities during the transition of care from pediatric to adult care for both emerging and established adults. The transformation stage, which happens during the teen years and early adulthood, poses excellent difficulties as patients move from specialized pediatric-centered care to adult-orientated healthcare. Through the synthesis of findings reported by Schmidt et al. (2020), Varty et al. (2020), and Bishop et al. (2020), this review will delve into transition interventions’ outcomes, young people’s experiences during the transition, and the role of neighborhoods in health outcomes.
The effectiveness of the comprehensive transitions of care in enhancing health outcomes and patient satisfaction, the challenges facing young adults in navigating the adult healthcare system, and the associated disparities based on socioeconomic status and geographic location are some of the key findings. The disparities are instrumental as far as the individuals’ health outcomes, better access to care, and general wellbeing during the period of transition to adulthood (Hawkley et al., 2022). Interventions to achieve healthcare equality include comprehensive transitional programs, programs to enhance healthcare access in underprivileged areas, and the development of young adults through health literacy and self-management training (Hawkley et al., 2022). We can ensure that young adults, as they transition into adulthood, have access to healthcare services of the same quality through addressing healthcare disparities.
Introduction
Healthcare disparities – referred to as the gap in health outcomes and healthcare access between people from different groups – are a serious challenge with regard to patient transfer during the transition from pediatric to adult care. The phase, which is the transition period, is usually in late adolescence and early adulthood, an important landmark in the care journey of individuals (Hawkley et al., 2022). It involves conquering different difficulties and barriers at any step of the transition from specialized care in pediatric centers to adult-focused healthcare. One of the essential things for young adults at this age is to study the effect of healthcare inequities in order to address the unique needs and behaviors of young adults (Hawkley et al., 2022). The review is devoted to the availability of pediatric healthcare transition interventions, how the narrative of children/youth in this transition, and the neighborhoods influence the outcomes. Through analyzing these variables, we get a clearer vision of how healthcare disparities affect health outcomes, access to care, and overall well-being, which later contributes to the development of targeted programs for enhancing the health transition experience of young adults (Hawkley et al., 2022).
The purpose of the systematic review by Schmidt et al. (2020) was to determine transition results achieved through the interventions that facilitate moving from pediatric to adult healthcare. The interventions were put to an extensive examination that yielded tangible results. Moreover, integrated interventions among health personnel, patients, and their families showed substantial transition results (Schmidt et al., 2020). These interventions are usually groups of training, placement of counselors, and individual transition plans customized to cater to specific individual needs. Moreover, delivering excellent transfers led to better health outcomes, increased healthcare use, and increased patient satisfaction (Schmidt et al., 2020). As such, those who had received comprehensive transition support were likely to adhere to their treatment regimens, how they managed their health problems, and when they sought preventive care services. Successful transitions led to and resulted in the attainment of a high level of self-management skills as well as more autonomy in health care decision-making in the youths (Schmidt et al., 2020).
Varty et al. (2020) did a qualitative meta-synthesis to examine youths’ experiences of the process of care transition from pediatric to adult care. The results indicated the challenges facing the youths during this time, lack of continuity of care and familiarity, and the transition from pediatric to adult care settings are among the leading identified issues. The youth majority complained that the transition was a time of overwhelming disillusion with the transition process administration while reporting navigating the adult healthcare system, establishing new relationships with healthcare professionals, and managing their health themselves as significant challenges (Varty et al., 2020). Additionally, privacy, confidentiality, and health issues stigma increased the stress of the transition process. The study emphasizes a vital point, which is that support specific to each young adult’s circumstances and challenges during the period of transition should be provided (Varty et al., 2020).
Bishop et al. (2020) published a scoping review that examined the role of neighborhoods in health outcomes’ during this transition. The paper has brought substantial variations in access to health services and health outcomes across classes and migrated locations to light. People living in slums or underprivileged areas often suffer from bad-quality health facilities because of the lack of access to medical centers, transportation woes, and cost factors (Bishop et al., 2020). Other than neighborhood characteristics that include crime rates, environmental hazards, and social determinants of health, it also constitutes a factor in health behaviors and outcomes. People living in low-income neighborhoods face higher rates of chronic illnesses, poor health outcomes, and shortened life expectancy as opposed to those residing in wealthy areas (Bishop et al., 2020). These injustices point to the need for an intervention to meet equity for youth reaching adulthood.
Implications of Healthcare Disparities on Individuals’ Health Outcomes:
The voids that are there are clearly seen by Schmidt et al.(2020), Varty et al. (2020), and Bishop et al.(2020) and have profound implications for one’s health outcomes, access to healthcare, and overall well-being as one moves into being an adult. Firstly, the disadvantage in access to health care and quality of care may result in delay and inadequate treatment for health conditions, which consequently cause health outcomes to get worse and health care to become more expensive. Some instances include adolescents from deprived neighborhoods or ethnic minority groups who are inaccessible to specialty care and preventive services, which creates health inequities.
More importantly, Varty et al. (2020) discuss the challenges and barriers as a call for attention to the psycho-social and emotional needs of young adults in transition. The uncertainty, anxiety, and fear about the adult care system may influence their mental health and the whole well-being. Furthermore, lack of enough support from healthcare providers, instances of discrimination, and stigma perpetuates the negative perception among young adults, which continues to lock them out of accessing the necessary healthcare, thus deepening the health disparities.
The identification of the socioeconomic and environmental variables by Bishop et al. in 2020 can also influence the individual’s behavior and lifestyle choices, hence influencing their long-term health outcomes. Such as access to unhealthy food options, insecure recreational areas, and costly healthcare services in poor communities may cause chronic diseases like obesity, diabetes, and cardiovascular diseases among residents.
Strategies to Address Healthcare Disparities and Improve Healthcare Transition Experiences:
To eliminate health inequalities and ultimately optimize the healthcare transition of young people, a multilevel strategy must be employed. The first task that healthcare systems must complete is creating comprehensive transition programs that will offer individualized assistance and materials to young adults as they leave pediatrics and move to adult care (Betz et al., 2023). These programs should include an inter‐professional setup with both pediatric and adult healthcare providers as well as patients and their family members taking a more active role in care deliveries and decision-making (Betz et al., 2023).
Retention of both access and quality of healthcare in poor neighborhoods is significant. Examples of such include, but are not limited to, the construction of more healthcare facilities, the adoption of better transport systems, and community-based initiatives (Betz et al., 2023). Similarly, social determinants of health comprising poverty, education, and housing insecurity must be addressed for the elimination of health disparities and health equity among young people.
Conclusion
In summary, the review of the literature demonstrated the great significance of healthcare disparities during the transition to adulthood. Through the synthesis of results from Schmidt et al. (2020), Varty et al. (2020), and Bishop et al. (2020), the challenges of healthcare inequity that immature and established individuals face are clearly seen. These disparities not only influence personal healthcare outcomes but also affect overall health and healthcare experience. The studies pointed to the multidimensional nature of healthcare disparities, which, among others, are resultant from social status, ethnicity, neighborhood characteristics, and proximity to healthcare facilities.
The healthcare disparities during the transition to adulthood should be effectively addressed to ensure that all young adults access equal and quality healthcare services. It is essential to create wide-sweeping transition programs that include individualized support and resources to ease the transition from pediatric to adult care (Betz et al., 2023). Also, initiatives to enhance healthcare access and provision in underprivileged rural and urban areas need to be factored in to lower the disparities and achieve health equity. Additionally, instilling health literacy, self-management skills, and empowerment among young adults can enable them to navigate the healthcare system well and voice their healthcare needs (Hawkley et al., 2022).
References
Betz, C. L., Coyne, I., & Hudson, S. M. (2023). Health care transition: the struggle to define itself. Comprehensive child and adolescent nursing, 46(3), 162-176.
Bishop, A. S., Walker, S. C., Herting, J. R., & Hill, K. G. (2020). Neighborhoods and health during the transition to adulthood: A scoping review: health & Place, 63, 102336.
Hawkley, L. C., Buecker, S., Kaiser, T., & Luhmann, M. (2022). Loneliness from young adulthood to old age: Explaining age differences in loneliness. International journal of behavioral development, 46(1), 39-49.
Schmidt, A., Ilango, S. M., McManus, M. A., Rogers, K. K., & White, P. H. (2020). Outcomes of pediatric to adult health care transition interventions: an updated systematic review. Journal of pediatric nursing, 51, 92-107.
Varty, M., Speller-Brown, B., Phillips, L., & Kelly, K. P. (2020). Youths’ experiences of transition from pediatric to adult care: an updated qualitative metasynthesis. Journal of pediatric nursing, 55, 201-210.
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