The Role of Nurses in Alleviating Minority Disparity in Health Care

It’s no secret that there are racial disparities in health care and health outcomes in the United States. Though the divide has improved over the years, it is still not where it needs to be. When we look at the numbers, health officials agree that this is a problem, but what is much more contested are the reasons for these disparities and thus what to do about this pressing problem.

 

Some of the areas patients experience these differences include quality of care, access to care, outcomes, provider biases, provider-to-patient communication and health literacy. According to the U.S. Centers for Disease Control and Prevention, black women are less likely to develop breast cancer, but 40% more likely to die from it than white women. The reasons for this are multi-faceted. Black women are less likely to receive preventative care or genetic testing, but they are also at higher risk for an aggressive type of “triple negative” cancer. Very few trials tend to include or properly represent black populations, so conditions, which present differently in African Americans have less research behind them. Perhaps the aggressive breast cancer fits into this category. Either way, the result is the same.

 

We also know that African American are more at risk for developing diabetes, hypertension or cardiovascular disease, but interestingly obese minorities are less likely than their white counterparts to receive nutritional counseling or health advice that could shift that trajectory. They are also 10% less likely to be screened for high cholesterol.

 

There are many factors here that we have no control over, but as health care professionals, there are definitely things that we can do to help improve results for black Americans. By improving overall health literacy, I think we can begin to tackle some of the root causes of the disparity. The U.S. Department of Health and Human Services defines health literacy as, “the degree to which individuals have the capacity to obtain, process, and understand basic health information needed to make appropriate health decisions.” In a population with literacy rates that are lower than their white counterparts, this is going to play a significant role. It can affect a person’s ability to understand medical advice, properly read prescription bottles and to properly take responsibility for their health. This is also a big problem where there are language barriers.

 

However, this is not something that falls solely in the hands of the individual. The healthcare system is an unnecessarily complex place, and it is up to us as healthcare providers to do what we can to ease this burden. We need to push for programs that educate, visual aids that make medications or courses of treatment easy to understand, and to encourage and model more honest patient communication. It’s important to communicate with patients in ways that they understand. Oftentimes, patients receive treatment from doctors, but don’t understand any of what the doctor explained to them. Remember, we are helping patients understand their own bodies and health. It doesn’t serve anyone in the community, if this is not accomplished.

 

Additionally, it is up to us to talk about health issues in our communities and to our friends and family. As minority nurses, we know the statistics. We know that outcomes are better when treatment is sought sooner; we know the dangers of poor diet and lifestyle choices. We know that distrust is a big reason for avoiding or delaying medical intervention. We know that medical advice might not be clear, so we can encourage asking questions and self-advocacy. We can be more vocal about the importance of preventative treatment and having the proper healthcare. In a system as complex as healthcare, what we don’t know can hurt us, and we must do what we can to bridge that informational gap.

 

I think we’ve been aware about the disparity in healthcare for sometime, but we have to start doing something with this information. We need to take the things that are ours to control and own them. We need to educate ourselves and our communities about the importance of preventative measures. Then we need to use our positions within the systems to address the common barriers, improve communication and push for health literacy programs. The more educated we can become about our health, the sooner we can bridge this gap and start living healthier lives.

 

 

 

Pearl, Robert, M.D. “Why Health Care is Different If You’re Black, Latino or Poor.” Forbes. Mar 5, 2015. www.forbes.com/sites/robertpearl/2015/03/05/healthcare-black-latino-poor

 

Health Literacy. HealthyPeople.gov. Oct. 8, 2020. www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/health-literacy