Concept 54: Health Disparities

Identify how health disparities are seen in the context of nursing and health care

• Unavoidable and Acceptable • Unavoidable and Unacceptable • Avoidable and Acceptable • Avoidable and Unacceptable

Describe Avoidable and Unacceptable disparities that health care frequently encounter

*Lack of health insurance and high healthcare cost *Language barriers *Lack of transportation to health care providers *Provider patient communication *Biased clinical decision making *Patient's mistrust and refusal

Exosystem

-- settings or events that influence the child's socialization even though the child has no direct role in them. -- INDIRECT effect on the child, because influence trickles down through other people in the child's life. -- New laws, government reform, environmental regulation, social unrest, financial upheaval, business and industry are a few examples

Macrosystem

--a personal set of values and beliefs that forms within the child based on that child's unique set of personal experiences AND that serves as a filter or lens through which that child interprets future experiences -- factors that influence a child is WHAT experiences a child will have and HOW the child will interpret those experiences. -- defined by the child's GENDER, the ERA in which the child grows up, the RELIGION that the child is exposed to, the POLITICAL IDEOLOGY surrounding the child, the SOCIO-ECONOMIC STATUS of the family and the child's CULTURE which may include issues of race, ethnicity, and heritage..

Chronosystem

--changes which occur during a child's life in the characteristics of the child as well as in the environment in which the child lives --changes over the life course in family structure, socioeconomic status, employment, placement of residence

microsystem

--refers to all the settings in which a child personally interacts and is influenced. Family, school, or social club. -- child affected DIRECTLY. -- child forms social relationships, takes part in activities that build cognitive or physical skills, experiences personal successes and failures, and is socialized first-hand through personal experience.

Mesosystem

--refers to those situations or events in which two Microsystems come together in some respect. --The people or activities from individual Microsystems interact to form a new experience for the child. -- can be long term and recurrent, solitary or one-time occurrences --an opportunity for child to build a bridge between two settings that might be unrelated. ex. child grows up in a home in which there is expectations for behavior, discipline style, etc., and goes to school in a classroom with a slightly different set of expectations and discipline style, child must cope with that transition independently every day.

Explain Whitehead's 7 determinants of health disparities that are useful as attributes

1. Natural, biological variation 2. Health damaging behavior that is freely chosen 3. Transient health advantage of 1 group over another when 1 group is 1st to adopt a health promotion behavior 4. Health damaging behavior in which the degree of choice of lifestyles is severely restricted 5. Expose to unhealthy, stressful living and working condition 6. Inadequate access to essential health service and other basic service 7. Natural selection, or health related social mobility involving sick people to move down social scale

Define and describe Health Disparities

A gap in the quality of health and health care among population groups that often parallel difference in... - Socioeconomic status - Racial/ethnic background - Education level *Difference in the quality of care received by minorities and non-minorities who have equal access to care

Describe an Avoidable and Acceptable

A natural disasters is avoidable because people can get shelter however its acceptable because no ne can stop mother nature

Describe and identify The Social-Ecological Model that explains health disparities

Aims to explain dynamic interrelation among various personal and environment factors • Evolves from the systems theory of child development - 5 socially organized subsystem related to human development. Each of these systems interacts within the context of the person life and provides diverse options and source of growth 1. Microsystem 2. Mesosystem 3. Exosystem 4. Macrosystem 5. Chronosystem *This system allows nurses to identify barriers and develop an intervention to reduce health disparities

Describe and identify The Structural-Constructivist Model that explains health disparities

Based on assumption of dual nature of human existence • Based on a mental representation by socially shared understandings with a society - Adopts a structural perspective • Supports the idea of social and cultural construction of race/ethnicity *Gives direction for nursing research and practice in understanding health disparities in both clinical and community setting

Describe and identify The Cultural Competence Model that explains health disparities

Bridges people together despite cultural differences • Entails 3 things: 1. Understanding importance of sociocultural influences on a patients health beliefs and behavior 2. Consider how cultural factors interact at multiple levels of health care delivery system 3. Devising intervention that take issue into account to ensure high-quality health care diverse patient population *Interpersonal interaction focus on the ability of a provider to bridge cultural differences to build an effective relationship

Describe an example Unavoidable and Unacceptable

Diabetes runs in the family and most likely able to get it but no reason why it can't be manage by exercise or eating healthy

Describe an example of Unavoidable and Acceptable

Older people go to ER compare to younger people due to age. Theirs nothing you can do about age since you can't change it

Describe an Avoidable and Unacceptable

Skin cancer is avoidable if people take care of themselves by sunscreen.. However considered unacceptable if people expose themselves when it can be prevented