Introduction
Health disparity is a common issue facing many American citizens. The United States’ healthcare system has been criticized by scholars and researchers because it does not support the needs of minority groups. Due to the exiting health disparities in this country, many patients or communities find it hard to access quality medical support and resources. New policies and healthcare laws have been aimed at minimizing the current gaps affecting the health outcomes of different American citizens. However, there are various social factors that have not been addressed for several decades. Such forces have continued to affect the health outcomes of many citizens. Any attempt to address a specific disparity in healthcare must, therefore, be informed by the major social forces experienced in this nation. This discussion examines the nature of inequities within the healthcare system that affect HIV/AIDS patients in the United States.
Health Disparity Identification
The health disparity targeted for this discussion revolves around the HIV/AIDS epidemic. Burt and Glick (2017) define “health disparity” as a form of gap whereby specific individuals are unable to receive desirable medical attention. Previous analyses have indicated that African Americans are 20 times more likely to get HIV than Whites in this country (Raymond-Flesch, 2017). African American patients living in rural areas are usually unable to receive superior medical services. This remains a major challenge since individuals who have this condition should receive adequate disease management services and empowerment. Statistics have revealed that more people continue to be affected by this terminal disease despite the fact that there are various incentives aimed at minimizing transmission rates and new infections (Raymond-Flesch, 2017). This means that affected patients in different regions are disproportionately represented whenever seeking medical support and disease management services. This means that the existing disparity cannot be explained using variations in patients’ preferences, health care needs, and treatment recommendations.
Racism and poverty are crucial factors that affect those who have HIV/AIDS (Noonan, Mondragon, & Wagner, 2016). Infection rates continue to increase in minority groups such as Native Alaskans, African Americans, Latinos, and Indian Americans. The provision of drugs for this condition appears to be disproportionate in different parts of the country. According to Burt and Glick (2017), individuals from minority races are unable to record positive HIV-related medical outcomes. They lack regular antiretroviral therapies (ARTs). This gap continues to exist despite the fact that disease management is critical for citizens who have this illness.
The availability of testing and counseling services is disproportionate in this country. Fortunately, several agencies and associations in the United States (and across the globe) have come up with various initiatives to deal with this disparity. Most of them collaborate in an attempt to implement evidence-based measures that have the potential to support the health outcomes of every American citizen (Burt & Glick, 2017). For example, the World Health Organization (WHO) and CDC offer timely reports and insights that can be used to address this disparity. Leaders in rural and urban health facilities can consider such reports to implement superior initiatives and tackle the challenges facing these citizens (Abram, Stokes, Welty, Aaby, & Teplin, 2017). ActionAid is an NGO that supports and works with members of affected populations of groups (Abram et al., 2017). These practices have been taken seriously to minimize this disparity. This kind of gap has resulted in numerous impacts. For instance, many patients who lack adequate health support are unable to pursue their goals. According to Raymond-Flesch (2017), such individuals record increased mortality and morbidity rates.
Social Determinants of Health
A social determinant of health (SDH) is any factor or aspect in a given community that dictates the wellness and health outcomes of its members. The leading SDHs associated with this disparity include racial background, economic position, education attainment, age, and gender. Individuals from minority groups are affected the most by this inequality. Similarly, the elderly and young people are unable to get desirable services. Those who have poor income or education tend to be affected the most by this disparity (Burt & Glick, 2017). This happens to be the case because they cannot access timely services. Some of them are not aware of their HIV statuses. Consequently, HIV-related health problems and disparities have continued to affect the lives and economic positions of many citizens in different parts of the United States.
This disparity can be clearly understood by examining how two unique dimensions (race and gender) affect many patients. Those from minority racial backgrounds are affected by problems such as poor education and lack of opportunities. They are also not supported by existing government policies and programs. Similarly, women are affected the most by this predicament. From this kind of problem, it is quite clear that these two SDHs can be addressed to record positive outcomes (Noonan et al., 2016). The reason for this argument is that such factors or determinants have continued to affect the health outcomes of many HIV patients. Once this is done, the problems and issues facing HIV patients will be addressed and make it easier for them to pursue their potential. The engagement of different actors and stakeholders can ensure that every individual succeeds in his or her life.
Health Care Financing
The issue of health care financing can be used to analyze this disparity. To begin with, the overreliance on employer-sponsored health insurance (ESI) has remained a major determinant of people’s health outcomes. With many patients from minority groups lacking permanent jobs, the situation has worsened since they lack proper insurance coverage. Additionally, those who have HIV/AIDS end up losing their jobs after becoming unproductive. This means that patients lack proper resources and insurance coverage to achieve their health aims (Raymond-Flesch, 2017). Medicare and Medicaid are government-funded programs that address the health needs of a small percentage of American citizens. Individuals who have Medicare and Medicaid can acquire prescription drugs and ARTs.
Medicaid and Medicare program meet the needs of a small fraction of HIV patients. However, those who are uncovered find it hard to achieve positive health results. The existing Health/Medical Savings Accounts have also been observed to focus on the health demands of persons who have competitive salaries and job opportunities. Since the disparity faces many patients from minority groups, it is usually impossible for them to purchase adequate health insurance cover (Raymond-Flesch, 2017). Although such incentives to maintain health have been embraced by different people, the most outstanding fact is that the situation has led to negative results in HIV patients from minority races. This has also been the same predicament facing women and girls from various backgrounds.
Health Care Delivery Systems
The nature of the United States’ health care system explains why several disparities continue to affect many citizens. The current gap facing patients infected with HIV can be attributed to a number of issues within the health care delivery system in this nation. To begin with, the disproportional access to screening for this disease is something that has affected the situation. Many people from minority groups and marginalized regions are unable to receive such services (Sanchez, Ybarra, Chapa, & Martinez, 2016). This has been as a result of poor funding procedures and programs to meet the needs of every citizen. More women and individuals from minority backgrounds continue to be affected. The second issue is that of rural v. urban health care delivery mechanisms and systems. Burt and Glick (2017) indicate that urban regions are supported using efficient care models and programs. At the same time, such regions are dominated by people from majority racial groups.
Minority groups form the largest percentage of the nation’s rural population. Women and young people from such races find it hard to receive adequate HIV treatment and disease management services. This problem arises from the nature or weakness of the country’s public health system. This nation’s health sector lacks adequate resources and ineffective care delivery systems. This system has not been able to address the needs of all patients or citizens (Sanchez et al., 2016). Diseases such as malaria and cancer have been seriously than the HIV epidemic. This gap has created a scenario whereby HIV patients from minority groups are unable to record positive health results. This disparity can also be used to explain why more people continue to be infected with HIV.
Health Policy
Medicaid is one of the policies or programs that been put in place to support the health needs of many Americans. However, it has not managed to address most of the social determinants of health identified above. This was the case because the program has failed to remove barriers such as reduced access to insurance coverage for terminal health conditions, the inclusion of existing medical conditions, and reduced costs for medical services (Chen, Vargas-Bustamante, Mortensen, & Ortega, 2016). Through the application of this policy, many people from different races were still unable to receive exemplary services. The law fails to support the needs of many women infected by HIV. Such groups still do not have access to quality treatment and care in this nation.
Experts have indicated that this law is incapable of transforming the situation and providing adequate insurance coverage to individuals below the age of 40. By the end of 2017, the policy had failed to address the level of this disparity. More people did not have access to ARTs and drugs to deal with this health problem. Unfortunately, the current government has failed to present a superior policy to address these issues. This failure has affected many people in different parts of the country. It has also resulted in an increased number of HIV patients (Abram et al., 2017). The most important thing is for different stakeholders to amend (or improve) this policy in an attempt to address existing issues. This is the case because the current program had resulted in numerous health problems and disparities.
Role of Nursing
With America boasting of a large percentage of licensed practitioners and professionals, there is need for nurses to be involved in various policy initiatives in order to minimize most of the disparities affecting different citizens. It is agreeable that the problem of nursing shortage is a major challenge. However, practitioners can use their competencies to advocate for patients’ needs. The first strategy (or leg) that can be considered by these professionals is engaging in advocacy campaigns. They can use the three aspects of legs of lobbying to address this issue (Chen et al., 2016). They can liaise with policymakers and politicians to develop a superior policy that has the potential to address this disparity. The second approach (or leg of lobbying) is for nurses to start powerful campaigns to compel the government to address this disparity. Leader can do so by implementing powerful programs to meet the needs of more HIV patients. The third strategy is educating individuals to protect themselves from this disease.
Additionally, nursing organizations can engage in lobbying and use their members to advocate for superior policies and laws that will deal with this challenge (Chen et al., 2016). The second strategy is for these nursing associations to empower and guide their members to initiate powerful campaigns in their respective societies (Chen et al., 2016). This move will tackle the current disparity and ensure that more people in the country are not affected by the above epidemic.
Conclusion
The current HIV scourge is affecting many citizens in the United States. This problem has worsened since it appears to have diverse impacts on patients from minority groups. Medicaid is an existing policy that has not managed to reduce the nature of this disparity. This means that new programs are needed to address the current gap. Nurses and professional agencies should engage in advocacy initiatives and campaigns to address this disparity. This strategy will eventually address the health needs of many HIV patients in the country.
References
Abram, K. M., Stokes, M. L., Welty, L. J., Aaby, D. A., & Teplin, L. A. (2017). Disparities in HIV/AIDS risk behaviors after youth leave detention: A 14-year longitudinal study. Pediatrics, 139(2), 1-12. Web.
Burt, R. D., & Glick, S. N. (2017). Racial disparities in HIV. Lancet, 4(7), e281-e282. Web.
Chen, J., Vargas-Bustamante, A., Mortensen, K., & Ortega, A. N. (2016). Racial and ethnic disparities in health care access and utilization under the Affordable Care Act. Medical Care, 54(2), 140-146. Web.
Noonan, A. S., Mondragon, H. E., & Wagner, F. A. (2016). Improving the health of African Americans in the USA: An overdue opportunity for social justice. Public Health Reviews, 37(12), 1-20. Web.
Raymond-Flesch, M. (2017). To address health disparities for Latino youth, promote their engagement in health care. Journal of Adolescent Health, 60(5), 477-478. Web.
Sanchez, K., Ybarra, R., Chapa, T., & Martinez, O. N. (2016). Eliminating behavioral health disparities and improving outcomes for racial and ethnic minority populations. Psychiatric Services, 67, 13-15. Web.