Health Inequity Creating Gaps in Access to Care Across the Nation
Unequal Healthcare Access in America
Innovations and advancements of modern-day medicine continue to ameliorate lives by mitigating disease burden and contributing to the growth in life expectancy. However, while these advancements exist, the access to and benefits from these opportunities are not always equitable across populations. The U.S. healthcare system holds large gaps in access and quality when it comes to equitable patient care. With the current system, underserved populations are often left with fewer resources, less attentive care, and overall access. Dr. Richard Besser, CEO of the Robert Wood Johnson Foundation, spoke on the reality of health inequity in America and stated that:
“When people are given healthy choices, they have to make them, absolutely. But at the same time, we want people to understand that the choices people make fundamentally depend on the choices that they have. America cannot be a healthy country if we’re leaving communities without those healthy choices.”
While it is a disheartening reality that certain populations in a country with a strong health system are isolated from the opportunity to achieve optimal health, this type of acknowledgement is the first step towards developing solutions that achieve health equity.
Health Inequity in Mental Health Care
Health inequity is evident across all disciplines of health but is especially prominent in behavioral health issues. Mental health services are one vital sector of health for which access remains not equal for all people. The inequity in mental health care has been felt deeply as the COVID-19 pandemic has resulted in an increase of mental health illnesses in addition to widening the gap of access to care. Since the start of the COVID-19 pandemic, the distribution in the prevalence of mental health illness has negatively affected minorities (Tomeer et al, 2022). With the increase in the likelihood of COVID-19 infection comes the increase in COVID-19 related stressors. Stressors of the pandemic, such as financial strain and grief, augment mental distress and have been seen at a higher rate among minorities (Tomeer et al, 2022). Not only does health inequity impact accessibility to mental health services but it also greatly affects trends in health-seeking behavior— particularly, who seeks care and to what degree. Only 25% of African Americans seek mental health care compared to the 40% of their white counterparts. This can be due to several factors such as health insurance, stigma, access and more (McLean Harvard Medical School Affiliate, 2022). Underserved communities are not only subjected to less accessible care but often have less confidence or lower perceived need to seek care for their mental health needs. Limiting the opportunity to access proper mental health care in minorities is keeping America behind in alleviating the burdens of health inequity. Advocating for the awareness of mental health practices and resources in marginalized groups is the catalyst to achieving equity in healthcare.
Strides in Improving Equity in Healthcare
The increased awareness and acknowledgment of health inequity has resulted in a push by many healthcare players to incorporate measures to ensure the greatest access is provided to the most people. The new Enhancing Oncology Model (EOM) is replacing the previous Oncology Care Model (OCM) in outlining all aspects of oncology care is a stellar example of this. While the OCM lacked efforts to improve health equity, the EOM has made deliberate strides to prioritize health care opportunities and access to all (Bresnick, 2022). Including incentives to engage in health equity programs and implementing social needs screening by the EOM are the crucial steps needed to catalyze change towards accomplishing total health equity.
A different approach to increasing health equity progress can be seen by programs such as the alternative care sites that have been recently encouraged in a Deloitte news report. Alternative care sites are smaller and less conventional healthcare sites that increase access points for patients, especially in underserved environments. By staffing alternative care sites with individuals of diverse populations and fostering close connections with patients, trust issues and stigma in underserved populations are mitigated (Cheney, 2022). Minority groups who may have felt disconnected or underserved by the traditional healthcare system can benefit from alternative care sites where they are able to receive care in close proximity to where they live and from people that share their background and experiences. Enabling an environment of trust and comfort will increase the likelihood of underserved people seeking and receiving proper care.
Cancer Support Community (CSC) is another healthcare player working towards ensuring an environment of health equity. CSC acknowledges that past and present injustices have contributed to medical mistrust. These lower clinical participation rates are a reflection, in part, of the unfavorable experiences that people sometimes experience within healthcare systems. CSC’s Health Equity department is developing a video series that will not only acknowledge how medical mistrust is justified, but also offer patients and caregivers varying viewpoints from cancer patients, their caregivers, and medical providers. The first module in the Justified Medical Mistrust video series will feature input from past clinical trial participants and healthcare experts from communities of color. Through candid conversations, the series will highlight how clinical trial participation can benefit the individual cancer patient and their community. It will also review the impact of past clinical trials on current treatment advances with a contemporary perspective. Be on the lookout for the official unveiling on CSC’s website in early 2023!
CSC’s Health Equity Vice President, Eucharia Borden, states “the time is long overdue to take what we have known about health care and cancer care disparities and convert that knowledge into action.”
Implementing programs and resources like those discussed will encourage the changes that need to be made in the healthcare system to allow for equal access and care across the nation. Advocating for these changes creates a society that empowers one another to ensure that no one is left behind in reaching optimal health.
Bresnick, Jennifer. “Small and Rural Hospitals Fall behind on Addressing Social Determinants of Health.” Digital Health Insights, 7 Nov. 2022, https://www.dhinsights.org/news/small-and-rural-hospitals-fall-behind-on-addressing-social-determinants-of-health.
CDCStreamingHealth, director. What Does Health Equity Look Like? YouTube, YouTube, 2 Feb. 2021, https://www.youtube.com/watch?v=kb4-0H2j0nQ&feature=youtu.be. Accessed 9 Nov. 2022.
Cheney, Christopher. “Deloitte: Alternative Care Sites Provide Solutions to Several Healthcare Problems.” HealthLeaders Media, https://www.healthleadersmedia.com/clinical-care/deloitte-alternative-care-sites-provide-solutions-several-healthcare-problems?utm_source=HLeNL&utm_medium=email&utm_campaign=HLBriefing.
McLean Havard Medical School Affiliate. “Black Mental Health: What You Need to Know.” Understanding Mental Health in Black Communities | McLean Hospital, 8 Nov. 2022, https://www.mcleanhospital.org/essential/black-mental-health#:~:text=Black%20Americans%20Are%20Less%20Likely,major%20contributor%20to%20this%20disparity