Date: July 1st, 2009
Thanks to enormous advances in public health and exciting breakthroughs in medical innovation, over the past century Americans have seen dramatic gains in health and longevity. The United States currently spends more on health care than any other nation and for most people, this means access to one of the best health care systems in the world. Unfortunately, it doesn’t benefit all people equally and the reality is that most minorities have less access to care, fewer options for prevention and treatment, and higher rates of disease and illness.
These gaps in health and quality of health care that we see in many different minority groups are often called health disparities—although some countries appropriately call them “health care inequalities.” There are a number of different causes of health disparities—some linked to personal differences like genetics and lifestyle, and others linked to social differences like income and language barriers.
The bottom line is that “[m]inorities and low income Americans are more likely to be sick and less likely to get the care they need,” according to Health and Human Services Secretary Kathleen Sebelius who recently co-hosted a high-level discussion on the issue. The White House “Health Care Stakeholder Discussion” also involved the Director of the White House Office of Health Reform and other administration officials, and focused on some of the many gaps.
A major outcome of this discussion was the release of the report Health Disparities: A Case for Closing the Gap. This report highlighted the need for health reform that closes these gaps and works towards health care quality for all Americans.
Where Are the Gaps?
While there’s still some debate on what causes health disparities, there’s general agreement that they result from a combination of genetics, environments, lifestyle and health behaviors, and societal factors that create barriers to accessing quality care. The gaps can vary from person to person, and definitely from group to group, affecting not only racial and ethnic minorities but other minorities that are based on gender, income, sexual orientation, and even age.
Genetics can play a huge role by putting members of minority groups at higher risk for certain diseases and illnesses. Lifestyle factors and health behaviors like higher rates of obesity, more alcohol use, lower rates of physical activity, and poor diets also play critical roles in health outcomes. Jobs and homes can even affect health if they expose people to environmental hazards or high levels of stress. All of these factors can be especially burdensome to low-income populations who may not have the luxury of leaving a job or home that’s bad for their health, or paying for nutritious food or gym memberships.
Society has also created barriers to health care access that can make it hard for some minorities to get quality care. Lack of insurance is a major concern and many minority groups have large numbers of uninsured—for example around 34% of Hispanics don’t have health insurance. This can make it hard to get care for an illness, let alone regular care that might help prevent future illnesses. Even with health insurance, low incomes can make it difficult to find money for co-pays, prescription drugs, and any care that isn’t covered.
Communication and cultural barriers also come into play. With some minority groups interactions with the health care system may be different than physicians are used to. For example, Hispanics are more likely to consult “folk-healers” and take a non-assertive approach with their physicians. Doctor-patient communication is often complicated by these cultural differences which may be made even trickier with groups who have low health literacy and trouble understanding health information.
Language barriers are also an enormous obstacle to physician-patient communication and understanding. Among Hispanics, nearly 8 million don’t speak English “very well,” and around 33% report having difficulty communicating with their doctors. Not being able to understand your doctor or talk about your concerns and symptoms is not only frustrating but can also be bad for your health.
Closing the Language Barrier Gap
The Alliance for Aging Research is addressing the language barrier gap by bringing important health education resources to more Americans through translated resources. Educating consumers about their health empowers them to talk to their doctors, learn more about their illnesses, and take charge of their health.
This summer the Alliance is releasing Spanish versions of two of its most popular resources—workshop kits on Alzheimer’s disease and osteoporosis. Both kits are designed for health and community leaders who put on educational workshops, and include brochures created for the workshop participants.
Standing Strong: Preventing and Treating Osteoporosis (Manteniéndose Firme: Prevención y Tratamiento de la Osteoporosis) educates participants about the importance of preventing and treating this serious bone disease. Around 10% of Hispanic women age 50 and older have osteoporosis—around 49% more have low bone mass which can lead to the disease. Hip fracture rates are also increasing most rapidly amongst Hispanics, a population found to misunderstand many elements of the disease. These materials help increase understanding and empower women to take charge of their bone health.
Alzheimer’s Disease: Helping Yourself Help a Loved One (La Enfermedad de Alzheimer: Ayudándote a Ayudar a un Ser Querido)¬ provides Spanish resources for the caregivers of loved one’s with Alzheimer’s disease. Hispanics have a higher risk of Alzheimer’s than non-Hispanic whites, but they’re usually diagnosed and seek treatment later. Once diagnosed, the burden of their care often falls to a loved one. Unfortunately, Hispanic caregivers are more likely to believe the symptoms are just a part of growing old, are less likely to use formal care services like adult day care, and often take on a heavy caregiving burden because they feel it’s their responsibility as family. The Spanish kit is designed to reduce this burden and help the caregiver’s feel less overwhelmed.