

Without health insurance, patients are more likely to postpone medical care,
more likely to go without needed medical care, and more likely to go without
prescription medicines. Minority groups in the United States lack insurance
coverage at higher rates than whites. Lack of a regular source of care.
Without access to a regular source of care, patients have greater difficulty
obtaining care, fewer doctor visits, and more difficulty obtaining
prescription drugs. Compared to whites, minority groups in the United States
are less likely to have a doctor they go to on a regular basis and are more
likely to use emergency rooms and clinics as their regular source of care.
Lack of financial resources. Although the lack of financial resources is a
barrier to health care access for many Americans, the impact on access
appears to be greater for minority populations. Legal barriers. Access to
medical care by low-income immigrant minorities can be hindered by legal
barriers to public insurance programs.
For example, in the United States federal law bars states from providing
Medicaid coverage to immigrants who have been in the country fewer than five
years. Structural barriers. These barriers include poor transportation, an
inability to schedule appointments quickly or during convenient hours, and
excessive time spent in the waiting room, all of which affect a person's
ability and willingness to obtain needed care. The health care financing
system. The Institute of Medicine in the United States says fragmentation of
the U.S. health care delivery and financing system is a barrier to accessing
care. Racial and ethnic minorities are more likely to be enrolled in health
insurance plans which place limits on covered services and offer a limited
number of health care providers. Scarcity of providers. In inner cities,
rural areas, and communities with high concentrations of minority
populations, access to medical care can be limited due to the scarcity of
primary care practitioners, specialists, and diagnostic facilities.
Linguistic barriers. Language differences restrict access to medical care
for minorities in the United States who are not English-proficient. Health
literacy. This is where patients have problems obtaining, processing, and
understanding basic health information. For example, patients with a poor
understanding of good health may not know when it is necessary to seek care
for certain symptoms. While problems with health literacy are not limited to
minority groups, the problem can be more pronounced in these groups than in
whites due to socioeconomic and educational factors. Lack of diversity in
the health care workforce. A major reason for disparities in access to care
are the cultural differences between predominantly white health care
providers and minority patients. Only 4% of physicians in the United States
are African American, and Hispanics represent just 5%, even though these
percentages are much less than their groups' proportion of the United States
population.
Age. Age can also be a factor in health disparities for a number of reasons.
As many older Americans exist on fixed incomes which may make paying for
health care expenses difficult. Additionally, they may face other barriers
such as impaired mobility or lack of transportation which make accessing
health care services challenging for them physically. Also, they may not
have the opportunity to access health information via the internet as less
than 15% of Americans over the age of 65 have access to the internet.
Health Disparities
Health
disparities (also called healthcare inequality in some countries) refer to
gaps in the quality of health and health care across racial (see Race and
health), ethnic, and socioeconomic groups. The Health Resources and Services
Administration defines health disparities as "population-specific
differences in the presence of disease, health outcomes, or access to health
care."In the United States, health disparities are well documented in
minority populations such as African Americans, Native Americans, Asian
Americans, and Latinos. When compared to whites, these minority groups have
higher incidence of chronic diseases, higher mortality, and poorer health
outcomes. Among the disease-specific examples of racial and ethnic
disparities in the United States is the cancer incidence rate among African
Americans, which is 10% higher than among whites. In addition, adult African
Americans and Latinos have approximately twice the risk as whites of
developing diabetes. Minorities also have higher rates of cardiovascular
disease, HIV/AIDS, and infant mortality than whites.
Groups affected by health disparitiesOften under emphasized are the groups
that are heavily affected by health disparities in America. Health
disparities are not just based on race, ethnic, and cultural differences.
Observations and surveys show that one’s choice of lifestyle limits or
benefit his or her access to health care. “Health inequalities exist for
lesbian and bisexual women, largely related to experiences of
discrimination, homophobia and heterosexism.” This known interference with
health care access is a prime example of heterosexual privilege and
homosexual prejudice prevalence in our society. Just as this lack of health
care affects minority races, ethnic groups, and less represented cultural
beliefs; lesbian and bisexual women are deteriorating their health by either
not seeing or not be attended to by health care professionals. It is
important that health care professionals consider the nine cultural
competency techniques suggested by the Agency for Healthcare Research and
Quality and make an effort to break the barriers put into place through
society’s homophobia and heterosexism.
Causes of health disparitiesThere is debate about what causes health
disparities between ethnic and racial groups. However, it is generally
accepted that disparities can result from three main areas:From the
personal, socioeconomic, and environmental characteristics of different
ethnic and racial groups (such as how certain racial groups, on average,
live in poorer areas with high incidence of lead-based paint, which can harm
children). From the barriers certain racial and ethnic groups encounter when
trying to enter into the health care delivery system; and From the quality
of health care different ethnic and racial groups receive. Each of these
dimensions have been suggested as possible causes for disparities between
racial and ethnic groups. However, most attention on the issue has been
given to the health outcomes that result from differences in access to
medical care among groups, and the quality of care different groups receive.
Disparities in access to health careReasons for disparities in access to
health care are many, but can include the following:Lack of insurance
coverage.





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