discussion board and two replies 1

Prepare An Adequate response to the following prompt

Choose 2 different vulnerable and underserved populations. Describe their health needs, and summarize the major challenges they face. Next, what are the racial/ethnic minority categories in the United States? Compared with Caucasian Americans, what are the health challenges minorities face?

Respond to classmate #1

We must help all regardless of their background. The bible states “And he came down with them and stood on a level place, with a great crowd of his disciples and a great multitude of people from all Judea and Jerusalem and the seacoast of Tyre and Sidon, who came to hear him and to be healed of their diseases. And those who were troubled with unclean spirits were cured. And all the crowd sought to touch him, for power came out from him and healed them all” (Luke 6: 17-26 English Standard Version). There are many different vulnerable and underserved populations in the United States. According to Shi & Singh (2017), “The causes of their vulnerability are largely attributable to unequal social, economic, health, and geographic conditions. These population groups encompass include racial and ethnic minorities, uninsured women and children, persons living in rurals areas, the homeless, the mentally ill, the chronically ill and disabled, and individuals with HIV/AIDS. The two vulnerable groups I will focus on will be racial minorities and the uninsured.

Racial minorities and the uninsured should be bettered cared for in our healthcare system. They are on the fringe of the quality of life, and truly vulnerable to bad health. To put things in perspective the uninsured rate ranged between 14.5 percent and 15.5 percent of the U.S. population from 2008 to 2013 (Vitaleri, 2016, p. 18). Palley (2016) states the estimated uninsured to be 40 to 50 million people in the United States (p. 148). And according to Ayanian (2015), “Al- though the United States has made progress in narrowing the gap in life expectancy between blacks and whites, from 7.6 years in 1970 to 3.8 years in 2010, a disparity remains — largely from blacks’ higher death rates at younger ages from heart disease, diabetes, and cancer, as well as higher risks for HIV infection, homicide, and infant mortality” (p. 1).

Their health needs and challenges vary. Likely to be less educated and poorer, According to Shi & Singh (2017) The uninsured face greater barriers to accessing needed health care and are more likely to report delays in seeking needed medical care or dental care (p. 278). Racial minorities as mention earlier experience higher rates of illness and mortality than white Americans.

Racial minorities are categorized into groups. In their journal Fiscella & Sanders (2016) state that the racial minorities are: Asian Americans, Black or African Americans, Hispanics or Latinos, Native Hawaiians and Other Pacific Islanders, American Indians, and Alaska Natives (p. 376). Compared to Caucasian Americans racial minorities face many health challenges, some I have mentioned earlier. In the textbook Shi & Singh (2017) list the challenges that racial minorities face,

1. Black Americans
   1. Shorter life expectancies
   2. Higher deaths from stroke and coronary heart disease than whites
   3. More likely than whites to report fair or poor health status
2. Hispanic Americans
   1. More likely to be uninsured or underinsured
   2. One-fourth of families live below poverty line
   3. AIDS is leading cause of death
   4. Higher proportion of Hispanics are overweight or obese
3. Asian Americans
   1. Higher rate of cancer than whites in stomach and liver cancer
   2. Cambodian refugees have high rate PTSD and depression
4. American Indians and Alaska Natives
   1. Poverty is associated with high injury-related mortality rate among these children.
   2. The rate of death due to alcohol is 7 times greater and the suicide rate is 3.5. times greater than the national averages.
   3. Higher rates for drug-induced deaths than among non-Hispanic whites.
   4. Higher homicide rates compared to non-Hispanic whites. (p. 271)

Healthcare disparities exist in racial minorities and the uninsured. They received much less in quality healthcare than compared to Caucasian Americans. Mainly due to economic reasons they receive lackluster care. Cost of healthcare has risen. And many of racial minorities and uninsured populations can ill afford health insurance. Reforms and cheaper insurance must come about for them to receive the care they need. The Affordable Care Act aided in increasing access for healthcare for these populations. According to Salmond & Echevarria (2017) the affordable care act is “more than insurance reform” and allows for greater access and improved quality to more affordable healthcare.

In conclusion the path to better care for the vulnerable and underserved is for reforms in our healthcare policy to allow for lower costs in healthcare premiums and lower health services costs, so that the underserved may be served properly. Dignity and care must be given to all. As it says in the bible, “There is neither Jew nor Greek, there is neither slave nor free, there is no male and female, for you are all one in Christ Jesus” (Galatians 3:28 English Standard Version).

Respond to classmate #2

Various terms are used to describe the populations in the United States that face greater challenges than the general population in accessing health care services and they include terms like “underprivileged”, “medically underserved”, “underserved populations”, “medically disadvantaged” and “American under classes”. For this discussion, we will be calling it the underserved populations. Underserved populations are described in terms of their vulnerability. The causes of their vulnerability are largely attributable to unequal social, economic, health, and geographic conditions. These population groups experience greater barriers to racial or cultural acceptance (Shi & Singh, 2013).

Predisposing, Enabling, and Need Characteristics are ways of grouping these areas of vulnerability together and thinking about them. There are certain characteristics that people may have that predispose them to certain levels of vulnerability such as: racial /ethnic characteristics, gender and age characteristics and geographic location. Next you have enabling characteristics and that includes insurance status and homelessness which are situations that can enable or cause vulnerability. Finally we have need characteristics. People who have more needs are more vulnerable like those people with chronic illnesses, disabilities, HIV/AIDS and of course mental health issues. If you don’t need as much health care you are not as vulnerable (Shi & Singh, 2013). Notice how all of these things pile up for example, a homeless person maybe or is more likely to be very young in age in terms of a predisposing characteristic and they are also more likely to have a mental issue which is a big need characteristic.

Talking more about vulnerability, let’s talk about rural health. Poverty is more common in rural areas and rural residents earn an average of 7,417 dollars less than urban residents. Also, 24 percent of children in rural areas actually live in poverty so if you are in a rural area one out of four children are likely to be impoverished. This seems like a very high rate. 20 percent of the US populations live in rural areas, which are not very big as only 10 percent of our physicians are based there and as a result, rural populations face greater barriers in access to care (Shi & Singh, 2013).

Health care facilities in rural areas generally are small and frequently provide a limited scope of services this causes a major challenge for them because limited services can also force rural health care providers to make decisions based on clinical impression more than the most up-to-date specialty knowledge or diagnostic technology (Klugman & Dalinis, 2008).

Another population category we can consider is women and children. Women who make up more than half of the population have a higher rate of health problems than men this could be attributed to stress from sexism, lower pay or other environmental sources.

Children also are increasingly affected by conditions that were not prevalent among older generations which are referred to as “new morbidities” or sicknesses for children. Children at younger ages are getting drug and alcohol addicted, and of course we have this horrible disease of obesity and type II diabetes affecting our children. With all of these school shootings recently, we see a major challenge experienced here that children are having mental health problems and we still have the age old problem of dealing with learning disabilities (Shi & Singh, 2013).

So, let’s look at the racial/ethnic minority categories in the United States by looking more at predisposing characteristic of race and ethnicity. How does it lead to disparities? There are mainly environmental stressors. First, you get racism which leads to trouble with employment and poverty and also you have poor food quality because a person lives in an impoverished area where he/she can’t get fresh fruits and vegetables very easily and also if you are working two or three jobs, you have lack of time to exercise. I experienced this myself as I am currently doing two trainings and I have no time for exercise which I was used to while in the military. All of these things can add together and end up being a situation where a racial or ethnic community experiences disparities in health outcomes. The United States has a racially and ethnically diverse population and the racial/ethnic minority categories in the United States are white, black or African American, American Indian or Alaska Native, Asian, and Native Hawaiian or other Pacific Islander , Hispanic or Latino (Shi & Singh, 2013).

Compared with Caucasian Americans, the African Americans face more health challenges. For example, they face the greatest threat from diabetes and are twice as likely to be diagnosed more than the white populations. Other groups of color also face health challenges related to diabetes. It was estimated in 2001 that the death rate from diabetes among Latinos was 40 percent higher than that among white, non-Latinos. Another health challenge faced by the minorities is that they have a higher prevalence of hypertension (high blood pressure), a major risk factor for cardiovascular disease, than do white, non-Latinos. Excessive weight plays a critical role in hypertension, and hypertension, in turn, contributes to racial/ethnic disparities in morbidity and mortality (Delgado, 2013).

The bible instructs us to be attentive to the vulnerable and the underprivileged in the society because if we ignore them Jesus also will ignore us when we pray. This is evident in the verse that says: “Who so stoppeth his ears at the cry of the poor, he also shall cry himself, but shall not be heard.” (Proverbs 21:13, King James Version).

Word Count: 910

References

Delgado, M. (2013). Social justice and the urban obesity crisis: Implications for social work. Columbia University Press.

Klugman, C. M., & Dalinis, P. M. (2008). Ethical issues in rural health care. Baltimore: Johns Hopkins University Press.

Shi, L., & Singh, D. A. (2013). Essentials of the U.S. health care system — with access (3rd ed.). Burlington, MA: Jones & Bartlett Publishers.

 

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