Health promotion program
The African American population continues to face inequalities in the American healthcare system. The minority population comprises nearly 15% of the US population. Despite some substantial progress, health disparities continue to be a significant issue in Black communities across the US. This has led to higher prevalence rates of chronic conditions such as diabetes, heart diseases, or cancer. Also, it has limited access to preventive screening services such as blood pressure checks, flu vaccinations, and dental checkups. This situation has led to poorer health outcomes in Blacks compared to Whites. This paper examines factors that have led to health disparities amongst the African-American population and then describes a health promotion program to remedy the situation.
Factors that contribute to health disparities
Social determinants
Some of the social issues that lead to health disparities in the black community include poverty, housing, education, access to healthy food, employment, and violence. Blacks record lower high-school and college graduates than Whites. This also leads to inequality in the job market with higher unemployment rates in black communities. As a result, African-Americans record the highest levels of poverty in the USA. Poor health outcomes and mortality are co-related with poverty (Noonan, Velasco-Mondragon & Wagner, 2016). Therefore, this makes them more susceptible to health conditions such as diabetes, heart ailments, and obesity. Also, infant mortality remains higher in these poor black communities.
The poor quality of housing amongst these communities also leads to a higher prevalence of certain diseases. For example, African-Americans have an uneven incidence of asthma due to the lower quality of housing. Further, their present segregated conditions expose them to higher rates of Cardio-vascular diseases. Across the USA, black neighborhoods have lower access to healthy food than other racial groups. Surveys show that food in black areas is of lower quality than in white regions. The majority of the food desserts are found in African American communities, an indicator of higher food insecurity rates. This malnutrition results in pregnancy complications and low-birth-weight. Further, the disproportionately higher rates of violence amongst the black communities negatively impact their health (Noonan, Velasco-Mondragon & Wagner, 2016). These rates lead to higher cases of deaths, injuries, and disabilities.
Racial determinants
Racism causes African-Americans to experience prejudice and discrimination in the healthcare system. Regardless of the level of education, age, or sex, racism continues to marginalize the community. Racism has led to unequal access to healthcare services, reduced health outcomes, and lower health insurance coverage. The burden of racism has impacted the mental health of African-Americans. Healthcare systems continue to show racial bias. Blacks complain of receiving lower patient care in their communities. Also, there have been notable incidences of white people receiving better medical treatments than black people with the same health issues. The discrimination has extended to health algorithms used to inform health decisions. The residential segregation system still prevalent amongst black communities also has limited access to healthcare. These areas usually have inadequate healthcare providers. Instead, African-Americans living in these areas tend to rely more on community health centers. Transportation to better health facilities becomes a significant problem due to lower incomes in these segregated communities. This psychological burden of racism has negatively affected black communities (Taylor, 2019). This has caused many of them to suffer premature deaths or chronic illnesses compared to whites.
Environmental determinants
Many African American communities are located near areas affected by environmental stressors such as water and air pollutants. These impoverished black communities face more health-damaging factors leading to significant disparities in health. Many neighborhoods are located near sewage treatment plants, industrial facilities, and hazardous waste sites. This exposure to environmental hazards leads to health disparities. Further, the disproportionate location of many black communities near contaminated sites exposes them to more health problems than any other racial group in the USA. This situation leads to more incidences of cardiovascular diseases and respiratory ailments within this community. (Morello-Frosch et al., 2011). Besides, inadequate health promotion facilities such as air quality and monitoring sites increase the disparity.
Systems in place to remedy the situation
Steps have been taken to reduce the disparity prevalent within the African-American community. One significant steps were Barrack Obama’s 2010 Patient Protection and Affordable Care Act (ACA). This law focused on increasing health insurance coverage. It aimed to expand access to health insurance among minority groups such as African Americans. The goal was to make health more affordable and improve the quality of care. This policy change had a positive effect on the black community. It boosted health access, with more than 8 million African-Americans benefiting from increased access to preventative health services and insurance coverage. ACA has also changed the delivery of healthcare in the USA. The laws seek to emphasize the funding of hospitals on the value of care over the volume of patients. This allows African Americans to benefit from the expansion of healthcare within the community centers. However, the Medicaid expansion under the ACA continues to face challenges. Over 15 states, including those with significant black populations such as Texas and Mississippi, continue to resist Medicaid expansion (Noonan, Velasco-Mondragon & Wagner, 2016). This limits the access of many in the black population to quality care and preventative services.
Health promotion program
Addressing the health disparities in the African American community requires a health promotion program that contains specific policy steps. The following health promotion program is based on four pillars that are increasing funding, expanding research, promoting health equity, and enhancing existing health programs.
Since African Americans heavily rely on community health centers, the federal government can increase funding to these centers. Increased funding will help these centers to improve their health infrastructure. They will also enhance the quality of care. This move will ensure broader health coverage for African-Americans. Further, the creation of more institutes dealing with minority health will help co-ordinate the grassroots efforts to reduce health disparities within the community. This also entails increasing the health workforce in African American communities so that a higher number can access quality care. For these initiatives to prove, capable state and federal health agency need to cooperate with local community leaders and non-governmental organizations and other private institutions. This will also help to sharpen focus on the more vulnerable individuals within the community, such as children, women, homeless, and refugees (Ubri & Artiga, 2016). These actions will promote the delivery of healthcare delivery within these local communities.
Health agencies need to expand research on the influence of social factors on the state of health disparities within the community. Collecting data relating to the social, economic status of African Americans will reveal its magnitude on health. Further, such an action will create further awareness of the social inequalities prevalent in these communities that are leading to health disparities. This routine collection of this data will help policymakers address the social factors that negatively affect African American health. Also, to solve these health disparities, policymakers need to look at institutional factors causing racial bias in healthcare, such as residential segregation (Williams & Sternthal, 2010). This will ensure that state and federal agencies implement more institutional interventions meant to reduce the effects of racism in healthcare.
An effective health promotion program aims to push for health equity. Racism has been deeply rooted in American society for centuries. Therefore, some health workers may not recognize racial bias in their actions. This calls for policymakers to address this by extensive and systematic training of healthcare providers. This training will help identify and eliminate any forms of racial discrimination within the American health system. It will enable health providers to be culturally sensitive. Another essential strategy would be to promote more cultural and ethnic diversity in healthcare teams across the USA (Taylor, 2019). Facilitating diversity will help encourage racial tolerance in the delivery of health.
To promote health, the federal government should enhance the existing health insurance systems such as Medicaid. The program continues to face some discriminatory requirements in some states across the USA. To counter this, policies should be implemented to encourage the expansion of Medicaid in all states. The system should offer non-discriminatory guarantees to broaden the coverage of African Americans (Taylor, 2019). Robust policies will expand access to community-based health providers who are key sources of care for many African Americans.
Barriers to the health promotion program
The economic challenges of African-Americans is a significant barrier in accessing affordable healthcare. A comprehensive health promotion program will have the problem of providing quality health to many African Americans. Also, this community has lower health literacy levels. This factor also causes health disparities. It limits their ability to make informed health decisions. Another barrier is the smaller number of black health professionals (Noonan, Velasco-Mondragon & Wagner, 2016). This affects the ability for them to influence policymaking decision that aligns with the culture of African-American communities.
There are specific barriers to implement an effective health promotion program. One, it is beyond the healthcare system to address some of the social determinants causing health disparities. For example, public health professionals cannot address issues such as residential segregation, high poverty, and unemployment rates within the community. Another barrier to success is funding. The public health professionals may not receive adequate funding to cover for the needs of minority groups such as African Americans (Ubri & Artiga, 2016). This inadequate funding will limit the capacity of the health force and make it challenging to expand access to preventive and quality care services.
Systems to achieve health equity
To promote health equity in African American communities, there must be political goodwill. This means the political system must be at the forefront of implementing solutions to reduce health disparities. It includes state and local governments, community leaders, and policymakers. They can help initiate social programs to empower African-Americans. An excellent political system will help drive affirmative actions to increase education and employment opportunities. These actions will boost income levels and so improve access to health. The political system will help formulate long-term policies to address health disparities (National Academies of Sciences, 2017). It will also guarantee continued funding and ensure sustained progress of health access and coverage.
References
Morello-Frosch, R., Zuk, M., Jerrett, M., Shamasunder, B., & Kyle, A. D. (2011). Understanding the cumulative impacts of inequalities in environmental health: implications for policy. Health affairs, 30(5), 879-887.
Noonan, A. S., Velasco-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(1), 12.
Taylor, J. (2019, December 19). Racism, Inequality, and Health Care for African Americans. Retrieved from The Century Foundation: https://tcf.org/content/report/racism-inequality-health-care-african-americans/?agreed=1
Ubri, P., & Artiga, S. (2016). Disparities in health and health care: Five key questions and answers. Kaiser Family Foundation. http://www. kff. org/disparities-policy/issue-brief/disparities-in-health-and-health-care-five-key-questions-and-answers/. Published August, 12.
Williams, D. R., & Sternthal, M. (2010). Understanding racial-ethnic disparities in health: sociological contributions. Journal of health and social behavior, 51(1_suppl), S15-S27.
National Academies of Sciences, Engineering, and Medicine. (2017). Communities in action: Pathways to health equity. National Academies Press.