By: Krystle Duffield, Melinda Mollenkopf, Tiffany Thompson

Objectives  Identify 3 health disparities that minorities face.  Identify 3 ways to increase access to health care for minorities.  Identify 2 ways to decrease health disparities among minority groups.

Epidemiology-Descriptive Who? Minorities: Total Population from 2000 census: 281,421,906 White: 75.1% African American: 12.3% Hispanic: 12.5% Asian: 3.6% Pacific Islander: 0.1% Other: 5.5% U.S. Department of Commerce. (2001). Profiles of general demographic characteristics: 2001 census of population and housing. U.S. Census Bureau. Retrieved March 13, 2010 from

Epidemiology-Descriptive Where: United States- Urban & Rural areas

Epidemiology-Descriptive When? 1900-present:

Critical Thinking Question: Why do you think that health care disparities exist for minorities?

Epidemiology- Analytic WHY? Health insurance, language, residency, income, and ethnicity have been found to be the most important determinant of access to health care (Zambrana & Carter-Pokras, 2010). African American and Hispanic children are three times more likely than white to be in poverty (Stanhope & Lancaster, 2010). Material barriers lead to unequal access to health care: such as insurance, transportation, educational, and ethnic culture (Zambrana & Carter-Pokras, 2010). Cultural barriers and lack of understanding of their way of life lead to ineffective communication and service delivery to minority populations (Mwachofi, Lewis, & York, 2009).

Epidemiology-Analytic HOW? Not seeking health provider and following recommended treatment (Mwachofi, Lewis, & York, 2009). Better health is more associated with social advantage than with social disadvantage (Zambrana & Carter- Pokras, 2010). “The most important predictor of quality health care is access (Cohen, 2003). There are serious disparities in access to care (Kaiser Commission, 2000)” (as cited in Mwachofi, Lewis, & York, 2009, p. 13).

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Critical Thinking Question: As nurses, how can we promote readily available health services to minority populations?

Healthy People 2010 Goals: Increasing years of healthy life Eliminate health disparities (Stanhope & Lancaster, 2010). Objectives: Promote healthy behaviors Increase access to quality health care Increase community prevention

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Critical Thinking Question: Based on Healthy People 2010’s goals, what are some ways that we could increase healthy years in minorities?

Healthy People 2010 How to increase healthy years in minorities? Health promotion and levels of prevention Primary Secondary Tertiary

Healthy People 2010 Primary Eating Healthy & Exercising (Siegal, Prelip, Erausquin, & Kim, 2010). Education Vaccinations (Stanhope & Lancaster, 2010). Encouraging use of internet to increase awareness of health information (Campbell, 2009).

Healthy People 2010 Secondary Cost of screening Why pay so much money for tests or insurance if you don’t think you have a problem. Uninsured and underinsured are less likely to seek preventative services such as screenings because of the cost and therefore more likely to acquire preventable illnesses (Stanhope & Lancaster, 2010). Once Hispanics’ demographic socioeconomic and health system characteristics were controlled they had significantly higher odds of receiving screenings such as mammograms (Zambrana & Carter-Pokras, 2010).

Healthy People 2010 Tertiary Minority populations are less likely to start rehabilitation programs and for those that do, they are less likely to successfully complete the program. “There are inadequate research and service delivery methods for minority populations with disabilities” (Mwachofi, Lewis, & York, 2009, p. 13).

Critical Thinking Question: How do we eliminate health care disparities in minorities?

The Community Health Nurses Role How do we eliminate health care disparities in minorities? Knowledge of culture and environment of minorities. Through community assessment the nurse gets a better understanding of that communities specific needs and getting the community involved leads to better outcomes (Stanhope & Lancaster, 2010). Increase access to care Passing the health care bill would decrease disparities for minorities because uninsured people will have easier access to health insurance. Provide free screening clinics for health problems such as obesity, heart disease, diabetes (Stanhope & Lancaster, 2010).

Critical Thinking Ethical Question: Do you think that everyone should have equal access to health care?

Health Planning Education Educate health care worker in cultural diversity in the community being served using EBP (Stanhope & Lancaster, 2010). Integrating the culturally educated heath care worker with EBP interventions that have been proven to have success will improve the communities’ outcomes (Moore et al., 2007) Community Motivation to Learn Have minority community member to teach health care workers about needs and desires. Community meeting to get community involved. Integrate cultural norms (Mwachofi, Lewis, & York, 2009).

Health Planning Assess the community environment, situation, and population. Find out the problems/ weaknesses of the community Find out strengths, resources, and funding that is available Find out what resources and funding is needed Transportation Communication Build trust in the community Language

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References Beach, M. C., Gary, T. L., Price, E. G., Robinison, K., Gozu, A., Palacio, A., Smarth, C., Jenckes, M., Feuerstein, C., Bass, E. B., Powe, N. R., & Cooper, L. A. (2006). Improving health care quality for racial/ethnic minorities: A systematic review of the best evidence regarding provider and organization interventions. BMC Public Health, 6(1), 104. Campbell, R. J. (2009). Internet-based health information seeking among low-income, minority seniors living in urban residential centers. Home Health Care Management & Practice, 21(3), Moore, D. E., Overstreet, K. M., Like, R. C., & Kristofco, R. E. (2007). Improving depression care for ethnic and racial minorities: A concept for an intervention that integrates CME planning with improvement strategies. Journal of Continuing Education in the Health Professions, [No volume/issue], Mwachofi, A. K., Lewis, B. M., & York, K. D. (2009). Enhancing service delivery to minority farmers: VR counselors' perceptions and recommendations. Journal of Rehabilitation, 75(2), Siegal, J. M., Prelip, M. L., Erausquin, J. T., & Kim, S. (2010). A worksite obesity intervention: Results from a group- randomized trial. American Journal of Public Health, 100(1), Sloan, F. A., Ayyagari, P., Salm, M., & Grossman, D. (2010). The longevity gab between black and white men in the United States at the beginning and end of the 20th century. American Journal of Public Health, 100(2), Stanhope, M., & Lancaster, J. (2010). Foundations of nursing in the community: Community-oriented practice (3rd ed.) St. Louis, MO: Mosby Elsevier. U.S. Department of Commerce. (2001). Profiles of general demographic characteristics: 2001 census of population and housing. U.S. Census Bureau. Retrieved March 13, 2010 from Zambrana, R. E., & Carter-Pokras, O. (2010). Role of acculturation research in advancing science and practice in reducing health care disparities among Latinos. American Journal of Public Health, 100(1),