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Issues and Challenges Associated With Developing Fair, Equitable Health Policy
November 28, 2016

Issues and Challenges Associated With Developing Fair, Equitable Health Policy

A well-functioning healthcare system must be coordinated, efficient, cost-effective, and goal-oriented. Unfortunately, these words donít summarize healthcare services in the United States.
Race, ethnicity, and immigrant status. The vast majority of minorities in the US are uninsured.3 American Indians and Alaska Natives have lower educational levels, higher unemployment rates, and consequently lower rates of employer-based coverage. Their needs are not acknowledged, and they have not attained full social, political, and economic equality. Native peoples feel unvalued, which initiates poor health that ultimately affects their well-being. They have higher disease rates and lower life expectancy when compared with other racial and ethnic groups in the US. Their population is younger due to higher mortality rate than all other American races. The rates of diabetes, mental disorders, cardiovascular disease, pneumonia, influenza, homicide, and chronic liver disease are exceptionally higher than any other racial or ethnic group. At least one-third of American Indians live in poverty without any health insurance, which plays a significant role in developing a disproportionately high incidence of disease and medical conditions, such as malnutrition, tuberculosis, and high maternal and infant death rates. In addition, poverty and secluded living hinders them to use healthcare facilities.4
One of the most important issues associated with providing healthcare to the Asian population is differences in language and socioeconomic characteristics. It is imperative to increase teaching second language courses, which act as a bridge linking new immigrants to society. Members of the older generation in the Asian population have limited English proficiency and find it very difficult to adjust to a foreign culture and understand healthcare in the US.5 They may prefer traditional forms of medicine and they may not be aware of healthcare programs due to language and literacy challenges. It is essential for organizations to familiarize Asian communities of their eligibility for the healthcare programs. It is necessary to provide one-on-one application assistance, language accessibility, and cultural competency to help individuals in Asian communities.6
Language barriers are also an important hindrance when it comes to providing healthcare to the Hispanic population.  In the US, very few healthcare providers speak Spanish. In most circumstances, sick individuals who are unable to speak or understand English rely on friends and family members to translate and interpret. This poses a greater risk as the interpreter may misunderstand or exclude a question that was brought up by healthcare professionals and the patient may omit the embarrassing symptoms.3 This problem will continue to rise until there are more healthcare providers available who are able to speak Spanish. Recruitment of bilingual healthcare professionals is an important element that can enhance quality of healthcare.2 In addition, it is important to have Spanish medical interpreters at healthcare facilities. This will result in better patient-practitioner relationships and communication, which will ultimately increase patients’ likelihood of receiving and accepting appropriate medical care. Studies indicate that when patients interact with clinical members who share a common race, ethnicity, or language, there is a higher chance of rapport building. Conversing in the same language can instill and strengthen the needed cultural values. This will lead to a greater interpersonal care, better medical comprehension, and higher chance of keeping follow-up appointments.4

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