Reducing Health Disparities

The Centers for Disease Control and Prevention (CDC) report on Health Disparities and Inequalities examined disparities in the health care service in the U.S that allied with various factors, ethnicity/race is one of them. The Hispanic/Latino group are among the affected ethnicity. The report examined various major diseases including measles, poliovirus, DTP as well as HIV/AIDs and disparities between different ethnic groups in the United States. Since the 1989-1991 measles resurgence that affected approximately 55,622 children a majority of them under the age of 5 years, of which racial/ethnic minority children were more affected, 16 times to be specific, the government develop Childhood Immunization Initiative. The program was to address the disparities in immunization coverage. To assess the progress of the initiative, CDC compared the coverage level of children between the ages of 19-35 months from 1995-2011 to the National Immunization Survey data. The disparities in MMR vaccination among the Latino/Hispanic infants rose from 87.9% to 92.4% in 1995 and 2011 respectively, during the same period, the number of non-Hispanic white children retained the >90. When it came to DTP vaccination coverage in the between the years 1995 to 2005, Hispanic children had 4-dose lower coverage than the non-Hispanic white. Poliovirus vaccination coverage had no disparities among the Hispanic and non-Hispanic white children for the same year (CDC, 2014, p.9-11). The U.S immunization programs adopted by the VFC has contributed to the elimination and return of the endemic measles transmission. 

Disparities also existed when it came to HIV/STD prevention interventions among men who have sex with other men. In the U.S, MSM is estimated to present 2% of people infected with HIV/AIDs, even though a 2010 report stated that these people form 63% of the new HIV infections (CDC, 2014, p.21).  In the years 2006-2009, the rate of HIV incidences increased to 12.2% mostly among the non-Hispanic black men, however, it remained stable among the white and Latino MSM. Similarly, STD incidence, for example, chlamydia, primary and secondary were high among non-Hispanic MSM than those of their Latino counterparts. A 2005 and 2006 correctional study found that “young black men and Latino MSM with older partners engaged on higher rates of sexual behaviors and had a greater likelihood of unrecognized HIV infection than those with younger partners…” (CDC, 2014, p. 22). Because of the HIV/STDs incidence amid MSM, there were many organization and programs created to deal with the issue. CDC first disseminated 3MV- a group level intervention program developed to help reduce the rate of HIV/STD among MSM- in 2004 and used the group in 2012 to help implement HIV behavioral prevention intervention among MSM of color Latino included (CDC, 2014, p.25). 3MV through CDC support since 2004 has delivered the intervention to thousands of MSM among color and other ethnicity. Because of this, strides have been made to reduce personal risk behavior and alertness concerning the prevention, testing, and treatments of HIV and STD  has contributed to the reduction of HIV/STD incidence and prevalence. One consequence of not accessing health care, especially for those people living with HIV/AIDS as well as STDs is that they are likely to unaware of their status, they are therefore likely to receive a treat of the disease after it has progressed (National Immigration Law Center, 2014). 

    While access to health care services is important and the United States government has tried its best to offer this service to its population, there are still a number of people not accessing these services. Access to health care compromises of three component: services, timeliness, and coverage. Over the past half a decade about 20 million persons have gotten access to health insurance coverage as a result of  the Affordable Care Act of 2010 and Patient Protection (Healthypeople.gov, 2014).  As much as the number of uninsured people has decreased, still millions of the U.S population do not have access to health coverage. Report from Healthy people Midcourse Review reveal a great disparity in terms of sex, ethnicity, education, family income, race, and age when it comes to access to care (Healthypeople.gov, 2014). These disparities exist by regions, for example, due to the shortage of workforce, millions of Americans in the rural areas lack primary care services. Similarly, these disparities exist within the levels from which on access health care, for instance, access to primary care, having an ongoing source of care, as well as health and dental insurance (Healthypeople.gov, 2014). Therefore, it is important for the government to make efforts,  for example, deployment of workforce dealing with primary care to regions with the shortage of such staff and train culturally competent care to attend to different groups of the population. Other specific issues that should be measured for the next few years include: addressing issues that affect access to health care, example, race, sex etc.; increasing and measuring insurance cover to allow patients access the entire continuum, monitor the changes in health care workforce, and increasing use of telehealth as a way of delivering health care services (Healthypeople.gov, 2014).  If these factors are dealt with, then the health care services will be accessed by all Americans. 

In an article “HIV Risk, prevention, and testing behaviors among heterosexuals at increased risk for HIV infection–National HIV Behavioral Surveillance System, 21 U.S. cities, 2010” by Sionean et al., (2014), investigated how behaviors increase HIV prevalence. According to the article, about 872,990 people are infected with HIV in the United States (Sionean et al., 2014, p.1). During the period June-December 2010, the National Behavioral Surveillance System (NHBS) collected data on selected metropolitan statistical areas (MSAs) among MSM, heterosexual, and injecting drug users; these populations are considered to have a high risk of getting HIV infection. The sampling of the research focused on people of low SES and those with no more than a High school education. The results were as follows: majority of the participants, African American 72% and Hispanic 21%, women 90% and men 88% reported to have had sex-vaginal and anal- without a protection with one or more sexual partner of opposed sex. Out of 71% men and 77%, women reported having ever had HIV testing, among the group Hispanic/Latino group registered lowest at 52% men and 62% women. Out of the group, only 34% of participants confirmed to have received donated condoms during the last 12 months prior to the interview and only 11% were part of behavioral prevention program (Sionean, et al., 2014, p. 6-12).  Another article “Unmet Needs for Ancillary Services Among Hispanics/Latinos Receiving HIV Medical Care — the United States, 2013–2014” by Korhonen et al., (2016), found that HIV infection is more than twice among Hispanic/Latinos than the non-Hispanic white. The CDC analysis from Medical Monitoring Project (MMP) found that Hispanic/Latinos from all age groups and sexual orientation had unmet needs, for example, 15% needed food and nutrition services, 21 needed eye care, 9% required transportation assistance, and 24% was in need of dental care (Korhonen et al., 2016, p. 1105). 

The research by Sionean et al., (2014) found that the group experience financial, structural and socio-cultural barriers thus health care disparities. HIV prevalence was more among those of heterosexual from the low socioeconomic status (SES) and of Hispanic/Latino ethnicity. Additionally, these people did not have enough access to HIV services. In the report by Korhonen et al., (2016), the participant experienced structural barriers, that is, they did not have their need met, thus making them disadvantaged health wise. To improve the health care issue raided by Korhonen et al., (2016) and Sionean et al., (2014), it is important for the government to delineates national response to decrease HIV infection and health care disparities among those group affected. Also, the national and local government can increase the reach of HIV prevention programs. Finally,  the government can address the unmet need for ancillary services to reduce health disparities among Hispanic/Latinos living with HIV. 

References

Centre For Disease Control and Prevention. (2014). Strategies for Reducing Health Disparities — Selected CDC-Sponsored Interventions, United States, 2014. Morbidity and Mortality Weekly Report, 63(1), 1-47. Retrieved from https://www.cdc.gov/mmwr/pdf/other/su6301.pdf

Healthypeople.gov. (2018, August 8). Access to Health Services | Healthy People 2020. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services

Korhonen, L. C., DeGroote, N. P., Shouse, R. L., Valleroy, L. A., Prejean, J., & Bradley, H. (2016). Unmet Needs for Ancillary Services Among Hispanics/Latinos Receiving HIV Medical Care — United States, 2013–2014. MMWR. Morbidity and Mortality Weekly Report, 65(40), 1104-1107. doi:10.15585/mmwr.mm6540a3

National Immigration Law Center. (2014, August). The Consequences of Being Uninsured. Retrieved from https://www.nilc.org/wp-content/uploads/2015/11/consequences-of-being-uninsured-2014-08.pdf

Sionean, C., Le, B., Hageman, K., Oster, A., Wejnert, C., Hess, K., & Bailey, G. (2014). HIV Risk, Prevention, and Testing Behaviors Among Heterosexuals at Increased Risk for HIV Infection — National HIV Behavioral Surveillance System, 21 U.S. Cities, 2010. Morbidity and Mortality Weekly Report, 63(14), 1-39. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6314a1.htm