From One to Many: The Benefits of Addressing Health Disparities
The National Institutes of Health defines health disparities as “the difference in the incidence, prevalence, mortality, and burden of disease and other adverse health conditions that exists among specific population groups ….” Many factors may impact an individual’s health status and outcomes, including age, gender, socioeconomic status, educational background, race/ethnicity, language and culture, sexual orientation, disability status, and even geographic locale.
Often, identifying and addressing a single health disparity can have a tremendous health and cost impact across a larger population. By addressing an issue in a subset of the population, often one solves systemic issues. When addressed for one, the positive impact extends to all.
Did you know:
- Women have worse long-term outcomes as well as increased hospital readmission following coronary by-pass surgery compared to their male counterparts?
- Patients with low literacy skills are 29% more likely to undergo a hospital admission?
- More than 30% of direct medical costs for Hispanics, African Americans, and Asian Americans in the U.S. are excess costs due to health inequities?
- Proceedings from a Workshop sponsored by the National Academy of Medicine, “Health Literacy and Older Adults: Reshaping the Landscape,” (at which Dr. Edwards was a panelist) indicate that health literacy challenges in older adults (a group with a higher prevalence of co-morbid conditions and a greater need for polypharmacy) are among the greatest in the U.S. population.
These are just a few examples of the price we all pay when one among us does not have access to or receive the care we each deserve. When you extend the problem to the population level, you can begin to imagine how quickly and significantly the repercussions can reverberate in a manner which has consequences – threats to life, limb, and economic security – for us all. Ignorance kills.
“When you look at the impact of health inequity across the multitude of segments of healthcare, and the challenges facing those with little or no preventive care, the medical and behavioral consequences of inequity add up over the years of a life. By examining these disparate populations, we inform the decisions we make as providers and employers to create better outcomes for all populations.”
– Z. Colette Edwards
How can your organization make a difference?
Insight MD® interprets healthcare analytics through both a clinical and business lens to address many of the manifestations and consequences of health disparities, including:
- variations in quality of care
- barriers to care
- diagnosis at a later or more severe stage of disease
- greater difficulty with adherence to treatment plans
- medically inexplicable variability in the type and scope of options offered to a patient
- less than optimal management of chronic pain
- unconscious bias by healthcare professionals
- greater utilization of the emergency room
- higher rates of readmission
- higher cost of care
Ready to Get Started?
According to the most recent (2016) National Healthcare Disparities Report by the Agency for Healthcare Research and Quality (AHRQ):
Key findings include:
- As a result of the Affordable Care Act, the uninsured rate decreased in the period from 2010 – 2016.
- Quality of health care improved in the areas of person-centered care, patient safety, care coordination, healthy living, and effective treatment. However, the majority of care affordability measures did not change.
- Disparities related to race and socioeconomic status persist, with the poor, uninsured, African American and Hispanic populations continuing to bear a much heavier burden than patients in other demographic groups.
- Specific findings regarding minority health can be found here.
Find out how your state stacks up here (as of 2016).
Minority Health: Recent Findings. Content last reviewed February 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/factsheets/minority/minorfind/index.html
Learn how Insight MD can help you address health inequality and gain skills in health literacy and cultural competency to improve the health and well-being of patients/employees and reduce costs in a medically appropriate way.
Sometimes, it’s tough to know how to best navigate through the healthcare system. Many liken it to trying to read and understand a foreign language. Do you know what this means? eht thgisni rotcod syas ot ekat eno dna llac em ni eht gninrom.
The Institute of Medicine defines heath literacy as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate decisions.”
Insight MD can help:
- employees navigate your benefits plan more effectively through innovative, proactive educational programs
- provide tips and reminders to employees to improve engagement in health and wellness programs
- increase patient engagement by developing more cohesive and comprehensive communications strategies
Reading literacy is not the same thing as health literacy, nor does it guarantee it. That means health illiteracy can impact anyone, regardless of their socioeconomic status or educational background. And the impact can be far-reaching, with implications for both quality and cost of care:
- increased chance of misdiagnosis
- longer time and more tests to make the correct diagnosis
- condition diagnosed at a later and potentially more deadly stage
- fewer preventive care visits and lower screening rates
- higher rates of hospitalization
- longer hospital stays
- higher utilization of the emergency room
- less engaged patient and/or patient perceived by the healthcare professional to be less engaged
- problems with care plan development and adherence
Cracking the Health Literacy Code
By the way, “eht thgisni rotcod syas ot ekat eno dna llac em ni eht gninrom” becomes “The Insight Doctor says to take one and call me in the morning” when you read the words with the letters in reverse order. Easy enough when you know the code. When you don’t, not so much. Words really do matter.
Ready to crack the health literacy code?
According to the US Department of Health and Human Services, “cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.” What happens if a patient looks, thinks, feels, lives, believes, or speaks differently than those providing care? A lot.
When applied to the healthcare arena, the degree of cultural competence can impact:
- the patient-practitioner relationship
- the quality and cost of care
- the ability to develop a care plan which can be successfully undertaken by the care team, the patient, and anyone else involved in the patient’s care
- the ability of the care team to approach the patient holistically and optimize health outcomes
Beyond Bedside Manner: Ignorance Kills
Though some are naturally gifted with a superlative bedside manner and may have a knowledge base and training in cross-cultural skills, many others may not be as well-versed as they would like. Recognizing the importance of culture, belief systems, body language and other non-verbal cues, and addressing potentially unconscious bias when interacting with patients can dramatically improve quality of care, increase engagement, and ultimately drive better health outcomes and drive down the cost of care.
A lack of understanding, an inability to communicate effectively, and a reluctance to render care within the context of a patient’s values can negatively impact both health and healing, life and limb. Ignorance kills.
In an increasingly diverse world, and with growing evidence of the importance of taking a whole-person view in care delivery, addressing the needs of patients for which there may be multicultural nuances has become a critical clinical skill.
It’s Time to Take Action
Insight MD can help you assess current performance and design interventions which will enhance your ability to optimize (1) the quality of care, (2) the cost to deliver care, and (3) the patient experience.
Taking action and moving strategically also means (1) better performance relative to HEDIS and CAHPS measures, JCAHO surveys, readmission rates, and (2) a demonstration of improved health outcomes, which facilitates participation in medical home, P4P, bundled and value-based payments, and Accountable Care Organization (ACO) models of care.
Ready for better outcomes?
What’s the business case for addressing health inequity and health disparities?