Healthcare Disparity in Western New York Research Paper

Healthcare Disparity in Western New York Research Paper

Healthcare Disparity in Western New York Research Paper

Every American citizen is entitled to quality and safe health services. Unfortunately, different regions in the country have recorded numerous gaps and disparities in medical services. In Western New York (WNY), many people are affected by the existing disparities in health services. This paper uses three peer-reviewed journal articles to examine the differences and disparities in health care services in WNY. The targeted disparity is the nature of inequality in accessing healthcare services.Healthcare Disparity in Western New York Research Paper

Topic Identification
New York is one of the states with uniform insurance cover and income (McDonough, 2015). However, the community still faces numerous healthcare delivery disparities. McDonough (2015) indicates that health disparities in different counties are associated with gender, racial, and ethnic differences. The elderly, disabled, and homeless persons lack access to exemplary healthcare services (Sanchez, Ybarra, Chapa, & Martinez, 2016). Individuals with psychiatric conditions lack access to adequate preventive and primary health care.

This health disparity is relevant to the nursing profession because of a number of reasons. The first one is that the existing gaps can empower nurses to develop superior models. Secondly, practitioners can examine the nature of these disparities and implement powerful strategies to promote health equity (Noonan, Mondragon, & Wagner, 2016). Curriculum developers in nursing can also examine the problem and offer evidence-based concepts to ensure more people receive high-quality health services.Healthcare Disparity in Western New York Research Paper

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Literature Review
The article “Racial and Ethnic Disparities in Health Care Access and Utilization under the Affordable Care Act” indicates that ethnicity and race are powerful categories that affect people’s health outcomes (Chen, Vargas-Bustamante, Mortensen, & Ortega, 2016). Some Americans from marginalized groups lack access to better health services such as African Americans, Asian Americans, and Latinos. The unavailability of resources explains why minorities find it hard to get timely health services. Due to the nature of health delivery systems, such groups are affected the most by numerous conditions such as cancers, chronic diseases, premature deaths, and homelessness (Chen et al., 2016). Obesity has also been found to affect many minority races. It is also a risk factor for numerous illnesses such as cardiovascular disease, diabetes, and cancer.Healthcare Disparity in Western New York Research Paper

In the second article “Improving the Health of African Americans in the USA: An Overdue Opportunity for Social Justice”, it is observed that many African Americans are affected the most by different types of cardiovascular disease. Statistics indicate that minority races are 30 percent more likely to record premature deaths in comparison with whites (Noonan et al., 2016). The percentage is also high for stroke-related deaths. In WNY, the existing health delivery systems targeting minorities are inadequate. The economic positions of such groups make it impossible for them to acquire evidence-based medical services (Noonan et al., 2016). The systems have also failed to consider specific illnesses that affect minorities.

McDonough (2015) indicates that health care access in America’s rural areas is quite low. The elderly lack quality services and care models. Additionally, veterans receive inadequate care in WNY. This analysis indicates clearly that WNY is a community with numerous health care disparities. The article “Eliminating Behavioral Health Disparities and Improving Outcomes for Racial and Ethnic Minority Populations” offers useful insights for minimizing disparities in healthcare services (Sanchez et al., 2016). For instance, new policies and superior health delivery systems can be designed to tackle the challenge. This issue is significant since policymakers, health professionals, and social workers can use it to implement powerful health promotion initiatives.Healthcare Disparity in Western New York Research Paper

Discussion: Personal Point of View
The ultimate goal of nursing is to transform the health experiences and lifestyles of every citizen. However, the existing social, economic, and health systems make it impossible for practitioners to achieve this objective. In Niagara country, different groups do not have access to exemplary medical services (McDonough, 2015). The number of nurses in the county is also low, thereby affecting the nature of services available to the targeted population. This complexity affects the mandate and objective of nursing. When individuals have unequal access to health services, it becomes hard for nurses to meet their needs. The profession of nursing should, therefore, be redesigned to mitigate such gaps.Healthcare Disparity in Western New York Research Paper

Researchers in nursing advocate for better policies to support veterans, minority races, and women. They also focus on new models and systems that can ensure the disabled and the elderly have access to quality health services. In WNY, statistics indicate that around 20 percent of the population lacks adequate medical services (McDonough, 2015). Niagara County is affected by diseases that are associated with this disparity. For example, cancer claims around 181 persons in every 100,000 annually in the county (McDonough, 2015). Diabetes affects around 8.9 percent of the county’s citizens (McDonough, 2015). Mental health conditions affect 9.7 percent of the population. Around 9 percent of the population is composed of minority racial groups. This means that such groups face discrimination whenever looking for health care services.Healthcare Disparity in Western New York Research Paper

Disproportionate access to medical services is one of the major disparities affecting New York’s healthcare sector. This discussion has revealed that minority groups, the elderly, disabled, and individuals with mental conditions lack adequate health services. Nurse practitioners must identify powerful models, influence new policies, and implement superior strategies to minimize these gaps. Such approaches will transform the situation and ensure more people have access to exemplary healthcare services.Healthcare Disparity in Western New York Research Paper

Persistent health inequality in the United States along multiple dimensions has
been put at the forefront by one of the challenging goals of Healthy People 2010 (USDHHS, 2000): to eliminate health disparities among all segments of the population,
including differences that occur by gender, race, or ethnicity, education or income,
disability, geographic location, and sexual orientation. In this paper we study the quality
of health and health inequality among racial/ethnic groups as well as across geographic
areas of the State of New York. Even though certain aggregate indicators of health (e.g.,
life expectancy at birth, mortality rate, etc.) in New York have improved during last few
decades (see NCHS, 2006), health disparities among racial/ethnic groups and among
regions continue to exist. For example, as we will show below, the prevalence of diabetes
is almost twice as high among Blacks compared to that among Whites; on the other hand,
many New York City neighborhoods and unsuspecting areas of Upstate New York are
characterized by extreme poor health. This is the first study to look at the health status
and its disparity among New Yorkers along these dimensions.
A question arises as to what causes poor health and health disparities. A large
number of studies have reported that socioeconomic status (SES) is a key factor affecting
quality of health and health disparity (see for example, Adler & Newman, 2002; Cutler &
Lleras-Muney, 2006; Adams, Hurd, McFadden, Merrill, & Ribeiro, 2003; Cutler, Deaton,
& Lleras-Muney, 2006; Deaton, 2006). There are four broad pathways—health care,
environmental exposure, health behavior, and chronic stress—through which SES affects
health (Adler & Ostrove, 1999). Because SES is an important mediator for quality of
health, studying health disparity cannot be separated from studying disparity in SES. Healthcare Disparity in Western New York Research Paper

Rawls’ First Principle of Justice (1971) requires that all individuals should have
the same opportunity to achieve their potential health levels; see Bommier and Stecklov
(2002). An egalitarian viewpoint of social justice requires that people in equal need of
health care be treated equally, irrespective of characteristics such as income, place of
residence, race, and so forth. Since discrimination in access to health care is likely to be
based on income, we focus on income-related health inequality in this paper. There seems
to be broad consensus among health policy analysts that socioeconomic inequality in
health is indeed inequitable and unjust, and is consistent with the Institute of Medicine
(2002) definition of health disparity—any difference in health after adjusting for health
care needs. This definition recognizes that factors such as income may be mediators of
disparity in health care.Healthcare Disparity in Western New York Research Paper

Numerous studies on measuring quality of health and health distributions have
focused on mortality rates, prevalence of diseases/risk factors, psychological morbidity,
quality of or access to health care services, and health care utilization rates.3
In addition
to looking at many of these factors, in this study we focus on a measure of health more
generally, and calculate an index of health and health inequality based on self-assessed
health (SAH) status. SAH is defined as the response to the survey question “Would you
say that in general your health is: excellent, very good, good, fair, or poor?” (Centers for
Disease Control and Prevention (CDC), 1999-2004).
SAH has been shown to be a good measure of overall health status. In their
review, Idler and Benyamini (1997) show that SAH has strong predictive validity for

We found that between 40% and 50% of the total health inequality in our sample is due to income-related
health inequality—an estimate that is much higher than 25% reported by Wagstaff and van Doorslaer
(2004) for Canada.Healthcare Disparity in Western New York Research Paper
See, for instance, Williams and Collins (1995), Ayanian, Weissman, Chasan-Taber, and Epstein (1999),
and Shishehbor, Litaker, Pothier, and Lauer (2006).
mortality. Sickles and Taubman (1997) compiled results from worldwide studies on the
association between self-assessed health and mortality, and reported that a lower level of
SAH has higher mortality odds. Manor, Mathews, and Power (2001) found that SAH has
a strong association with longstanding illness. Furthermore, Lahiri, Vaughn, and Wixon
(1995) show that SAH is a useful predictor of the severity of diseases and disability.
Humphries and van Doorslaer (2000) found that health inequality calculated on the basis
of SAH status gives similar results to the results calculated based on a more objective
health indicator (viz. McMaster Health Utility Index). More recently, Safaei (2006) finds
SAH to be statistically more reliable than the binary chronic conditions as a measure of
overall health.
In this paper we generate a continuous measure of health by modeling the fivecategory SAH as an Ordered Probit Model (McKelvey & Zavoina, 1975) conditioned by
several objective determinants including different diseases, behavioral risk factors, and
socio-demographic characteristics. The estimated values from this model are used as a
measure of individual health and income related health inequality using concentration
index and concentration curve (Kakwani, Wagstaff, & van Doorslaer, 1997).Healthcare Disparity in Western New York Research Paper
Furthermore, to be useful for policy purposes, the income related health inequality is
decomposed into its determinants (Wagstaff, van Doorslaer, & Watanabe, 2003) for the
whole sample and specific sub-samples.
The paper is organized as follows: The estimation procedures—the methods to
calculate quality of health, income related health inequality and their determinants—are
described; the data used in the empirical analysis is documented; results are then
presented; and finally we summarize our conclusions.
In modeling SAH we follow the same procedures as Cutler and Richardson (1997,
1998) and Groot (2000). In the empirical modeling of the quality of health, three related
concepts are distinguished: a true quality of health denoted as h*
, a vector of objective
measures of health denoted as ho
, and a subjective measure of health denoted as hs
. The
true quality of health is a latent variable, which is unobservable.Healthcare Disparity in Western New York Research Paper