Despite living in the US, not every American citizen has access to the same resources, such as healthcare, or the basic requirements that can give them the greatest chance of living a full and healthy life. Some social determinants mean specific groups and individuals have fewer opportunities or a lower standard of living. This can negatively impact their health, while other people have an advantage. We discuss some of these determinants and how healthcare professionals can try to balance this to ensure everyone is treated fairly.
Where people are born and raised
The area where people are born and raised can impact their early health, potentially affecting them later in life. For example, being raised in a rural area may mean having little or no access to healthcare. Suppose you compare this to an urban or suburban area with witches and specialist healthcare services. In that case, someone raised in a rural environment can be disadvantaged, particularly in rural areas with more poverty and less access to private or public transportation to access healthcare services.
Another way location can affect health is when you’re trying to get health insurance. According to HealthCare.Gov, your site can affect your premiums. The state and local rules, cost of living, and competition differences are all mentioned as possible reasons for this.
In areas with higher premiums, some people may be unable to afford health insurance. The costs tend to be higher, reflecting the increased expenses of accessing health care and medications. Even if the cost of living is higher and the average salary reflects this, there are often groups of people living in that location whose income falls below the average wage. For example, they may work in a lower-paid job because they are less qualified or commute outside the local area due to work scarcity. Alternatively, being disabled, retired, or caring for a family member can also place them outside the salary range many neighbors earn. However, they still face the same high premiums.
Education
Education can also have a direct or indirect impact on the health of an individual. One direct link is not receiving a sufficient level of education and guidance to prepare them for looking after their health.
Being healthy isn’t always something people can control, but it’s often possible for them to give themselves the best chance by eating the right foods and participating in regular exercise. Schools, where education and funding are low, will mean many children start their life eating the wrong foods and doing little practice. Sports equipment and maintenance of school sports teams can be costly. Schools with bigger budgets will always have an unfair advantage over those with lower budgets.
Being able to invest in sports education and after-school sports has several benefits. It encourages students to be active and stay healthy wherever possible. It also looks good on their record and can help them gain a place at a reputable university. So, although the link is a little more indirect, funding for sports in schools can help students grow up to be better educated, which will increase their chances of financial success later in life. This can mean being able to afford better healthcare.
There are always exceptions to this. People who have limited education and a rough start in life regularly go on to start successful businesses or find opportunities many people didn’t expect them to and earn more than some well-educated people. However, a good education is generally more likely to lead to better opportunities and increased financial stability.
The Workplace
Where people work can also impact their health in several ways. One example is working in a low-paid manual job with few or no benefits, such as health insurance. Smaller businesses may not provide insurance policies for their employees because they don’t make enough to cover this or don’t want to incur extra costs.
Not only will the worker be spending a lot of time putting physical strain on their body, but health problems this aggravates may not be covered by health insurance. They may not prioritize paying for this because they have food, bills, rent, a mortgage, and a family to care for financially. By the time they have paid for all of this, it doesn’t leave them enough money for anything else, even if the overall cost results in their poor health.
The workplace is somewhere you spend most of your waking hours, so, if possible, it should involve doing something you enjoy. Otherwise, it can also be a place that causes ill health, with more people being coerced into working longer hours to earn more money or to avoid the threat of losing their job to someone else; this can cause physical and mental health problems. However, even being unemployed comes with some health risks. Going from having a purpose and routine, even in a monotonous job, to having nothing to do all day can be problematic. It might sound good, but looking for work and falling into a sedentary lifestyle can cause various health issues.
Financial stability
Financial stability is probably one of the most obvious determinants of Americans suffering from poor health and being unable to access the same healthcare as those who are more financially stable.
Many people enjoy the occasional drink or unhealthy food as a treat, but when this becomes a regular consumption, it poses a bigger health risk. Although it can be detrimental to being financially stable, poor mental health due to financial worries can lead to unhealthy habits such as drinking excessively or eating the wrong food. It can also lead to depression and anxiety as the problem of overeating, drinking too much, or not feeling motivated to exercise becomes more overwhelming.
There can also be a reluctance to seek medical advice for people who have lower incomes because of the cost of treatment or higher insurance costs in the future for those with health insurance. This can mean that health problems that may not seem serious can go untreated and become a bigger threat to the person’s health, potentially risking their life.
Self-employment can be another factor in financial stability. For small business owners who are doing well, it can be easier to afford health insurance and the cost of treatment. Still, for anyone just starting or whose finances change dramatically from month to month, it’s impossible to set aside money regularly to take care of their current and potential health problems in the future.
Although there are ways to look after your health with little or no money, good health is not guaranteed outside human control. Money can increase the chances of experiencing a better quality of life, feeling less anxious, being happier and healthier, and having access to better healthcare if the worst happens.
Social status and inclusion
Social status and inclusion (or exclusion) can also be responsible for people’s healthcare and the level of finding and getting the right medical help.
Race is one example where other factors can make it more challenging to access healthcare services or for people to take care of their health. Some of these factors include living in poor neighborhoods, not having the financial means to buy the types of food that provide the right balance of nutrients, being turned down for employment due to ethnicity, the availability or accessibility of education, and access to transport. These are mostly indirect factors that lead to a lack of income, making individuals less likely to be able to look after their health.
Social status can also be a factor regardless of race. Like some individuals and groups mentioned, their social status is often linked to their income, which means having limited financial means to buy healthier foods, live in clean and safe accommodations, and pay for insurance to protect themselves from future health problems. Homeless people will be unable to afford healthcare and may need to rely on charitable organizations, limiting their options. Similarly, someone with drug or alcohol dependency, gypsies, disabled people, single-parent families, and immigrants face different challenges and prejudices when accessing essential healthcare.
Raising awareness
People tend to be preoccupied with their own lives and the health of themselves or their loved ones. This doesn’t mean they’re selfish, just that they are unaware of the health determinants faced by other people, preventing them from getting the same level of care they receive. That’s why raising awareness is an important first step in bringing about positive change.
As a nursing professional, you could use your knowledge to undertake research, then present qualitative and quantitative evidence which shows the differences in how accessible healthcare is for some people. In your day-to-day role, some of the differences will become increasingly obvious. However, the general public doesn’t always see the inner workings of the healthcare system.
Your professional observations can be backed up by facts and statistics, which can help bridge the gap between vulnerable groups and those with the authority to make changes to promote inclusivity.
You can also write medical papers and articles to draw other ’professionals’ and the public’s attention to inequality and encourage them to campaign for change, providing the information you share doesn’t breach any confidentiality agreements.
Making adjustments
Only after a particular problem has been pointed out can change happen. So, you can implement change you can implement change after making the relevant people and agencies aware of the issues. Although nurses don’t have the authority to bring about these adjustments, they can make suggestions. Your experience and knowledge are extremely useful here because you see patients regularly, get to know them professionally, and hear why they can’t or won’t seek further help or have delayed seeking help for so long that the problems have worsened. All your experiences are invaluable in seeking solutions and ensuring that any implemented changes will suit the affected patients. Be able to use your knowledge to adjust the healthcare you deliver. For example, a patient concerned about cost might prefer less expensive treatment options. While you can’t change the costs involved, there may be cheaper but still effective alternatives you can suggest to them. Talking them through all the options available helps them make a more informed choice.
Helping and directing more at-risk patients
Sometimes there won’t be other options to suggest, or the risks to their immediate health might be too high. However, charities, medical centers, and other agencies can help your patients.
There are several places where low-income patients can go if they don’t have adequate health insurance. This includes applying to Medicaid if their household income falls below a certain amount, seeking help from relevant charities such as cancer charities for patients with a cancer diagnosis, community health centers that can provide free or lower-cost care when fitting, and emergency rooms if the problem becomes life-threatening.
You can assess and advise your patients on a case-by-case basis to help them if they’re concerned about costs without risking their health. Your knowledge will help them find the most affordable treatment methods.
Working with other agencies
As a nursing professional, you can help vulnerable patients seek help by working with and building professional relationships with other agencies. Your knowledge of these services can help when trying to find somewhere to refer or direct them to. As you build up contacts over time, you learn the best people to speak to and can some of these ahead ofbefore a patient to them for help.
This prevents your patients from spending valuable time and money traveling to another location only to learn that the people there cannot help them. If the health problem is serious, you won’t want to waste time and expose them to increased risk.
Also, by working with other agencies, such as those based in the community, you can raise your awareness of the problems your patients face, which will help you to share this knowledge with authoritative figures to encourage further improvements.
Advocating for more inclusive care and services
The above steps help when advocating for underrepresented patients and anyone who may struggle to access the healthcare available within the US. Raising awareness can lead to improvements, and so can working with other agencies to highlight problems and encourage those in power to make the required changes or at least start addressing healthcare inequality.
You can also study and gain a Master’s in Nursing careers, allowing you to choose between working in a big town or city or utilizing your skills and knowledge in less inhabited locations. Carson-Newman University tailors their degrees to students who want to study online and advance their nursing careers. A Master’s degree will enhance your skills in building strong relationships with other professionals and the local community to amplify the voices of medical professionals and the patients you’re advocating for.
You could get involved in local policy-making and campaigning to build awareness and encourage change. This doesn’t have to be limited to just policies around healthcare but can be linked to other factors which affect health inequality. You might advocate for better education for young people born into poverty-stricken areas or further education for adults who have had a poor start in life. Speaking up and helping to increase the accessibility of instruction can help to improve their chances of better jobs and the ability to pay for healthcare or qualify for positions where this is fully or partially covered.
There are indeed inequalities within healthcare. However, by working within this industry, you can help to be part of a positive change, encouraging inclusion, speaking out for those whose voices are rarely heard, using your knowledge, and much more to make a positive change. This can be challenging but also incredibly rewarding. As a nursing professional, your goal is to help people, and this is a great way to achieve that.
