Introduction: Identifying the Clinical Problem
Often referred to as health inequities, health disparities remain an area of concern for healthcare institutions and policymakers throughout the United States. Differential access to medical attention faced by racial and ethnic minorities is a complex issue, which continues to be on the agenda for the majority of federal health agencies. In addition, treatment modalities are another challenge, which contributes to systemic health disparities among the aforementioned group (Wilkins et al., 2020). The disproportionate burden in regards to healthcare access and quality attributed to racial minorities has been well documented for centuries, according to Atrash (2018). The widespread inequities in health status among racial and ethnic minority groups can be easily explained. Many aspects contribute to these disparities, including lower-income, lack of education, poor environmental conditions, and even certain lifestyle choices. All of these can be attributed to inequities in healthcare access and the quality of medical services provided to minorities.
It is evident that race and ethnicity are complex concepts, which are often constructed and re-constructed by society as a whole or simply those in power. Thus, they lead to a tangible impact on the people who are considered “different” and are, therefore, subjected to faulted perceptions and different treatment. Although there have been some shifts for the better in terms of the attitudes white Americans have towards racial minorities, these underprivileged groups still have to battle health disparities. It is crucial to recognize that these individuals have a higher risk of developing a chronic disease, contracting AIDS, having diabetes, or dying prematurely (Zheng et al., 2017). Additionally, they often have to deal with racial profiling while visiting the medical office. Racial profiling is an alarming issue “through its disparate and adverse health impact on those targeted by this practice, as well as members of their communities” (Laurencin & Walker, 2020, p. 393). Thus, the purpose of the research is to address the issue of health disparities among racial and ethnic minorities in the United States by evaluating the interventions designed to end them.
Methods: Criteria for Choosing the Articles
In regards to the methods for choosing the articles presented in this paper, there were not many. Full access to the articles was needed in order to go analyze the content in detail. As for the selection criteria for the articles mentioned in this paper, there were many. First, they had to deal with a similar research question by either designing or assessing an intervention targeted at ending health disparities. Second, they had to be peer-reviewed in order to ensure the information’s accuracy as well as the authors’ credibility. Third, another important aspect that factored in the inclusion process was the date. Articles published earlier than in the last 5 years were automatically excluded in an effort to introduce information, which would be fresh and up-to-date. In addition, they had to be published in English for obvious reasons.
Synthesizing the Literature
The article by Hood et al. (2017) centers around the process and impact of engaging black-owned barbershops in a 6-month intervention study aimed at promoting physical activity among black men in an effort to reduce health disparities. As for the methodology, during the period between February and April 2012, the researchers recruited the barbershops based on certain criteria. The recruitment process consisted of calling prospective barbershops, sending them an organizational eligibility letter, visiting those that were considered eligible, and, finally, signing an agreement with the chosen barbershops. After 14 barbershops were involved, structured interviews with the owners were conducted. The results demonstrated that the main reasons why the owners agreed to participate included “commitment to their community, perceived client benefits, personal interest in physical activity, and a perception that the study had the potential to make a positive impact on the barbershop” (Hood et al., 2017, p. 377). This study was an important addition to this paper because it presented the strategies for organization-level recruitment to engage members of racial and ethnic communities in the interventions targeted at ending health disparities among minorities.
The study by Muncan (2018) presented an overview of community-based interventions aimed at reducing racial and ethnic health disparities for those struggling with cardiovascular diseases. In regards to methodology, Muncan (2018) used electronic platforms such as PubMed, MEDLINE, and Sociological Abstracts by utilizing a variety of relevant keywords. The researcher clarified the inclusion of the theoretical and empirical articles chosen. Through the analysis of 17 publications, Muncan (2018) concluded that a multi-layered system solution should be prioritized in the design of interventions aimed at ending racial and ethnic health inequities. This research was crucial for the appearance because it managed to identify the main structural and psychosocial challenges faced by racial minorities and to suggest strategies for designing interventions to end those obstacles.
The study by Liao et al. (2016) was selected because it evaluated the strategies used to mediate health inequities, focusing primarily on the prevalence of hypertension among the Hispanic population. Using the based address sampling design, the researchers created, distributed, and analyzed the data from annual surveys among the 6 Hispanic communities, which were a part of the Racial and Ethnic Approaches to Community Health (REACH) initiative funded by the Centers for Disease Control and Prevention (CDC). The results demonstrated the positive impact of emphasizing the change of eating habits and the elimination of alcohol on REACH communities in terms of their precedence in hypertension. This study demonstrated the strategic value of involving the communities in the interventions by introducing neighborhood food watch initiatives and church-based health and lifestyle education programs.
Jain et al. (2019) assessed the effectiveness of a multifaceted intervention aimed at eliminating health inequities in Hepatitis C virus (HCV) screening. The researchers competed for the intervention, which consisted of “provider and patient education, an electronic medical record-enabled best practice alert, and increased HCV treatment capacity” (Jain et al., 2019, p. 40). The results demonstrated that the intervention increased the rate of HCV screening among high-risk groups such as older patients and those working in primary care. This study showed the nuances of designing a successful intervention to reduce health disparities, which was the main reason for its inclusion.
The study by Liu et al. (2020) provides an immense amount of insights in regards to the most appropriate and effective strategies for interventions needed to address health disparities among minority cancer patients. The research team analyzed the interventions focused on racial and ethnic minorities aged 40 and older, which were considered effective in increasing the uptake rates of cancer screening. Liu et al. (2020) used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to conduct a systematic review of 26 academic articles chosen. The results showed the most important factors in designing such interventions, which included the involvement of community health workers to spread awareness, the utilization of culturally relevant materials, as well as the incorporation of ethnically sensitive strategies.
Comparing the Articles
The primary similarities and differences between the studies synthesized in this paper originate from their designs and limitations. The articles by Muncan (2018) and Liu et al. (2020) are systematic reviews of other health disparities interventions rather than primary research. Therefore, although they examined a sufficient number of publications from various databases, these publications included limitations and inconsistencies of their own, which now became a part of these reviews. On the other hand, Hood et al. (2017), Liao et al. (2016), as well as Jain et al. (2019) presented primary data. However, the first two studies are examples of qualitative research, which usually does not tend to be statistically representative (Monthe-Kaas et al., 2019). Jain et al. (2019) are the only ones who offer experimental research aimed at both designing and assessing an intervention aimed at reducing disparities in health and the quality of medical care among minorities.
Areas of Further Study
It is apparent that the literature synthesized in this paper does not offer a more complex look at the methods of evaluation of interventions targeting racial minorities and aimed at eliminating health inequities among these groups. Thus, the primary concern remains the need to identify the strategies for such assessment in order to create a framework for identifying the most effective studies and extracting strategic insights from them. In addition, none of the studies address the socioeconomic burden of the recent pandemic and its impact on the ethnic and racial communities and their access to high-quality insurance coverage.
References
Atrash, H. K. (2018). Health disparities: Challenges, opportunities, and what you can do about it. Journal of Human Growth and Development, 28(3), 223-231.
Hood, S., Hall, M., Dixon, C., Jolly, D., & Linnan, L. (2017). Organizational-level recruitment of barbershops as health promotion intervention study sites: Addressing health disparities among black men. Health Promotion Practice, 19(3), 377-389.
Jain, M. K., Rich, N. E., Ahn, C., Turner, B. J., Sanders, J. M., Adamson, B., Quirk, L., Perryman, P., Santini, N. O., & Singal, A. G. (2019). Evaluation of a multifaceted intervention to reduce health disparities in hepatitis C screening: a pre‐post analysis. Hepatology, 70(1), 40-50.
Laurencin, C. T., & Walker, J. M. (2020). Racial profiling is a public health and health disparities issue. Journal of Racial and Ethnic Health Disparities, 7, 393-397.
Liao, Y., Siegel, P. Z., White, S., Dulin, R., & Taylor, A. (2016). Improving actions to control high blood pressure in Hispanic communities — Racial and Ethnic Approaches to Community Health Across the U.S. Project, 2009–2012. Preventive Medicine, 83, 11-15.
Liu, D., Schuchard, H., Burston, B., Yamashita, T., & Albert, S. (2020). Interventions to reduce healthcare disparities in cancer screening among minority adults: A systematic review. Journal of Racial and Ethnic Health Disparities, 8, 107-126.
Munthe-Kaas, H. M., Glenton, C., Booth, A., Noyes, J., & Lewin, S. (2019). Systematic mapping of existing tools to appraise methodological strengths and limitations of qualitative research: the first stage in the development of the CAMELOT tool. BMC Medical Research Methodology, 19(1).
Muncan, B. (2018). Cardiovascular disease in racial/ethnic minority populations: illness burden and overview of community-based interventions. Public Health Reviews, 39(1).
Wilkins, C. H., Schindler, S. E., & Morris, J. C. (2020). Addressing health disparities among minority populations. JAMA Neurology, 77(9), 1063-1064.
Zhang, X., Pérez-Stable, E. J., Bourne, P. E., Peprah, E., Duru, O. K., Breen, N., Berrigan, D., Wood, F., Jackson, J. S., Wong, D., & Denny, J. (2017). Big data science: Opportunities and challenges to address minority health and health disparities in the 21st century. Ethnicity & disease, 27(2), 95-106.