Introduction
Health depends on a variety of factors, many of which cannot be controlled with the help of medications and treatments. Social, environmental, and economic characteristics of individuals and communities can impact health in a positive or a negative way. Thus, the term “health disparity” is a part of healthcare research. It is a “particular type of health difference” that is born out of disadvantages one faces due to their living situation and inherent characteristics (Office of Disease Prevention and Health Promotion [ODPHP], 2017). For example, the ODPHP (2017) identifies such potential causes for health inequities as race and ethnicity, gender, age, sexual and gender identity, disability, access to food, education, transportation, and much more. It is apparent that the high number of factors creates a complex problem for researchers and healthcare providers.
The main question arising from the concept’s description and complexity is which can be considered the best way to reduce healthcare disparities. Follow-up inquiries are concerned with various approaches to intervention programs and their success. This topic is of great interest as its relevance to the healthcare field continues to grow with the appearance of new viruses and rising economic and social inequalities. Every healthcare professional faces health inequity as it directly affects patients from different backgrounds.
Search Criteria
To investigate the concept of healthcare disparities and potential interventions to reduce them, the present research was limited to peer-reviewed and academic studies. The articles have to be published in the last 3-5 years to ensure that the information adequately represents the current state of healthcare and the most prominent concerns. Such databases as PubMed, Cochrane Library, and MEDLINE were searched. In addition, Google Scholar was used to increase the number of possible articles. The following keywords were utilized separately and in combination: “health disparities,” “community health improvement plan,” “health inequities,” “strategic planning.” As a result, four research articles were selected for further review.
Articles’ Credibility and Relevance
The chosen articles are credible sources that are relevant to the topic under the investigation. All works were published in peer-reviewed journals, including the American Journal of Public Health, Health Affairs, PloS One, and the Annals of Family Medicine. Moreover, they represent recent findings as their publishing dates range from 2018 to 2019. Furthermore, all papers deal with the topic of healthcare disparities, discussing the effectiveness of various intervention programs in lowering the impact of health inequities on people. In particular, the debate surrounding structural and community-based interventions is presented. This approach makes the articles highly relevant for modern solutions to complex issues that cannot be addressed with treatment-focused healthcare alone.
Annotated Bibliography
Brown, A. F., Ma, G. X., Miranda, J., Eng, E., Castille, D., Brockie, T., Jones, P., Airhihenbuwa, C., Farhat, T., Zhu, L., & Trinh-Shevrin, C. (2019). Structural interventions to reduce and eliminate health disparities.American Journal of Public Health, 109(S1), S72-S78. Web.
In their study, Brown et al. (2019) examine various approaches to reducing health disparities. According to the authors, structural interventions acknowledge that social, economic, physical, and political spheres of one’s life can be changed in order to improve a person’s health. Therefore, Brown et al. (2019) present several themes that unite successful interventions. The first is understanding the context of each disparity and the connections between them. Next, authentic engagement and a disease-agnostic approach are highlighted – interventions that do not focus on a single health condition but target a variety of inequities improve health in general (Brown et al., 2019). Finally, the researchers outline the need to choose an appropriate location and time for an intervention and account for possible unintended consequences. This article is included as it describes the traits that any intervention for the discussed issue should have. Brown et al. (2019) find that structural interventions are effective in eliminating or reducing health disparities.
Fry, C. E., Nikpay, S. S., Leslie, E., & Buntin, M. B. (2018). Evaluating community-based health improvement programs.Health Affairs, 37(1), 22-29. Web.
The second study is conducted by Fry et al. (2018), who evaluate the quality and outcomes of community-based health improvement initiatives. The authors argue that the role of these programs in community health continues to grow, and more funding is dedicated to these efforts. However, using publicly available data from programs completed between 2002-2006, Fry et al. (2018) find that most community-based programs result in insignificant improvements in community health. The researchers also discovered that most programs tend to address only one specific health issue, including obesity or smoking, and the findings of such studies reveal an interesting connection. For example, in interventions aimed at reducing smoking, people gain weight, while in obesity-focused programs, people report higher smoking rates. Therefore, the authors conclude that focusing on one health outcome may be disadvantageous to communities’ overall wellbeing. This finding corresponds to the previous paper’s conclusion that structural interventions have to target multiple factors to deal with health disparities.
Haldane, V., Chuah, F. L., Srivastava, A., Singh, S. R., Koh, G. C., Seng, C. K., & Legido-Quigley, H. (2019). Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes.PloS One, 14(5), e0216112. Web.
Haldane et al. (2019) conduct a systematic review of health interventions based on community participation. While the researchers do not consider health disparities directly, they address the need for acknowledging power relations and economic and social contexts when developing policy and programs. This idea contributes to their findings that empowerment programs positively impact people’s health. Moreover, Haldane et al. (2019) argue that robust organizational processes that include community engagement on all levels of implementation lead to better health outcomes. The authors suggest that such interventions should not be viewed as a linear process, and community engagement has to be a constant presence in creating new programs. The systematic review is relevant to the current investigation as it presents a plethora of evidence supporting the role of community engagement and programs in improving people’s health.
Woolf, S. H. (2019). Necessary but not sufficient: Why health care alone cannot improve population health and reduce health inequities.The Annals of Family Medicine, 17(3), 196-199. Web.
Finally, in the article by Woolf (2019), the author discusses whether healthcare alone is sufficient in supporting population health and eliminating health disparities. The researcher bases the investigation on health domains, existing public policy, and current healthcare systems. According to Woolf (2019), health care is only one factor that influences one’s wellbeing – others include one’s health behaviors, socioeconomic status, surrounding environment, and public policy. Therefore, health disparities also cannot be solved with the help of medical interventions without a program that acknowledges the presence of other domains. Woolf (2019) advocates for the inclusion of “non-health” sectors into health policy, such as housing and education, in order to reduce health disparities. This discussion of health policy is consistent with other findings, and it is relevant to the topic due to its nuanced approach to creating interventions. The author contributes to the investigation by examining existing policy and healthcare systems and highlighting their potential limitations.
Summary
The annotated bibliography presented above reveals several corresponding ideas about health inequities and interventions. First, it is apparent that health disparities depend on a variety of factors, and they should be acknowledged when designing and implementing a program to reduce inequity. Second, such interventions have to be structural and disease-agnostic, addressing domains of health rather than specific conditions that arise as a result of people’s disadvantages. Finally, community engagement in policy and program creation can be a valuable resource of knowledge and people’s increased interest in improving population health.
References
Brown, A. F., Ma, G. X., Miranda, J., Eng, E., Castille, D., Brockie, T., Jones, P., Airhihenbuwa, C., Farhat, T., Zhu, L., & Trinh-Shevrin, C. (2019). Structural interventions to reduce and eliminate health disparities.American Journal of Public Health, 109(S1), S72-S78. Web.
Fry, C. E., Nikpay, S. S., Leslie, E., & Buntin, M. B. (2018). Evaluating community-based health improvement programs.Health Affairs, 37(1), 22-29. Web.
Haldane, V., Chuah, F. L., Srivastava, A., Singh, S. R., Koh, G. C., Seng, C. K., & Legido-Quigley, H. (2019). Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes.PloS One, 14(5), e0216112. Web.
Office of Disease Prevention and Health Promotion. (2017). Disparities. Web.
Woolf, S. H. (2019). Necessary but not sufficient: Why health care alone cannot improve population health and reduce health inequities.The Annals of Family Medicine, 17(3), 196-199. Web.