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This paper aims to compare and contrast quality improvement in the domain of health care disparities with quality improvement in other domains.
Abstract
Purpose
This paper aims to compare and contrast quality improvement in the domain of health care disparities with quality improvement in other domains.
Design/methodology/approach
The author provides a descriptive essay and review to put forward the findings of their research.
Findings
In the USA, health care quality improvement systems have largely been accepted and institutionalized. Most if not all hospital and health care systems now have quality monitoring and improvement teams. In contrast, despite a plethora of stark reports in the literature showing that the US health care system has failed to deliver health care with equity when the care of Whites is compared with that of racial and ethnic minorities, there is not a parallel health care disparities improvement system in most health care settings.
Practical implications
Paralleling many steps that have been taken to improve quality in general, health care workers and health systems must take steps to improve structures and processes of care to reduce health care disparities.
Originality/value
Pinpoints some important distinctions between improving structures and processes of care related to health care disparities, and those related to other aspects of quality improvement. Doing so will save lives, and in the process improve overall quality.
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Keywords
Intersectionality theory is a social justice theory customarily employed to address inequities which arise in the academic or legal arenas as it relates to race and gender. The…
Abstract
Purpose
Intersectionality theory is a social justice theory customarily employed to address inequities which arise in the academic or legal arenas as it relates to race and gender. The application of intersectionality theory extends beyond the convergence of multiple social identities. It provides an invaluable framework to examine the convergence of social identities, the social determinants of health and a global pandemic in communities of historically marginalized and underrepresented persons. The purpose of this paper is to examine how the coronavirus pandemic has exacerbated the disparities experienced by African American and Latinx persons using the principles of intersectionality theory as the schema.
Design/methodology/approach
A literature review was performed on the scholarly articles examining the disproportionate incidence and mortality rates of African Americans and Latinx persons in America.
Findings
The current literature confirms that the disparities which existed prior to the onset of the coronavirus pandemic have been magnified by systemic oppression and racism of historically marginalized and underrepresented persons in America. The coronavirus pandemic has spotlighted the disparities in sustainable employment and access to health care for African American and Latinx persons.
Originality/value
Employing a social justice theoretical framework of intersectionality provides an opportunity to examine the lived experiences of African American and Latinx persons without race/ethnicity being the primary focal point. Future research will illustrate the urgent need for public health policy reform to eradicate the disparities experienced by African American and Latinx populations.
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Washington Patient Safety Coalition (WPSC) brings individuals and healthcare organizations together to identify and work on patient safety priorities. It holds bi-annual strategic…
Abstract
Purpose
Washington Patient Safety Coalition (WPSC) brings individuals and healthcare organizations together to identify and work on patient safety priorities. It holds bi-annual strategic planning sessions to assess program effectiveness around current organizational goals and to develop new goals. The purpose of this paper is to describe how WPSC members came to identify health disparities as a priority, and what they did to integrate this into organizational strategy.
Design/methodology/approach
For the 2015 strategic planning session, WPSC staff used 2012-2015 internal activities records to conduct a SWOT analysis. The author conducted stakeholder and member “Sensing Surveys” and framed action items on two underlying considerations: first, positioning of the members within the patient safety landscape, taking into account where the members are most “touching” the issue of disparity and are most appropriately positioned to act as change agents and, second, WPSC is not an established content expert in health disparities.
Findings
The author focused the efforts on assisting the Governor’s Interagency Council in promoting Culturally and Linguistically Appropriate Services standards. This Council helps to drive policy, but not necessarily operationalizing it. WPSC has ability to fulfill that role; the membership is comprised of organizational leaders, those positioned to operationalize the Council’s disparity interventions. The WPSC saw an opportunity to partner the efforts, bridging gaps between policy and operational action.
Practical implications
This viewpoint shows the power of a small collaboration interested in broadening awareness of a complex issue.
Originality/value
Health disparities are complex and multifaceted. Within the Seattle area there were many organizations committed to working on this topic, each with their unique value add to the issue.
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Keywords
After discussing the high and rising health care costs in the USA, its disparities, and the suggested demand, supply, and managed competition‐side strategies to contain health…
Abstract
Purpose
After discussing the high and rising health care costs in the USA, its disparities, and the suggested demand, supply, and managed competition‐side strategies to contain health care costs and their ethical implications, this paper seeks to explore whether or not these strategies will further aggravate the existing health care disparities.
Design/methodology/approach
This conceptual paper utilizes various appropriate exiting economic and ethical theories. The economic and ethical theories utilized are relevant to the problem of rising health care costs; to the proposed demand, supply, and managed competition‐side cost containment strategies; and to the existing health care disparities.
Findings
This paper demonstrates that the suggested cost containment strategies do in fact aggravate existing health care inequities and are not always ethical.
Originality/value
Given the present health care reform debate in the USA and various misconceptions about it, the author believes that the paper and its findings should in fact be viewed as a contribution.
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Adam Hege, Quirina M. Vallejos, Yorghos Apostolopoulos and Michael Kenneth Lemke
The purpose of this paper is to provide an overview of the literature pertaining to occupational health disparities experienced by Latino immigrant workers in the USA and to…
Abstract
Purpose
The purpose of this paper is to provide an overview of the literature pertaining to occupational health disparities experienced by Latino immigrant workers in the USA and to advance a general framework based on systems science to inform epidemiological and intervention research.
Design/methodology/approach
Using papers and other sources from 2000 to the present, the authors examined the employment conditions and health outcomes of Latino immigrant workers and critically analyzed the pervasive evidence of health disparities, including causal mechanisms and associated intervention programs.
Findings
The occupations, including the work environment and resultant living conditions, frequently performed by Latino immigrants in the USA represent a distinct trigger of increased injury risk and poor health outcomes. Extant intervention programs have had modest results at best and are in need of more comprehensive approaches to address the complex nature of health disparities.
Practical implications
An integrated, systems-based framework concerning occupational health disparities among Latino immigrant workers allows for a holistic approach encompassing innovative methods and can inform high-leverage interventions including public policy.
Originality/value
Reductionist approaches to health disparities have had significant limitations and miss the complete picture of the many influences. The framework the authors have provided elucidates a valuable method for reducing occupational health disparities among Latino immigrant workers as well as other populations.
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Women’s health is considered a big public health issue, impacting personal well-being, family reproduction, and society’s development. Since the foundation of the People’s…
Abstract
Purpose
Women’s health is considered a big public health issue, impacting personal well-being, family reproduction, and society’s development. Since the foundation of the People’s Republic of China, major improvements in women’s social status and health have been made. However, far less has been achieved with respect to gender equality and women still face health disparities. The purpose of this paper is to provide a better understanding of health and health care disparities among women and their determinants in China today.
Design/methodology/approach
This paper used the Statistical Yearbook of Health and Family Planning 2014, the 2010 Women’s Social Status Survey and 2010 census data from the National Bureau of Statistics to give an overall description of disparity in health care and health outcome facing women.
Findings
Progress in health is not equally shared by the female population, and the differences in women’s health by region and in urban and rural areas are considerable. The existing health disparities are still faced by women in terms of life expectancy, hazardous working environment, and health care services. As to gender differences among the elderly aged 60+, men have better health status compared to women. In addition, women are more financially dependent on other family members for the main source of daily living, reflecting their economic disadvantages.
Originality/value
This study gives a comprehensive and the latest overview of trends of women’s health progress, disparities in health care, and health outcomes both in female population and between genders by using three data sources.
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Keywords
Harsimran Kaur Sidhu and M. Claire Greene
Adults with autism spectrum disorder (ASD) are more likely to have a poor health status because of being diagnosed with a range of physical and mental health conditions and…
Abstract
Purpose
Adults with autism spectrum disorder (ASD) are more likely to have a poor health status because of being diagnosed with a range of physical and mental health conditions and experience disparities in health care. The purpose of this study is to find barriers to health care experienced by adults with ASD and find gaps in health care which health-care providers can work to fill.
Design/methodology/approach
This scoping review aimed to identify studies that report on disparities in health and health-care service provisions experienced by adults with ASD. The authors included articles that described health-care disparities for patients with ASD and were published in peer-reviewed journals between January 2010 and April 2022. The authors searched the following databases and medical journals to search for eligible studies: Google Scholar, Pubmed, Elsevier, Sage Publications and Embase. The authors comprehensively searched key terms related to ASD, health care and disparities.
Findings
The core defining features of ASD, which include communication and social impairments and deficits in sensory processing, were found to be barriers in the health-care experience of adults with ASD. Continued research and changes in health care, such as developing interventions to empower patients, adequately training providers and increasing the accessibility of the health-care system, are necessary to ensure adults with ASD receive adequate medical care.
Research limitations/implications
Additionally, clarifying the current literature on this topic can guide future research efforts to explore the influence of factors such as gender and the spectrum of autism itself leading to various levels of abilities and their influence on the health-care experience of adults with ASD.
Practical implications
Overall, the findings from this scoping review underline the importance of providing readily accessible evidence-based, age-appropriate primary and hospital health care for adults with ASD.
Social implications
Further interventions are needed to empower patients, adequately train providers, increase the accessibility of the health-care system, increase support for ASD patients and decrease discrimination.
Originality/value
This paper is a scoping literature review of the original work done by researchers in the field of developmental disorders and health care.
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Keywords
Zeenat Hashmi and Ashish Singh
A woman's nutritional status significantly determines her overall well-being. The authors critically examine the trends — including socioeconomic disparities — in undernutrition…
Abstract
Purpose
A woman's nutritional status significantly determines her overall well-being. The authors critically examine the trends — including socioeconomic disparities — in undernutrition among Muslim women in India, a notably socio-economically disadvantaged group. The authors also investigate trends and variations across the dimensions of caste, place of residence (rural/urban), education, economic status and geographic regions.
Design/methodology/approach
The analysis leverages the nationally representative National Family Health Surveys (NFHS) of India conducted between 1998 and 2021. The authors examined poor–rich ratios, concentration indices, disparity ratios and predicted probabilities of being underweight (captured using Body Mass Index).
Findings
From 1998 to 2021, there has been a decline in undernutrition prevalence among Muslim women. However, stark socioeconomic variations persist. While the prevalence has decreased over time across all socioeconomic groups, disparities — both within and between groups — remain significant and, in many cases, have expanded. For certain socioeconomic subgroups (e.g. Muslim women with no formal education or those in the Central and Northeast regions), the disparity doubled between 1998 and 2021. In regions like the South, where undernutrition prevalence is low or has reduced, disparities remain significant and generally have increased.
Originality/value
To the authors’ knowledge, the study is the first to provide a comprehensive examination of the prevalence, trends and socioeconomic disparities in undernutrition among Muslim women in India over the past two decades.
Peer review
The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-04-2023-0320
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Keywords
Health disparities have been a growing concern in the USA. Differences in access to healthcare play a role in these health disparities. This article presents a model that…
Abstract
Health disparities have been a growing concern in the USA. Differences in access to healthcare play a role in these health disparities. This article presents a model that illustrates access to healthcare in two rural Midwestern communities. The simulation model developed helps determine if people in these communities have equal access to health care and if physician’s insurance coverage practices prevent certain people from accessing care. From the simulation, it can be determined which characteristics may lead to the disparities in access to health care. Using the results of such a simulation model, the community may then begin to take action in order to ensure equal access to health care for all people within the community and help reduce health disparities.
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Mohammad Azhar Ud Din, Muzffar Hussain Dar and Shaukat Haseen
The study aims to compare India's public health expenditure at the international and state levels. The paper also empirically examines the regional disparities in NRHM spending…
Abstract
Purpose
The study aims to compare India's public health expenditure at the international and state levels. The paper also empirically examines the regional disparities in NRHM spending across the 21 selected states of India.
Design/methodology/approach
The tools of absolute β-and σ-convergence are used in the analysis to test the regional convergence. The average annual growth rate across the states is the dependent variable for β-convergence, and time is the second dependent variable but is used for s-convergence. In contrast, the initial value of NRHM expenditure and the coefficient of variation of NRHM expenditure are used as independent variables, respectively. Descriptive statistics are also used for the study. The data are annual and cover the panel from 2007 to 2020.
Findings
The study attests to the hypothesis of β-and σ-convergence for the selected states in the period mentioned. The observed convergence in NRHM expenditure is due to the shift in the government's attention from the non-high focus high focus states to high states through the national rural health mission policy. The coefficient of variation across the states also shows a declining trend and provides the robustness of the σ-convergence.
Originality/value
As far as the literature is concerned, none of the existing studies examines the convergence of a public health expenditure scheme like the National Rural Health Mission across the Indian states by applying the techniques of β-and σ-convergence. The novelty of the study is using the newly updated dataset and validating the convergence hypotheses in the National Rural Health Mission expenditure case.
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