Challenges / Barriers to Equitable Health Care
Eliminating health disparities does not depend solely on providing access to health services; it also requires comprehensive strategies that affect the social, cultural, environmental and economic determinants of health. Many barriers affect the ability to provide health care to underserved, culturally diverse groups:
Lack of Trust
A lack of trust exists between many racial and ethnic groups and the health care system.1 Combine lack of trust with documented evidence that racial and ethnic groups continue to receive lower-quality health care, and the challenges to implementing health programs can be overwhelming.
Lack of Health Insurance
Culturally diverse communities and the poor make up a disproportionate share of the uninsured population in the United States.
Language and Cultural Barriers
Acquiring quality health care is difficult when the patient and the health care provider speak different languages and have different sets of cultural beliefs.
The Environment
It is difficult to maintain good health when the environment in which you live and work is not conducive to good health. Racial and ethnic groups from low-income communities are more likely to live in neighborhoods without adequate access to recreation facilities, efficient transportation systems or affordable, healthy food. Research shows that businesses and industries that sell products such as tobacco, alcohol and fast food, target culturally diverse communities more often than other communities.
Lack of Physical Activity
The lack of participation in physical activity is a risk factor for several chronic health conditions that are prevalent in many racial and ethnic populations. Several factors impede efforts to provide such initiatives:
- limited resources to develop programs
- competing family or other obligations among various cultural groups
- lack of individual importance
- limited availability and accessibility of recreation facilities and services and
- lack of culturally appropriate interventions.
Sources:
Halbert CH, Armstrong K, Gandy OH, Baker L. Racial Differences in Trust in Health Care Providers. Arch Intern Med. 2006;166:896-901.
Smedley BD, Stith AY, Nelson AR, Editors. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare. Institute of Medicine. Washington, D.C.: National Academies Press; 2003.
Gamble VN. Under the Shadow of Tuskegee: African Americans and Health Care. American J of Public Health.1997;87(11); 1773-1778.
Smedley BD and Syme DL, Editors. Promoting Health: Intervention Strategies from Social and Behavioral Research. Institute of Medicine. Washington, D.C.:National Academy Press; 2000.
Mikkelsen L, Cohen L, Bhattacharyya K, Valenzuela I, Davis R, Gantz T. Eliminating Health Disparities: The Role of Primary Prevention. Oakland, CA: Prevention Institute; 2002.
