Discussion: System-Based Health Disparities
Write 1-2 paragraph with in-text citation and references in APA format with url link.
· Define a systems-based perspective in relationship to health inequalities/disparities.
· Describe the potential nursing role in addressing health inequalities/disparities at the system level.
· Provide an example from your geographic area about which inequities could most benefit from a systems-based approach
In your response, identify one aspect of your peers’ explanation of the nurse’s role in addressing health inequalities/disparities at the system level with which you agree and one aspect with which you have a different opinion. Share the aspect with which you agree with your peer and explain why. Then, share the different opinion you have and explain the reason behind your different opinion, using an example.
Use your personal experience, if it’s relevant, to support or debate other students’ posts. If differences of opinion occur, debate the issues professionally and provide examples to support opinions.
Cite any sources in APA format.
In the context of health disparities or inequalities, a system-based perspective views health outcomes as an interconnection of different aspects that determine health and well-being. It recognizes that people’s health is not determined by individual behaviors or choices but by social, economic, environmental, and political factors such as economic development. For example, economic factors such as education and income account for access to poor nutrition (Giger & Haddad, 2021). The system-based perspective acknowledges the need to identify the root causes of health inequalities since treating individual health conditions does not develop solutions for health disparities.
Nurses have a responsibility to address health inequalities through advocacy and policy development. They are the first point of contact with patients, meaning they understand patient needs more comprehensively. With this knowledge, nurses identify potential obstacles and make efforts to speak on behalf of patients to promote their rights, interests, and well-being. Nurses may join organizations to gain a collective voice and control policy changes (University of North Carolina Wilmington, 2021). Furthermore, nurses have the potential to address health disparities through research. They conduct studies to identify the root causes of health inequalities and propose evidence-based solutions to address them. Research provides critical data, including demonstrating the impacts of social determinants of health on populations, to inform policy changes.
An example from my geographic area that would benefit from a systems-based approach would be inequalities in healthcare access for older adults. This population is often isolated, lacks comprehensive care access, and faces significant financial challenges. In this case, a systems-based approach would include extensive research into health disparities among older adults and subsequent nurse advocacy to develop policies favoring older adults.
References
Giger, J. N., & Haddad, L. (2021). Transcultural nursing: Assessment & intervention (8th ed.). Elsevier.
University of North Carolina Wilmington. (2021, March 15). How nurses can shape health policy. https://onlinedegree.uncw.edu/articles/nursing/how-nurses-shape-health-policy.aspx
Discussion #2
Healthcare delivery doesn’t just involve patients and care providers but is in fact a very complex system that involves healthcare system, health insurers, individuals, regulators, politicians, community leaders, and many other stakeholders. Medicine is increasingly complex, involving a highly connected system of people, resources, processes, and institutions (Clarkson et al., 2018). This approach of care delivery where each stakeholder is set up to perform their responsibilities by virtue of their profession as well as by using complex models involving data, compute system etc. is termed as system-based approach to healthcare delivery. But this approach is not always ideal to identifying and addressing healthcare disparities, but systems thinking, and systems methodologies may help researchers move beyond current stalemates and enhance the production of knowledge regarding the causes of health disparities as well as the identification of effective policies or interventions (Roux, 2011).
One of the most powerful things nurses can do to reduce health disparities is to advocate for their patients. This may include advocating for patient rights, appropriate resources, interpreters, distress screening, or even cultural-competence training (Villanueva, 2022). Nurses can involve in advocacy through local and national chapters of nursing associations to garner support among political leaders and stakeholders to address healthcare inequalities seen in their community.
State of Utah expanded Medicaid under the provision from Affordable Care Act (ACA) in 2019, but a provision in Utah’s Medicaid waiver that allows the state to close enrollment at any time has significant implications for health coverage (Mann, 2019). Medicaid has been lifeline to many individuals in the community to gain access to healthcare for themselves and their family members. But State of Utah has added a provision to close enrollment at any time, which has been affecting many individuals living in poverty from accessing Medicaid. This provision creates significant inequalities for many individuals. Removal of this provision through advocacy by meeting with political leaders and other stakeholders is a system-based approach that can benefit many Utahns.
References
Clarkson, P. J., Dean, J., Ward, J., Komashie, A., & Bashford, T. (2018). A systems approach to healthcare: from thinking to practice. Future Healthcare Journal, 5(3), 151–155. https://doi.org/10.7861/futurehosp.5-3-151 Links to an external site.
Mann, C., (2019). One step forward, two steps back: Utah’s Medicaid expansion. (2019). Commonwealth Fund. https://doi.org/10.26099/4bpv-y454
Roux, A. V. D. (2011). Complex systems thinking and current impasses in health disparities research. American Journal of Public Health, 101(9), 1627–1634. https://doi.org/10.2105/ajph.2011.300149 Links to an external site.
Villanueva, C. (2022). The role of nurses in addressing health disparities. UCI Nursing. https://nursing.uci.edu/2022/08/nurses-addressing-health-disparities/#:~:text=One%20of%20the%20most%20powerful,or%20even%20cultural%2Dcompetence%20training Links to an external site. .