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1.4 million Children in the United States are of non-white race or ethnicity (March 2010), this compromises 43% of American children and shows an increase over 11% since 2000. Mortality rates are substantially higher in minority children for all-cause mortality. Overall mortality rates are consistently found to be significantly higher in African American and other minority children. Specifically, disparities are found in specific mortality rates for certain diseases, acute-lymphoblastic leukemia and congenital heart defect among others. Asthma has also been a topic of many studies. Race is considered to be more strongly associated with higher rates of African American children with unmet health care needs and lower access to primary health care providers than income is.[20] One of the most important ways to help reduce health disparities is to work to reduce language barriers between patients and physicians. Language barriers are a major problem because of five main difficulties:[19] First, arriving at an accurate diagnosis is difficult, because an adequate history cannot be obtained. Second, treatment options cannot be adequately explained and discussed. Third, it is impossible to obtain truly informed consent for diagnostic and therapeutic procedures. Fourth, any attempts to provide health education are severely compromised. Finally, it is very difficult for physicians to act as effective advocates for patients we do not really know. If physicians and other clinicians are able to reduce language barriers the resulting improved communication can improve compliance, reduce the number of emergency room visits, and enhance patient understanding.[19] Gunderman suggests that there are a few ways for physicians and the health care system in general to reduce language barriers like using nonverbal communication through gestures, the use of visual aids, and printed materials and videos in patients' native languages. They can also improve their fluency in the non-English equivalents of basic medical terms. The use of trained interpreters can also prove extremely valuable. There is debate about what causes health disparities between ethnic and racial groups.[21] However, it is generally accepted that disparities can result from three main areas: The Institute of Medicine report, Race, Ethnicity, and Language Data[1] identifies current models for collecting and coding race, ethnicity, and language data; ascertains the challenges involved in obtaining these data in health care settings; and makes recommendations for improvement. A study of 20,000 cancer patients in the United States found that African Americans are less likely than European Americans to survive breast cancer, prostate cancer, and ovarian cancer even when given equal care, but that other forms of cancer had equal survival chances, which suggests that biological factors may be at work.[22] The National Partnership for Action to End Health Disparities (NPA) was established to mobilize a nationwide, comprehensive, community-driven, and sustained approach to combating health disparities and to move the nation toward achieving health equity. The mission of the NPA is to increase the effectiveness of programs that target the elimination of health disparities through the coordination of partners, leaders, and stakeholders committed to action. http://minorityhealth.hhs.gov/npa/ The National Stakeholder Strategy (NSS) for Achieving Health Equity is a product of the NPA. This document provides a common set of goals and objectives for public and private sector initiatives and partnerships to help racial and ethnic minorities—and other underserved groups—reach their full health potential. The strategy incorporates ideas, suggestions and comments from thousands of individuals and organizations across the country. Local groups can use the National Stakeholder Strategy to identify which goals are most important for their communities and adopt the most effective strategies and action steps to help reach them. http://minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=33&ID=286 |
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