Question

What factors do you think contribute to the disparities in health among ethnic, socioeconomic, and gender groups in Nigeria?

Answer 1

Multiple socioeconomic factors contribute to health disparities, including income, education, residential segregation, stress, social and physical environment, employment, and many others. Disparities according to income and education have increased for smoking, with low-income persons smoking at higher rates.

FACTORS CONTRIBUTING TO HEALTH DISPARITIES

Health disparities refer to gaps in the quality of health and health care across all racial and ethnic groups, but there is wide debate about what causes health disparities. The reasons appear to be multi-factorial, poorly understood, and complex. There are patient-driven contributors to consider such as income, insurance coverage, medical settings where care is received, timeliness of care received, and patient adherence to treatment plans. There are provider contributors, including lack of cultural competency, negative stereotyping influencing clinical decision-making, racial/ethnic bias, and physician practice styles. Lastly, data depict that a major portion of the responsibility for racial/ethnic health and health care disparities resides with health care systems.1,23

Thus, three broad categories of causation appear to emerge: patient factors, provider factors, and institutional factors. Let us examine each of these.

First, health disparities result from the personal, socioeconomic, and environmental characteristics of ethnic and racial groups such as poorer living conditions, racial and ethnic segregation, at-risk housing (e.g., lead-based paint), racism, discrimination, stereotyping, and lack of quality basic education, cultural, and language barriers. The term “vulnerable population” has been used in conjunction with health disparity. Flaskerud and colleagues24 define a vulnerable population as one that experiences health disparities as a direct result of a lack of resources and/or an increased exposure to risk, such as minority populations, the poor, disabled, homosexuals, and immigrants.

Secondly, health disparities result from the difficulties racial and ethnic groups encounter when trying to enter a seemingly fragmented health care delivery system. Hill and colleagues25 note the relationship between perceived discrimination and racism on health status and outcomes. There have been several explanations offered as to how public health, medical care, and health service providers influence health and health care disparities. Health care inequities occur when providers intentionally or unintentionally convey lower expectations for patients categorized as underprivileged due to race/ethnicity, income, education, class, gender, or religion. As a result, these groups may develop lower expectations for positive health outcomes and perceived limited resources as compared to patients of higher socioeconomic backgrounds. This seems in part to be associated with the physician's race/ethnicity. Many studies document that minority patients are more comfortable with health care providers of similar race/ethnicity. Some research suggests that minorities are less likely to receive a kidney transplant once on dialysis and less likely to receive pain medication for bone fractures, and that these differences exist even in the absence of financial constraints.1 There are numerous documentations in the literature regarding the disparities among minority patients in cardiovascular medicine, maternal and child health, mental health, cancer, and asthma care. Minorities are less likely than whites to be offered both diagnostic and therapeutic procedures, such as revascularization procedures that could result in better patient outcomes.1,12,26

Patients from minority backgrounds may not receive recommended health promotion and preventive health care services. There are substantial differences in the amount and quality of health care that minorities receive. This may be due in part to minorities not having access to a regular source of care such as a primary care physician. Also, minorities may live in medically underserved areas where there are fewer physicians or other health care providers. Minorities are more likely to be enrolled in health insurance plans that place limits on covered services and offer a limited number of health care providers. Shapiro and colleagues27 found that African Americans were more than twice less likely to receive combination HIV drug therapy and 1.5 times less likely to get preventive treatment for opportunistic infections than whites. Hispanic Americans were 1.5 times less likely than whites to receive combination HIV drug therapy.

Thirdly, health disparities result from the quality of health care that different ethnic and racial groups receive, such as lack of insurance coverage, lack of a regular source of care, lack of financial resources, legal barriers to public insurance programs, structural barriers such as poor transportation, and inability to schedule appointments quickly or during convenient office hours. The health care financing system is fragmented. Racial and ethnic minorities find themselves enrolled in health insurance plans with limited health service coverage and a limited number of health care providers.

https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/health-disparity&ved=2ahUKEwio1bqSufTtAhWiheYKHVWTCRYQFjADegQIMRAE&usg=AOvVaw3suoi1hABz0nL_XAJgBZEX