HCA 3302, Critical Issues in Health Care 1



HCA 3302, Critical Issues in Health Care 1

Course Learning Outcomes for Unit VII Upon completion of this unit, students should be able to:

2. Defend an opinion on critical issues facing the U.S. health care system in the 21st century. 2.1 Discuss specific health inequality and inequity examples.

3. Evaluate the impact of commonly accepted business principles used to create an equitable health

care system. 3.1 Analyze the factors necessary to create a more equitable health care system.

Course/Unit

Learning Outcomes Learning Activity

2.1 Unit Lesson Chapter 12 Unit VII PowerPoint Presentation

3.1 Unit Lesson Chapter 12 Unit VII PowerPoint Presentation

Required Unit Resources Chapter 12: Health Inequalities and Health Inequities Unit Lesson In this unit, we will discuss health inequalities and health inequities in the United States. Specifically, we will discuss what the health inequalities and health inequities in the United States are, how they are measured, possible ways to reduce them, and the ethical issues raised. Health inequalities and health inequities that exist have an overall negative impact on health outcomes. In the United States, health disparities exist for various reasons such as socioeconomic status, gender, ethnicity, race, and geographical region (Morrison & Furlong, 2014). Health disparities are gaps that exist between different populations who are at a social disadvantage because of social health determinants. However, since the 1980s, there has been considerable attention to the issue of health inequalities (Murray et al., 1999).

Health Inequalities and Health Inequities The term health has many definitions. One common definition is the absence of disease. More specifically, health involves certain indicators such as life expectancy, survival rate, morality, and disease prevalence and incident. Further, individual health status is often assessed in many different ways by researchers. Various populations have many drastically different health belief systems and definitions surrounding health (Morrison & Furlong, 2019). Health inequality is a descriptive term referring to the total variation in the status of health across a specific population of individuals or to a difference in health between two or more populations (Morrison & Furlong, 2019). Health inequalities usually include a comparison of population averages and inferences are made about the results. Health inequalities are variances between groups of individuals and populations. Health inequity is a normative term that deals with differences that society judges to be morally unacceptable. A health inequality is not always considered a health inequity, but there is a correlation between the two. For

UNIT VII STUDY GUIDE Health Inequalities and Health Inequities

HCA 3302, Critical Issues in Health Care 2

UNIT x STUDY GUIDE Title

example, the United States population does not consider elective plastic surgery a necessary health need; therefore, the population would not consider unequal access to elective plastic surgery to be an inequity (Morrison & Furlong, 2019). Typically, moral judgment is involved when determining if a health inequality is a health inequity as well. This can also be determined based off societal perception. Determining if a specific instance or situation is considered a health inequity requires the comparison and measurement of at least two populations. A population needs to be defined, and this involves important ethical and moral decision-making (Morrison & Furlong, 2019). It is important to choose populations that have distinct differences and different health inequalities. This will allow for more comparison between the populations chosen.

Measurement of Health Inequalities There are many different statistical measures of health inequality. The topic of measurements using statistics is an extremely large topic, and we will just brush the surface of it with a few examples. Health inequities are measured by rates such as diagnostic rates (Morrison & Furlong, 2014). Health inequality is measured with simple statistical measurements such as the rate difference (RD) and the rate ratio (RR). The RD is a subtraction from the numeric measure of group A’s health status from group B (Morrison & Furlong, 2019). The RR is derived from dividing the numeric measure of group A’s health status from group B’s health status. The statistical numbers surrounding health inequalities can be used to assess health inequalities over time. The aggregate numbers, if improved, can simultaneously show an increase in health inequalities in a population (Morrison & Furlong, 2019).

Reducing Health Inequalities There are several various ethical issues that play a part in determining possible interventions in hopes of reducing or eliminating health inequalities. Much consideration needs to be made concerning the relationship between equality of outcomes and equality of treatment, which are part of the principles of vertical and horizontal equity (Morrison & Furlong, 2019). To reduce the health disparities in the United States, social determinants need to be eradicated, and equal distribution of resources across all populations is needed. In health care, horizontal equity deals with the equal distribution of resources throughout a population. Vertical equity is the division of various resources for diverse need levels; however, this can be quite complicated because of the complex interplay of social factors. Another issue that arises when trying to reduce health inequalities is the relationship of leveling up and down to achieve an equity goal (Morrison & Furlong, 2019). Finally, there are also many social resources that play an important role in determining the best course of action to reduce health inequalities. The U.S. government, lawmakers, health practitioners, and policy makers seek to improve overall population health and to eliminate or reduce variations in health based on race, socioeconomic factors, geographic location, ethnicity, and social factors (Arcaya et al., 2015). One example is the Patient Protection and Affordable Care Act (ACA) that aims to reduce social determinants and move toward a more fair and equitable health care system.

Conclusion Health inequalities and health inequities are essential concepts for understanding some ethical problems in health care. Addressing health inequalities and health inequities requires a deeper awareness and acknowledgement of the magnitude of social issues. Despite efforts to reduce health inequalities and health inequities, they persist and unfortunately are even increasing in some instances. The need for changes to address these health inequalities and health inequities is prevalent because of the existence of health care gaps and the longevity between least and most advantaged populations (Morrison & Furlong, 2019).

HCA 3302, Critical Issues in Health Care 3

UNIT x STUDY GUIDE Title

References

Arcaya, M. C., Arcaya, A. L., & Subramanian, S. V. (2015). Inequalities in health: definitions, concepts, and theories. Global Health Action, 8(1).

Morrison, E. E., & Furlong, B. (Eds.). (2014). Health care ethics: Critical issues for the 21st century (3rd ed.).

Jones & Bartlett Learning. Morrison, E. E., & Furlong, B. (Eds.). (2019). Health care ethics: Critical issues for the 21st century (4th ed.).

Jones & Bartlett Learning. Murray, C. J. L., Gakidou, E. E., & Frenk, J. (1999). Critical reflection: Health inequalities and social group

differences: What should we measure? Bulletin of the World Health Organization, 77(7), 537–543. https://www.who.int/bulletin/archives/77(7)537.pdf

  • Course Learning Outcomes for Unit VII
  • Required Unit Resources
  • Unit Lesson
    • Health Inequalities and Health Inequities
    • Measurement of Health Inequalities
    • Reducing Health Inequalities
    • Conclusion
    • References

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