Economic Disparities and Access to Health Care in the US: A Report

This report delves into the critical issue of economic disparities and their impact on access to health care in the United States. It begins by defining economic disparities and their relationship to health outcomes, highlighting how socioeconomic status significantly affects the quality of care received. The report examines key issues, including clinical, environmental, and behavioral factors, and the role of race and income in healthcare. It discusses the growing income inequality in America, the rising costs of medical care, and disparities in health insurance coverage. The report then proposes various solutions, such as improving quality through information technology, performance measurement, provider incentives, and national leadership. It also emphasizes the importance of training healthcare professionals and promoting patient self-management to address health disparities effectively. The report concludes by advocating for comprehensive strategies to ensure equitable access to high-quality healthcare for all Americans.

Running head: ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
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1ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
Table of Contents
Introduction..........................................................................................................................2
Issues related to economic disparity in the health care in US.............................................2
Clinical factors.................................................................................................................3
Environmental and behavioral factors.............................................................................3
The role of race and income in health care in America...................................................3
Growing inequality in income of Americans...................................................................4
Rising cost of medical and health care facilities.............................................................4
Inequality in the health insurance....................................................................................4
Response to the issue...........................................................................................................5
Improving quality............................................................................................................5
Information technology...............................................................................................6
Performance measurement...........................................................................................6
Provider incentives..........................................................................................................6
Access to care of high quality..........................................................................................6
National leadership..........................................................................................................7
Training of health care professionals...............................................................................8
Patient self-management..................................................................................................8
Better data........................................................................................................................8
Conclusion...........................................................................................................................9

2ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
References............................................................................................................................9

3ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
Introduction
The term economic disparities refer to economic inequality. The term economic
inequality refers to inequitable distribution of income and opportunity between all the people of a
society. Income inequality includes differences in the pay between individuals1. Health
disparities can be there on the basis of a number of factors such as age, gender, income and
others. Similarly there can be economic disparities in relation to health care system as well. This
is so because socioeconomic status of an individual affects the quality of health care received by
an individual. Individuals who are not covered by any medical insurance are the ones who
receive poor quality of treatment and care, moreover they receive limited medical care including
the treatment and screening activities2. They are also not provided with proper medications and
diagnostic tests for overcoming chronic diseases. In the US, where there is income inequality in
many states have to suffer from shortage of doctors3. The main aim of the paper is to discuss
about the critical issue of economic disparity and the health care and recommend solutions to the
same . The paper will discuss the issues of economic disparity and health care in US and will
also include argumentative response to those identified issues.
1 Bor, Jacob, Gregory H. Cohen, and Sandro Galea. "Population health in an era of rising income inequality: USA, 1980–2015." The
Lancet 389, no. 10077 (2017): 1475-1490.
2 Dickman, Samuel L., David U. Himmelstein, and Steffie Woolhandler. "Inequality and the health-care system in the USA." The
Lancet 389, no. 10077 (2017): 1431-1441.
3 Flynn, Lindsay B., and Herman Mark Schwartz. "No exit: social reproduction in an era of rising income inequality." Politics &
Society 45, no. 4 (2017): 471-503.

4ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
Issues related to economic disparity in the health care in US
It has been found out from a study that the Americans with low income suffer from a
number of disease such as- heart stroke, diabetes, and other chronic disease as compared to the
Americans with higher income. It has also been found out that Americans who live in families
where theincome is less than $35000 in a year they tend to be sadder and nervously as compared
to families that earn more about $ 100,000 in a year4.
Clinical factors
Moe barriers are faced by the low income American’s while accessing the health acre
facilities in America. This is so because they are not given new drugs and also lack access to
specialty and primary care services. Moreover the low income Americans are usually employed
by organizations that do not offer benefits related to health care facilities5. Even after the act for
affordable care got implemented, majority of low income Americans remain uninsured. Those
who are not ensured will lack regular medical care6.
Environmental and behavioral factors
Moreover the behavioral risks tends to be higher for the low income Americans such as-
issues related to obesity, lower physical activity, smoking and even substance use7. These risks
4 Frank, Robert H. "How rising income inequality threatens access to the legal system." Daedalus 148, no. 1 (2019): 10-18.
5 Peckham, Trevor K., Marissa G. Baker, Janice E. Camp, Joel D. Kaufman, and Noah S. Seixas. "Creating a future for occupational
health." Annals of Work Exposures and Health 61, no. 1 (2017): 3-15.
6 Healthaffairs.org. 2020. "Overcoming Disparities In U.S. Health Care | Health Affairs". Healthaffairs.Org.
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.24.2.445.
7 Hertz, Thomas, and Andrew Silva. "Rurality and Income Inequality in the United States, 1975–2015." Rural Sociology (2019).

5ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
are further influenced by the community and home environment where they stay. This is quite
evident from the fact that neighbourhoods which are poor have a high density of retailers of
tobacco. Moreover the low income Americans have lower access to counselling activities,
pharmacotherapies and also experiences higher level of stress which makes it even more difficult
for them to quit smoking8. Moreover the low income Americans also have to face various
structural challenges that contributes to other dieses and disorders such as obesity and other
chronic dieses9.
The role of race and income in health care in America
Races have a major impact on various socio-economic factors including the income
factors. This is so because black Americans still continue to have shorter life expectancy and
lower incomes when compared to the white Americans10. There are a number of factors
contributing to the health disparities based on race however the central role is played by financial
hardships that further leads to segregation and exploitation and also has an effect on the physical
and mental health of the people11.
8 Jaumotte, Florence, Subir Lall, and Chris Papageorgiou. "Rising income inequality: technology, or trade and financial
globalization?." IMF Economic Review 61, no. 2 (2013): 271-309.
9 Malat, Jennifer, Sarah Mayorga-Gallo, and David R. Williams. "The effects of whiteness on the health of whites in the USA." Social
Science & Medicine 199 (2018): 148-156.
10 Nguyen, Quynh. "“Mind the Gap?” Rising income inequality and individual trade policy preferences." European Journal of Political
Economy 50 (2017): 92-105.
11 Mandel, Hadas, and Moshe Semyonov. "The growing racial pay gap is linked to rising income inequality and continued occupational
segregation and discrimination." USApp–American Politics and Policy Blog (2016).

6ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
Growing inequality in income of Americans
The inequality in income in America is growing continuously that is much evident from
the fact that gini coefficient has continuo increased since 197012. It has also been understood that
while low income leads to poor health status it is also the poor health that leads to lower income.
Rising cost of medical and health care facilities
The cost of health care facilities is continually growing in America and it was found out
from a research that about 1 in every 5 low income Americans did not get access to health care
facilities because they were unable to afford it13. Therefore this is how the sick low income
American become even are sick due to lack of access to affordable medical facilities.
Inequality in the health insurance
The low income Americans often do not qualify for Medicaid. All they can get is the
subsidy under the Obamacare however even those policies can only cover doctor and hospital
practices. In rural areas, these services may be insufficient for looking after the health of the low
income Americans. Moreover the low income Americans are less likely to be covered by health
insurance facilities because only one third of them receive a health insurance cover under their
employers14.
12 Nikolaev, Boris, and Daniel L. Bennett. "Rising Income Inequality and Economic Growth… Are Americans Better Off? Evidence
from Subjective Well-Being Data." Rising Income Inequality and Economic Growth… Are Americans Better Off (2020).
13 Peters, Heiko, and Maya Volwahsen. "Rising income inequality: do not draw the obvious conclusions." Intereconomics 52, no. 2
(2017): 111-118.
14 Rebeira, Mayvis, Paul Grootendorst, Peter C. Coyte, and Victor Aguirregabiria. "Does rising income inequality affect mortality rates
in advanced economies?." Economics: The Open-Access, Open-Assessment E-Journal 11, no. 2017-16 (2017): 1-23.

7ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
Response to the issue
Therefore from the above paragraph it is understood that there are a number of issues that
are being faced by the low income Americans in health care sector15. Some of these includes-
lack of access to appropriate health care facilities, behavioral risk due to environmental factors,
the role of human race along with unequal income in accessing facilities related to medical care.
Growing inequality of income and lack of health insurance facilities and the rising cost of health
care facilities are all some of the issues related to economic disparity in health care16. In order to
overcome the disparity in the health care facilities it has become important to have a broader
view in order to have a better understanding on the race and ethnicity, socio-economic status of
the patients and geographic disparities. Moreover some of the solutions as have been identified
to overcome the health disparity issues includes- promoting the personal responsibility and
patients dignity, a focused approach is needed for proving patient centered care, improving
communication and focusing on cultural contexts. Some of the specific recommendations as per
THE CLOSING THE HEALTH CARE GAP ACT, includes- improving the quality through the
use of information technology in health care and carrying out performance measurement.
Provider incentives are required to be given, there should be better access to high quality care,
there needs to be a national leadership, proper training of heath care professional and self-
management of patients.
15 Sjoding, Michael W., and Robert P. Dickson. "Economic disparities and survival from critical illness." The Lancet Respiratory
Medicine 5, no. 8 (2017): 601-603.
16 Struminger, Bruce, Sanjeev Arora, Sarah Zalud-Cerrato, David Lowrance, and Tedd Ellerbrock. "Building virtual communities of
practice for health." The Lancet 390, no. 10095 (2017): 632-634.

8ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
Improving quality
There are disparities in the health care system of US majorly due to the a number of
quality problems. These quality issues are leading to worse care and also less than optimum care
for patients. Therefore there is a requirement for improving the general care quality.
Information technology
It is necessary to have health information technology because information relayed to
robust care and access of the same can help the patients and the providers in creatively
redesigning the clinical practices. That can help in not only improving the quality of health care
services but will also help in overcoming the gaps that are leading to health disparities. Therefore
all the provide need to have access to this HIT17. It will also help the nurses and the physicians
who work closely in relation to their patients for providing better quality care at lower costs.
Performance measurement
Next, it becomes necessary to assess the care such that it can be improved. There need to
be an appropriate tool for measuring the performance such that the consumers, the patients and
the providers make decision that are based on evidences.
Provider incentives
There must be some type of providers incentive for promotion of the clinical residing that
can help in improving the quality of care and also in closing all the gaps. Government has also
started paying for episodes and not outcomes. moreover the officials have also started to rethink
the strategies for payment such that payment is made only for results and not for doctor
17 Subica, Andrew M., Neha Agarwal, J. Greer Sullivan, and Bruce G. Link. "Obesity and associated health disparities among
understudied multiracial, Pacific Islander, and American Indian adults." Obesity 25, no. 12 (2017): 2128-2136.

9ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
procedures or visits. Therefore the system of pay for performance must be there even for the
health care profession including the doctors. Therefore people should consider paying for those
types of care that can help in closing the gaps in health care service quality.
Access to care of high quality
In order to overcome the health care disparities, it has become necessary to address the
issues related to lack of insurance services and increasing cost of health care. Due to the rising
cost of health care facilities, it is affecting the uninsured people and is also reducing access to
high quality of care. The best way to overcome this issue in order to improve the quality of
health care and reduce the cost it is necessary to carry out competitive innovation activities as is
done in case of other activities in the economy. Lower cost of health care facilities can help in
making coverage and care affordable in the system. The main idea behind it is to link payment
efficiently and effectively to the results that are valued by the patients for the purpose of making
the healing process fast and for the purpose of closing all the gaps in the heath care system. Such
a health care system needs to be there where all the patients and the providers will be motivated
to work together for improving the health care facilities.
Moreover many patients have raised their voices related to different health care concerns.
It is also believed that by fostering competition, health disparities and quality chasms cannot be
fixed. There is a need for vigorous attention on the vulnerable population.
National leadership
According to THE CLOSING THE HEALTH CARE GAP ACT, a more reinvigorated,
reauthorized and properly funded minority health office is require at the health and human
services department that aims at overcoming health disparities. However it is not enough to have

10ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
a single office. There is a needed for leveraging and engaging the entire apparatus for federal
health including the centre for Medicare and Medicaid services or CMS, the national institute of
health, centre for disease control and prevention and others for the purpose of addressing the
disparities systematically wherever and whenever they will occur. With the help of the federal
health apparatus, the health disparities can be brought to the top of the agenda for all the agencies
of federal health such that all the agencies will be charged to consider the disparities of health
care as they are implemented, managed and developed.
Training of health care professionals
It is necessary to train the health care professionals such that they can deal with the
population of health disparity. This is so because the providers need to have a proper idea about
the patients they are dealing with and caring for, and therefore they are required to understand
these communities. There is a need for training that uses evidence based model for the purpose
of understanding competency and cultures18. THE CLOSING THE HEALTH CARE GAP ACT
promotes the model curricula development in competency and in cultural fluency. Therefore the
training programs needs to be invested in board certified and high quality providers who will
take the initiative of working with these communities and will they should also be provided right
incentive such that the trained providers stay in their roles. A positive step towards this includes-
increasing the minorities number of health professionals. However more focus requires to be
given to the outcome that can help in providing care of highest quality. Therefore the
18 Yamada, Tetsuji, Ching C. Chen, Weihong Zeng, Barret Levine, and John M. Carter. "Global perspectives of different healthcare
systems and health: Income, education, health disparity, health behaviors and public health in China, Japan and USA." Journal of
Community Medicine and Public Health Care 5, no. 2 (2018): 039.

11ECONOMIC DISPARITIES AND ACCESS TO HEALTH CARE
concordance of patients providers is important as the bottom line is the ultimate outcome and not
the means for getting to that place.
Patient self-management
By improving the quality of care, the providers needs to understand that patients are
responsible for managing their chronic illness themselves. In order to improve the health care
quality, patients require the providers to help them in getting better at self-management.
Better data
Demographic data is required in relation to the ethnicity, race, primary language and also
Socio-economic status for the people who are receiving health care19. This data can help in
establishing the care disparities, however the health market for private services and the health
programs of the federal need even more detailed information about the population seeking heath
care facilities for the purpose of refining and targeting interventions. For instance, about half of
the enrolments related to insurance are engaged in health plans that do not collect the
demographic data.
Conclusion
Therefore from the above discussion, it can be concluded that it is necessary to overcome
economic disparities even in the health care system because it prohibits people from their basic
fundamental rights. Moreover there can be some major long term impacts of economic disparity
in the health dare such as spread of infectious diseases due to lack of proper equal treatment of
19 Venkataramani, Atheendar S., Rachel Brigell, Rourke O'Brien, Paula Chatterjee, Ichiro Kawachi, and Alexander C. Tsai. "Economic
opportunity, health behaviours, and health outcomes in the USA: a population-based cross-sectional study." The Lancet Public
Health 1, no. 1 (2016): e18-e25.