QUESTION

Discussion board replies (2 – 450 word replies)

Instructions

Reply prompt: Respond to the two discussion questions who reached a different conclusion than you did. Identify the points of difference in your analyses and explain how your sources and analysis led you to your conclusion. Replies must be at least 450 words each discussion reply. Each reply must reference at least 3 scholarly sources and follow current APA format (including both in-text citations and a reference list). You must also support each reply with thoughtful analysis (considering assumptions, analyzing implications, and comparing/contrasting concepts and include thorough biblical worldview integration.  (900 words total, 2 replies)

Discussion Question #1

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            Health insurance in the United States has changed greatly over the past decade. The Affordable Care Act allowed thousands of previously uninsured people to have access to health insurance. Unfortunately, having health insurance does not always equate to having access to health care. There are many populations that have difficulty receiving care.

            One population that is vulnerable to a lack of health care are homeless people. “Across the United States, approximately 578,424 people are homeless each night” and include families, veterans, and children without parents (Shi & Singh, 2017). Providing care to the homeless population is very challenging as the population has a broad range of needs. There are children who need vaccines, single men and women who need care after leaving an abusive relationship, and those who have mental illnesses that either need to be institutionalized or simply need appropriate medication and/or therapy. A major obstacle for providers in the delivery of health care to persons who are homeless, is the lack of a permanent address or traditional way of contacting the patients (McInnes, Li, & Hogan, 2013). This lack of ability to communicate easily causes care to be fragmented as providers are forced to rely on the patient contacting them instead of being able to contact the patient if further treatment is necessary.

            Another challenge homeless individuals face when seeking care is the feeling of be ostracized by the health care community or other people in general (McInnes, Li, & Hogan, 2013). This feeling causes most homeless people to avoid getting routine care and instead rely on more emergency room or urgent care settings to deal with major health issues (Lebrun-Harris, et al., 2013). Unfortunately, urgent or emergency room care is not what most homeless people need. A large percentage of homeless people suffer from some type of chronic illness that needs routine care, such as diabetes, HIV/AIDS, tuberculosis, or mental illnesses (Lebrun-Harris, et al., 2013).

            Another population that has challenges accessing health care are those who live in rural areas. Rural communities, like the homeless community, have a broad range of health care needs. People in these communities also, “face a higher burden of heart disease, stroke, diabetes, mental health disorders, tobacco usage and substance abuse” (Shi & Singh, 2017). One major barrier rural communities have to overcome in accessing care is the lack of medical providers. Most doctors and physicians choose to live in larger cities where the population is greater and the income potential higher. For example, “About 20% of the US population-more than 50 million people-live in rural areas, but only 9% of the nation’s physicians practice in rural communities” (Rosenblatt & Hart, 2000). The lack of local doctors results in people not seeking routine care as it would mean traveling, taking time off of work, or possibly loosing income if they are farmers. So much like the homeless population, those in rural communities depend on hospitals for their care (Greenwood-Ericksen, Tipirneni, & Abir, 2017).

            A final population vulnerable to healthcare access are those who are of racial or ethnic minority categories. These groups include “black or African American (12.3%), Hispanics or Latinos (16.3%), Asians (4.4%), Native Hawaiian and other Pacific Islanders (0.1%), American Indian and Alaska Natives (0.9%) or some other race (5.5%)” (Shi & Singh, 2017). Minorities face a number of health challenges compared to Caucasian Americas. For example, American Indians, Alaska Natives, and Hispanic Americans have a higher rate of alcohol abuse, higher homicide rates, and a higher population living below the national poverty line (Shi & Singh, 2017). Black Americans are more likely to die from a stroke or heart disease than white Americans and “Korean Americans have a fivefold incidence of stomach cancer and eightfold incidence of liver cancer compared with whites” (Shi & Singh, 2017).

Another minority group that faces challenges in health care are displaced refugees from war torn areas. Many of these people are new to the United States and do not speak English or even have someone that can take them to their health care appointments. Furthermore, many of them have not had access to any routine care before coming to America. For example, at the community dental clinic I work in we treat a large Arabic population and most of the patients I see have never had any form of dental treatment. As a result, most are scared and unsure of what is going on and compounding this with a language barrier makes treatment very difficult.

Many different populations within the United States struggle with receiving health care. As a country we need to work together to overcome some of these barriers to care. As Jeremiah 22:3 states, “This is what the Lord says: Be fair-minded and just. Do what is right! Help those who have been robbed; rescue them from their oppressors…Do not mistreat foreigners, orphans, and widows…”.

References

Greenwood-Ericksen, M., Tipirneni, R., & Abir, M. (2017). An Emergency Medicine-Primary Care Partnership to Improve Rural Population Health: Expanding the Role of Emergency Medicine. Annals of Emergency Medicine. doi: http://dx.doi.org/10.1016/j.annemergmed.2017.06.025

Lebrun-Harris, L., Baggett, T., Jenkins, D., Sripipatana, A., Sharma, R., & Hayashi, A. (2013). Health status and health care experiences among homeless patients in federally supported health centers: findings from the 2009 patient survey. Health Services Research, 48(3), 992. Retrieved from http://go.galegroup.com.ezproxy.liberty.edu/ps/i.do?p=AONE&u=vic_liberty&id=GALE|A332789620&v=2.1&it=r&sid=summon&authCount=1

McInnes, K., Li, A., & Hogan, T. (2013). Opportunities for Engaging Low-Income, Vulnerable Populations in Health Care: A Systematic REview of HOmeless Person’ Access to and Use of Information Technologies. American Journal of Public Health, 11-24. Retrieved from https://search-proquest-com.ezproxy.liberty.edu/docview/1468675781?pq-origsite=summon&accountid=12085

Rosenblatt, R., & Hart, L. (2000). Physicians and rural America. Wetern Journal of Medicine, 173(5), 348-351. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071163/?tool=pmcentrez

Shi, L., & Singh, D. (2017). Essentials of the U.S. Health Care System (Fourth ed.). Burlington, MA: Jones & Bartlett Learning.

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Discussion Question #2

Getting certain populations the care that is needed, and care that is affordable is one of the most difficult items in the health delivery system.  There are many populations and demographics that require care but, are unable to receive it due to economic, or geographical issues. Women today have longer life expectancies than men now, living almost 8 years longer than males.  Even though women are living longer, they suffer from higher morbidity and poorer health than the male counterpart (Shi & Singh, 2017).  Women also have a higher prevalence of certain health problems over the course of their lifetime.  The amount of acute and chronic illnesses in women is higher and can cause more short and long-term disabilities.  Women have also suffered from higher mortality rates from heart attacks than men, and they also suffer from higher cholesterol levels of men at older ages (Shi & Singh, 2017).  Women are also the fastest-growing population that is being diagnosed with the autoimmune disease AIDS. With this significant factor affecting women, they need to have health care that addresses these issues. There is a significant number of women that suffer from mental illnesses, like depression, anxiety, two times more than men. The major issues facing women’s health include the delivery of health care, and getting women educated on the growing health problems. Women have a greater risk for chronic disease, and those that are economically disadvantaged have an even higher risk to be physically disabled (Khoury, 2013). Children’s health has very unique aspects with delivery, that can include developmental vulnerability, dependency and differential patterns of morbidity and mortality. Developmental vulnerability refers to the rapid and cumulative physical and emotional changes that characterize childhood and the potential effects that illness, injury, or untoward family and social circumstances can have on children (Shi & Singh, 2017). Children are dependent on their parents, school officials, caregivers and occasionally neighbors to find out that they need health care or need to seek health care services.  Exodus 17:12 says “when Moses’ hands grew tired, they took a stone and put it under him and he sat on it. Aaron and Hur held his hands up – one on one side, one on the other – so that his hands remained steady till sunset.”  We need to reach out to those that are struggling with getting the proper care, children sometimes do not know that they need to get care or to do not know how they can get the care that is needed.  The Lord wants us to help these people. 

 Race/Ethnic Minority Categories in the United States

Evidence suggests that racial and ethnic minorities generally have poorer access to health care, receive poorer quality care and experience worse health outcomes. The different categories of races and minorities include Black Americans, Hispanic Americans, Asian Americans, Asian/Pacific Islander, American Indians and Alaska Natives. Some health challenges that Black Americans face are shorter life expectancies, higher rates of premature death from stroke and coronary heart disease, more than double the infant mortality rates, this disparity is more likely to report fair or poor health and has a 665% higher homicide rate compared to whites (Shi & Singh, 2017).  Studies have shown that minorities face serious problems with the health care delivery system, they also have less health insurance coverage, access to care and quality of care (Saulsberry, 2016).  Cultural influences can also play a role on patients that suffer from chronic conditions, and how they approach disease management (Saulsberry, 2016).  Health care should not be separated by race or ethnic background, the health care delivery system needs to provide equal, quality, accessible care to everyone.

References

Khoury, A.& Hall, A & Anderson, E. & Zhang, J. (2013). The association between chronic disease and physical disability among female Medicaid beneficiaries 18-64 years of age. Disability and Health Journal. 6(2) 141 -148. http://rx9vh3hy4r.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=The+association+between+chronic+disease+and+physical+disability+among+female+Medicaid+beneficiaries+18-64+years+of+age&rft.jtitle=Disability+and+Health+Journal&rft.au=Khoury%2C+Amal+J&rft.au=Hall%2C+Allyson&rft.au=Andresen%2C+Elena&rft.au=Zhang%2C+Jianyi&rft.date=2013-04-01&rft.pub=Elsevier+B.V&rft.issn=1936-6574&rft.eissn=1876-7583&rft.volume=6&rft.issue=2&rft.spage=141&rft_id=info:doi/10.1016%2Fj.dhjo.2012.11.006&rft.externalDBID=BSHEE&rft.externalDocID=339589814¶mdict=en-US

Saulsberry, L & Blendon, J. (2016). Challenges confronting African Americans and Hispanics living with  chronic illness in their families. Chronic Illness. 12(4), 281-291.  DOI:   10.1177/17423953166653452

Shi, L., & Singh, D. A. (2017). Essentials of the U.S. Health Care System (4 ed.). Burlington, MA: Jones  & Bartlett Learning