Addressing Disparities in Care with an Integrative Care Model
- African Americans - The death rate from suicide for African American men was almost four times that for African American women, in 2009.
- American Indians/Alaska Natives - Violent death- unintentional injuries, homicide, and suicide- account for 75% of all mortality in the second decade of life for American Indian/Alaska Natives.
- Asian Americans - From a CDC 2012 report, suicidal ideation for Asian American female students from grades 9 to 12 reported at (15.0) compared to (7.9) for Non-Hispanic White females.
- Hispanic/Latino Americans - The death rate from suicide for Hispanic men is almost five times the rate for Hispanic women, in 2009.
- Native Hawaiians/Pacific Islanders - Leading causes of death include cancer, heart disease, stroke, diabetes, and unintentional injuries. Other health conditions and risks include hepatitis B, HIV/AIDS, and tuberculosis.
The U.S. Census Bureau's 2014 National Projections report shows continued population growths by distinct ethnic cultural minority groups outpacing the White non-Hispanic population. While the diversity of experiences and talents can be appreciated in this time of global enterprise and development, the diversity of needs and barriers to care complicate service access and effective assessment and treatment of population health goals. Disparities in care continue to exist for social and ethnic minority groups and can be reflected by low rates of treatment utilization, high criminal justice involvement, high threshold rates of acute care, and lower access to preventive care.
The U.S. Surgeon General identified specific risks for disparity in care for minorities:
- They are less likely to receive diagnosis and treatment for their mental illness;
- They have less access to and availability of mental health services; and
- They often receive a poorer quality of mental health care.
The American Medical Association reported "racial and ethnic minorities experience a lower quality of health services and are less likely to receive routine medical procedures and have higher rates of morbidity and mortality than non-minorities. Disparities in health care exist even when controlling for gender, condition, age and socio-economic status."
A plan of action to address disparities in care must include: treatment integration for medical and behavioral health issues; an intelligent clinical work flow design to recognize population health risk indicators for minority groups. Implementing standard screenings and appropriate usage of culturally and linguistically congruent tools are also key steps. However, a knowledge of population specific morbidity risks and prevention needs can help shape a more aggressive and responsive plan to reduce disparities in care. Consider acculturation as a continuum factor for minority and recent immigrants. Analyze your organization's understanding of unique cultural values, norms and beliefs; identify the health goals that must be met for each cultural ethnic minority group and develop strategies to address the successful implementation of the goals. Be a 'health guru" attuned to population health risk and disparities in care. Take time to learn more about minority group health needs and national agendas to reduce risk and improve care.