"About 30% of Hispanic and 20% of African-Americans lack a usual source of health care compared with less than 16% of European-Americans" (Agency for Healthcare Research and Quality, 2003). "Racial and ethnic disparities in health care, whether in insurance coverage, access, or quality of care, are one of many factors producing inequalities in health status in the United States" (Lillie-Blanton & Lewis, 2005, p. 1). "No universally accepted definition of health disparities or health inequities currently exists; to some, disparities are simply differences in health processes or outcomes between population groups" (Meyers, 2007, p. 1).
"Clearly understanding ethnical and racial health disparities demands a careful examination of all groups in all societies in which such disparities exist" (Dressler, Oths & Gravlee, 2005, p. 233). Eliminating disparities in health and healthcare was a priority identified in the U.S. Department of Health and Human Services Healthy People 2010 initiative (Kilbourne, Switzer, Hyman, Crowley-Matoka & Fine, 2006).
In this research report the author has described the current health situation and issues facing African-American Women in the New York city. After describing the current health status i.e population, birth rate, health status, infant mortality rate, the author focussed on the major issue i.e HIV Aids. The main focus of the research report is racial and ethnical disadvantages, as well as discrimination in regards to being HIV positive attempting to receive primary care treatment. It is challenging and to eradicate these disparities for government and institutions partially because their causes are tangled with a controversial history of race relations in United States. However, it is important to assure better fairness and liability in the healthcare system to a rising regional base, including those who purchase, pay and health plan and for those too who provide health care. (Lillie-Blanton & Lewis, 2005). As currently much research has been conducted on healthcare disparities and information is available on healthcare disparities, the focal point of research has been changed from assessing and exploring disparities toward exploring the roots and causes of these health disparities as well as developing interventions to improve them. James, Thomas and Lillie-Blanton (2007), state that facts and figures are still incomplete for certain racial and ethnic subgroups, and for those who self recognize with more than one racial group. "Information that documents health care disparities is important to understanding where progress has been made and the challenges that remain" (James, Thomas & Lillie-Blanton, 2007).
Current Health Status: African-American Women in New York
Dressler, Oths, and Gravlee (2005) state that based on present investigation comparatively little development was made toward the objective to eliminate racial and ethnic inequalities among the health status pointers throughout the last 10 years. Progress toward the goal of eliminating health disparities will require more concerted efforts during the next 10 years. For HIV prevention to be successful in communities of color, such as Pacific Islanders, Hispanics and/or American Indians, research must specifically target the African-American communities.
In the New York Metro African-American population is the leading than any other city in the United States which is almost 3.5 million. This is approximately 9% of the whole Black population of the United States. While there are 2.4 million African-Americans in the New York City . African-American women form 52%.(CDC Health, United States report, 2007)
Health Statistics show that 18% of African-American Women in New York City currently smoke, 79% are overweight in the age group of 20 years and above Life Expectency has increased as of 1900 which was averaged 33 .5 and now its 76.5. 41% have hypertension problem in African-American in New York State
Overall infant mortality rate in the United States (the number of deaths among infants aged <1 year per 1,000 live births) declined from almost 100 deaths per 1,000 births in 1900 (3) to 6.89 in 2000 (4). However, the rate did not turn down significantly from 2000 to 2005. The infant mortality rate turned down somewhat but significantly from 6.86 in 2005 to 6.68 in 2006. The 2007 rate (6.75) was not significantly dissimilar from the 2006 rate (6.68) (4 -- 6). Additionally, substantial distinctions in infant mortality rates amongst racial/ethnic groups continues and even increased, showing that not all racial/ethnic groups have gained advantage equally from social and medical advances (Matthews TJ, MacDorman MF, 2010). The data show that the highest infant mortality rate was for African-American Women (13.35), with a rate 2.4 times that for non-Hispanic white women (5.58).
Racial/ethnic differences in infant mortality rates might imitate, partially, distinctions in motherly socio demographic and behavioural risk factors. For instance, infant mortality rates are higher than the U.S. average among infants born to mothers who are "teenagers, unmarried, smokers, have lower educational levels, had a fourth or higher order birth, or did not obtain adequate prenatal care" (Matthews TJ, MacDorman MF, 2010).
"Medical care makes a limited contribution to population differences in health but may have a greater impact on the health status of vulnerable populations, such as African-American women with HIV / AIDS" (Williams, 2002, p. S43). Kilbourne et al. (2006) defines health disparities as "observed clinically and statistically differences in health outcomes or healthcare use between socially distinct vulnerable and less vulnerable populations that are not explained by the effects of selection bias" (p. 2114). Observed differences in health22outcomes or health status represent inequalities or measured gaps between groups (Kilbourne et al., 2006). "These disparities in health outcomes or health status may because or exacerbated by patient, provider or system level factors that result in differential treatment" (Kilbourne et al., 2006, p. 2114). "A large body of evidence documents pervasive racial and ethnic health disparities in diagnosis and treatment of minority persons once they enter the U.S. health care system" (Williams, 2002, p. S43).The health disparities are present within various facets ranging from technology to basic forms of diagnostic and treatment interventions, which includes healthcare coverage (e.g., Medicare and Veteran Affairs health system), disease progression (e.g., HIV / AIDS progression stages) and medical facility (e.g., primary care facilities; Williams, 2002).
Minority women face many challenges when it comes to medical care, such as access to medical services and insurance coverage. Williams (2002) stated minority women are less likely to be insured and are more likely to have public health coverage, which is limited in medical treatment and services
Evidence from Literature
The widening gap in health disparities is receiving increased national attention; vast literature exists documenting the substantial racial, ethnic and socioeconomic differences in health status, treatment, access to services, and health outcomes (DeLoach,2003). HIV health disparities still continue to plague the African-American female community. The research study was an attempt to understand the essence of the lived experience of African-American women with HIV / AIDS that will help to bridge the gap on racial and ethnic health disparities in medical/primary care settings among this vulnerable community. The reasons are complex and include poverty, discrimination, inadequate access to healthcare, distrust of medical services and physicians, and high risk behaviours. Stigmas and discrimination are factors that remain heavily within urban communities in regards to HIV / AIDS issues.
There are also gaps in patient-provider communication and trust within the primary care setting. Armstrong, Ravenell, McMurphy, and Putt (2007) stated that "adding to concerns about the overall decline in trust is the recognition that distrust maybe particularly prevalent among racial and ethnic minority groups" (p. 1283). Potvin, Gendron, Bilodeau, and Chabot (2005) argue that the first challenge of overcoming health disparities in the primary care setting is to formulate a program theory that takes25into account the social determinants of health and the mobilization of diverse factors for social change.
The report can help local community and state health organizations establish more effective treatment and prevention programs geared toward African-American women, especially young African-American HIV / AIDS infected females. In many communities, there is lack of information and consideration about the outbreak feeds stigma and bias against people living with HIV / AIDS. Effective and efficient health communication efforts regarding treatment and prevention programs are the key components to decreasing HIV / AIDS within minority communities.
Health Status of African-American Women
Copeland (2005) found that despite outstanding improvements in the general health at national level through the past twenty years, undeniable facts show that the nation's racial and ethnic minority Americans are suffering rising inequalities in the occurrence, pervasiveness, mortality, and burden of diseases and bad health effects compared with European-Americans. In a recent analysis of racial and ethnic disparities, Williams (2002) found:
"Differences in access to and use of health services between 1977 and 1996 concluded that the gap between African-Americans and European-Americans has not narrowed over time. The study also found that even if income and health insurance coverage were equalized, racial and ethnic differences in outpatient care would not be eliminated due to one half to three quarters of these disparities are not accounted for by the previous stated factors." (p. S43)
A research study by Levine, Briggs, Kilbourne, King, Fry-Johnson, Baltrus, Husaini, and Rust (2007)…