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Barak concludes by suggesting that the issue and concept of diversity take on a "special urgency" in human service healthcare organizations among the organization as a whole and staff, and that the organization review its quality of service and commitment to the community in order to truly impact the lives of diverse populations.
Managing Diversity: Best Practices
HR Management often works off of the ideals of 'best practices.' This concept is discussed in the next article, "Managing the Diversity Revolution: Best Practices for the 21st Century Business." Aronson takes a more general approach to diversity but one that can be applied directly to the healthcare industry nonetheless. Aronson points out many of the trends previously identified with regard to diversity problems in the nation's business climate as a whole. In particular the author points out that diversity issues may stem from a number of causes including cultural differences and systematic discrimination, which may be widespread in a number of industries including the healthcare industry.
Among the populations more likely to be discriminated against according to the author include women and older Americans, as well as those living under lower socio-economic status, as confirmed by the previous articles examined. The author suggests that corporate attempts to improve diversity programs should include outreach programs that focus specifically on these underserved populations if diversity programs are to be fully successful and meaningful within any industry.
Aronson proposes a broad approach to diversity initiatives, one that is inclusive of the many different facets of diversity including: race, ethnicity, gender, age, religion, disability and sexual orientation (Aronson, 2002:46). It is along these lines the author claims that a person is most likely to be discriminated against and treated unfairly, and it is along these lines that most stereotypes have been developed by healthcare officials, providers and other agents.
Among the critical elements of a successfully implemented diversity awareness program according to the author is a commitment from top management to promote the ideals of diversity. Management has to be held accountable for the results of a workable diversity program; otherwise according to the author, diversity programs become more optional than necessary, and generally result in an "unfocused effort" producing only "spotty results." Further the article suggests that diversity programs need be supported at all levels and administered with regular and consistent assessments of successes in order to be truly impacting.
Communication according to the author is also a critical aspect of a successful diversity program and ensures that an organization remains responsive to the needs of not only diverse employees but also diverse community members. A good diversity program as proposed by Aronson is one that "embodies values that are consistently upheld and regularly reaffirmed" (Aronson, 2002:46). A program is only as good as it is on paper if it is not followed through on and if the day-to-day practices that are adopted by an organization do not produce real world results.
Thus it will be important for health care providers and organizations to not only implement programs that are diverse in nature but for them to also monitor their progress and reaffirm their commitment to diversity on a consistent basis. Diversity efforts can be focused in many different categories and in many system wide practices in order to assure the best possible outcomes. The best practices among diverse organizations are those that promote opportunities for everyone. Within the health care industry this would include not only the employees of health care organizations but also the community and patients that are recipients of the care being provided.
Progress in Reform
In the article "Reflecting on Progress, Health and Racism: 1900 to 2000" Keigher suggests that though the health care industry is on the service dedicated to health promotion, risk reduction and disease prevention, it generally only does so for certain populations, particularly those that are more affluent. The lack of a diverse and well rounded approach according to the author is the result of the "raw forces of capitalism" that govern the method in which the U.S. health care system is run.
The author acknowledges the large body of evidence that exists suggesting that disparities in health care treatment and services generally result from the inaccessibility of health care as well as the ineffectiveness of the health care system "in dealing with the complex patterns of ill health among ethnic minority groups" (Keigher, 1999: 243). The author suggests that the government need get involved in order the aid health care reform and promote more diverse practices among all populations, particularly those that are poor and underserved.
Further the author acknowledges that within the modern health care system there are "enormous disparities" that exist among individuals of varying socioeconomic status, race and ethnicity and that the proportion of quality care is not progressing or improving for ethnic minority groups in particular. The author points out many of the same inequalities noted by the previous authors, including a higher incidence of AIDS, cancer related deaths, adolescent teen pregnancies and poor neonatal outcomes more common in minority populations than in affluent ones.
In many cases the author acknowledges that access to adequate primary care has declined for the most part because fewer and fewer individuals are able to obtain adequate health insurance coverage. The author quotes a U.S. Public Health Service reporting system which tracks the nation's annual progress in health goals including reducing the health disparities that exist among subpopulations and achieving access to preventive services for everyone. The author notes that there is still room for substantial improvement and that the weakest areas of performance still reside in the realm of diversity efforts.
Disparity within the healthcare industry can be attributed to the current U.S. federal structure which according to the author is designed to help the "rich get rich" and to protect capital rather than to ensure that diversity programs that serve the underserved are meaningfully and successfully carried out. Racism and inequality according to this article are still deeply ingrained in social policy and that policy is evident within the health care industry and within health policy implementation programs.
The author closes by urging communities and physicians as well as officials to work together to develop more feasible solutions to the health care crisis and diversity issues that still dominate the health care industry. The author suggests that the modern health care industry is no better off than it was in the early 1900s, when diversity was virtually non-existent, as the same discrepancies in care that existed in the past exist today, with little hope for reform.
In each of these articles it is evident that diversity is a critical issue within the health care industry. For diversity programs to be effective, it is evident that HR Management must work directly with top medical professionals and operations management teams to develop initiatives that are all encompassing and that address the discrepancies that currently exist with regard to the lack of equal services and healthcare distribution within the nation.
With regard to diversity the healthcare industry is failing. According to the many studies conducted of diversity initiatives, there are still many populations that are inadequately served with regard to health care. Among the major groups affected according to these articles include individuals living in poor conditions, those of low socio-economic status, racial minorities and women.
One might conclude from analyzing each of the articles presented that the key to diversity reform within the healthcare industry is collaboration among health care organizations, communities and among state and federal agencies. It seems that at the most basic level, health care reform is limited by capitalistic programs that have created an industry based on profits rather than on serving the needs of the population. Reform in this area is most likely to be the slowest to develop however.
In the meantime there are many things that healthcare organizations can do to encourage diversity. Among the suggestions offered by the articles reviewed include adoption of educational and training programs that emphasize the importance of a diverse approach not simply among employees and health care workers but also among the community at large. A unification of efforts between social workers and health care providers might be the first step in bridging the cultural and ethnic gap that currently exists among the healthcare community and among underserved populations.
Diversity is intimately tied to the field of Human Resources. For diversity to be widely adopted and successful in any industry, it must be embraced by HR Management, who has the obligation of dispersing initiatives and promoting diversity programs among top management and the community at large. HR can act as the driving force behind diversity program.
Diversity campaigns should also work on finding new avenues to increase public awareness of the healthcare crisis that exists among underserved populations, and provide avenues for relief and assistance to those populations most likely to be negatively impacted by a lack of quality health care, such as underserved populations.
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