Health Inequities and Disparities

by Angela Richard-Eaglin, DNP, FNP-BC, CNE, FAANP

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    00:05 Okay, so continuing on the focus of why this is important? Health inequities is a big reason.

    00:12 So what happens is that we determine based on bias sometimes and status.

    00:16 How we're going to distribute resources to different people or groups of people based on multiple different things, social conditions they live in or born in, grow, live, work, age, when we think about the determinants of health, right? Why did that happen? Well guess what, It happened as a result of those structures we talked about earlier, when we talk about structural racism.

    00:38 And I do like to broaden that because it has gone way beyond racism.

    00:43 There are several isms that create health inequities.

    00:47 And also phobias.

    00:48 So when we talk about -isms and -phobias, what am I talking about? Racism, classism, sexism, elitism, ableism, lots of different things that going back to that word of relegation, where we relegate people to a lesser than space, and we somehow decide people don't deserve equal rights and access to these resources.

    01:12 So the here come the health inequities.

    01:14 So case in point, sometimes it's even based on flawed research.

    01:19 When we think about how some of these health inequities show up as a result, especially as a result of race.

    01:27 When we don't think about race being a social construct, then we create certain myths.

    01:33 A prime example of that is using the estimated glomerular filtration rate, which is a test that's used to determine how well your kidneys are functioning.

    01:44 So that test, there was a study done in which black people were assigned a different value in terms of what the value arranges for normal, as opposed to non black people.

    01:58 And what happens is it relegates black people into a different space where it falsely shows that their results are higher than other people who are non black.

    02:11 So it prevents black people from getting on that transplant list sooner rather than later.

    02:17 And then what happens oftentimes, is that by the time their numbers reach the standard, for the non black people, it's too late because they're too sick to be on there, based on that flawed number.

    02:29 The reason why that number is flawed is because these researchers decided that black people have larger muscle mass than white people or everybody else.

    02:39 That's absolutely not true.

    02:41 There's no scientific or biological basis for that.

    02:45 So that's just one prime example of health inequities and unfair distribution of resources.

    02:52 And we'll talk about more of those things throughout this series.

    02:55 So another key concept for us to understand and look at is health disparities.

    03:01 Well, health disparities are higher burdens of illness and injury, and disability, and unfortunately, mortality experienced by one group relative to another.

    03:12 Now that could be a direct correlation to racism when we think about the maternal mortality rate.

    03:19 And it doesn't even matter when we think about people like Serena Williams, who is rich.

    03:24 So when we think about classism, it doesn't even matter how much money you have when people allow their biases to get in the way of health care what can happen.

    03:33 And you know, that stories widely publicized, if you want to look deeper into that, but people lose their lives all the time because of -isms and biases.

    03:44 And I mentioned phobias earlier, xenophobia, homophobia, transphobia.

    03:48 Going back to in the space of health care, when you decide to become a health care provider, you decide to take care of humans, regardless of all of that stuff.

    03:59 It doesn't matter what you believe.

    04:00 You decide that you're going to treat people with respect and dignity.

    04:04 And then when we talk about health care disparities.

    04:08 That's another big problem that I've seen a lot of in my almost 30 years of practice.

    04:13 So the differences in how we treat people based on their ability to pay an insurance coverage, right? We see those patients Bill of Rights all the time.

    04:22 Bills of rights rather in those hospitals all the time in clinics, right? It says that we're going to provide care to people regardless of their ability to pay, in general.

    04:33 That's what it says.

    04:34 Well, it doesn't say we're going to decrease the quality of care we're going to provide, but we see it all the time.

    04:40 We see providers avoiding certain tests, because people can't pay for it.

    04:46 Well, the first thing I want to just be frank and say is it doesn't come out of our pockets. It has healthcare professionals.

    04:53 And I think that our primary responsibility is to see this as a service and not a business.

    05:00 People hate to hear me say that but I'm always going to say it because humans first.

    05:05 So I need to treat every single human being that I come into contact with that respect for human life and dignity, and compassion, and mercy, and focus on the service of this.

    05:16 So if I would order a test for the richest man in the world who came in here with symptoms of XYZ, and then this person who does not have a home comes in and they have the exact same symptoms, I'm going to order the exact same test.

    05:31 Why? Because every human deserves the right to optimal health care and optimal health outcomes.

    05:37 So healthcare disparities, lead to sentinel events.

    05:42 What are sentimental events? Home cost to patients basically even resulting up to death.

    05:47 We'll talk about that a little more in the series too.

    05:50 But these disparities occur as through acts of omission and commission.

    05:55 So just keep that in mind.

    About the Lecture

    The lecture Health Inequities and Disparities by Angela Richard-Eaglin, DNP, FNP-BC, CNE, FAANP is from the course Introduction to DEIB.

    Author of lecture Health Inequities and Disparities

     Angela Richard-Eaglin, DNP, FNP-BC, CNE, FAANP

    Angela Richard-Eaglin, DNP, FNP-BC, CNE, FAANP

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