Discussion: Health Promotion in Nursing Care

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The American healthcare system is faced with the great challenge of inequality which displays a disproportionate impact on marginalized communities, including people of color (Boyd et al., 2020). Such inequalities are the reason behind the gaps in the acquisition of health insurance coverage, leading to uneven access to care services and poor health outcomes among the minority populations. Additionally, studies show that African Americans are significantly impacted by these inequalities contributing to the high prevalence of chronic conditions such as hypertension and diabetes, in addition to the increased mortality rates among this minority population. This discussion provides an analysis of the health status of African Americans, as part of the minority population, in comparison to the national average.

Health Status of African Americans

African Americans make up approximately 13.4% of the United States population. The current health status of black Americans displays an increased prevalence of chronic conditions such as hypertension, obesity, cardiovascular diseases, sexually transmitted infections, and diabetes as compared to whites. Increased morbidity and mortality rates among African Americans have been associated with several economic and social factors. For instance, studies show that African Americans have a more likelihood of not seeing a doctor when they are sick, as a result of high healthcare costs (Yearby, 2018). Despite the significant advances in the current healthcare system in the U.S., there is still evidence reporting that racial and ethnic minorities such as black Americans still receive a lower quality of care services leading to poor health outcomes as compared to the whites. As of 2019 August, it was reported that approximately 68 million people had been covered by the Medicaid program, with black Americans accounting for 20%. Given that most black Americans have lower social and economic status, they tend to be poorer than other demographic groups, hence making it harder for them to enroll in health insurance programs like Medicaid.

Health Disparities

The death rate among African Americans has declined by about 25% over the past 17 years precisely for populations above the age of 65 years, as reported by the Centre for Disease Control and Prevention (CDC). However, studies also show that young African Americans have a higher probability of dying at an early age as a result of increased risks for stroke, heart disease, cancer, pneumonia, diabetes, and HIV/AIDs among other conditions, as compared to their white counterparts. Social factors common among this minority group contributing to the above-mentioned health disparities include unemployment, smoking, alcoholism, obesity, sedentary lifestyle, and poverty among others (Bell et al., 2020). Consequently, this group of individuals is also faced with nutritional challenges such as unfavorable nutritional environments, food deserts, food swamps, and food insecurities. For instance, black Americans are associated with poverty and a low level of education, which makes it hard for them to access quality and healthy foods as compared to the economically rich racial majorities. They end up consuming fast foods, among other unhealthy foods, which increases their risk of cardiovascular conditions and obesity.

Barriers to Health

            Various barriers to the accessibility of quality health care services have been identified for the African American population. Predominating barriers include decreased understanding of care plans, inability to pay for care services, lack of transportation to care facility, and the inability of incorporating the recommended health care plans into their routine daily living pattern. These barriers are associated with several cultural, educational, socio-political, and socioeconomic factors. For instance, cultural beliefs among African Americans promoting unhealthy eating habits and sedentary lifestyle, in addition to failure to follow up on routine screening, negatively affects their overall health and utilization of healthcare services irrespective of their social or financial status (Lewis & Dyke, 2018). Consequently, the low socio-economic status among African Americans in terms of low income, unemployment, low education level, and occupation status is also a significant inhibitory factor towards accessibility to quality healthcare services. Lastly, as part of the minorities, blacks in the U.S have limited political influence towards the development of appropriate policies such as the “Obama Care,” to promote their access to quality care services.

Health Promotion Activities

With regard to the numerous health disparities affecting African Americans, several health promotion activities have been proposed over the years to help promote the health and well-being of this minority group. The self-help initiative was introduced among African Americans to promote taking personal responsibility for their health and improving their quality of life. Self-help health promotion practices among black Americans include routine screening for predominating health conditions, physical exercise, healthy diet plans, adoption of recommended care plans, and disease prevention practices at home (Fletcher et al., 2018). Consequently, for the religious members of the community, faith-basedorganizationslike churches have promoted structural health promotion activities including education, health fairs, and smoking cessation among others.

Approach for Health Promotion and Disease Prevention

            One of the most effective approaches that can be utilized by African Americans in promoting their health as part of the care plan is the adoption of Pender’s health promotion model. According to the CDC, black Americans are at high risk of chronic diseases, with cardiovascular diseases being the leading cause of death among this group of individuals. Health promotion practices focusing on lifestyle modification have displayed great significance in reducing the risks of cardiovascular diseases. Pender’s health promotion model, on the other hand, provides a foundation promoting the examination of the background influences of this minority population, in line with the health promotion practices that can lead to a healthy lifestyle (Fletcher et al., 2018). At the primary level, this model encourages regular exercise and a healthy diet to prevent chronic diseases and promote healthy living. At the secondary level, the model promotes routing screening for hypertension, diabetes, and cancer among other common diseases. Lastly, at the tertiary level, the model promotes education programs and rehabilitation among the affected individuals.

Cultural Beliefs and Practices

Other than social and economic factors, several cultural factors among black Americans must be considered when developing the most effective care plan. Some of such cultural beliefs include lack of trust in complementary medicine, misconceptions about immunization, and strong religious beliefs against organ donation among other medical procedures. With the theory of cultural humility, clinicians can now come up with flexible care plans, while still upholding the patients’ cultural values and beliefs (Boyd et al., 2020). This theory is based on the importance of preventing cultural discrimination and promoting the equal provision of care to the culturally diverse population.

Conclusion

Health promotion practices are crucial among the general population in disease prevention and improved quality of life. Minority populations such as African Americans, are faced with numerous health disparities as compared to the whites, hence the need for more health promotion activities. However, when coming up with a care plan for this minority population, it is necessary to identify and respect their cultural values and beliefs to promote positive outcomes.

 

 

References

Bell, C. N., Sacks, T. K., Tobin, C. S. T., & Thorpe Jr, R. J. (2020). Racial non-equivalence of socioeconomic status and self-rated health among African Americans and Whites. SSM-population health, 10, 100561.https://doi.org/10.1016/j.ssmph.2020.100561

Boyd, R. W., Lindo, E. G., Weeks, L. D., & McLemore, M. R. (2020). On racism: a new standard for publishing on racial health inequities. Health Affairs Blog, 10(10.1377). https://doi.org/10.1377/hblog20200630.939347

Fletcher, G. F., Landolfo, C., Niebauer, J., Ozemek, C., Arena, R., & Lavie, C. J. (2018). Promoting physical activity and exercise: JACC health promotion series. Journal of the American College of Cardiology, 72(14), 1622-1639. https://doi.org/10.1016/j.jacc.2018.08.2141

Lewis, T. T., & Van Dyke, M. E. (2018). Discrimination and the health of African Americans: The potential importance of intersectionalities. Current Directions in Psychological Science, 27(3), 176-182. https://doi.org/10.1177/0963721418770442

Yearby, R. (2018). Racial disparities in health status and access to healthcare: the continuation of inequality in the United States due to structural racism. American Journal of Economics and Sociology, 77(3-4), 1113-1152. https://doi.org/10.1111/ajes.12230