Addressing Healthcare Disparities in Minority Communities: The Role of an APRN

QUESTION

This week’s reading looks at Biosocial Theory, which is largely characterized by the linking of psychosocial factors to physiology, genetics, and evolution (Smith & Hamon, 2021). The theory itself examines the interaction between social and biological aspects of human experience and behavior. The biosocial theory has several underlying assumptions such as families playing a significant part in human development and having an impact on the modern family, and that biosocial impacts can be both biological and social in nature (Booth et al., 2000). According to the theory these variables are not determinants of human conduct but can create limitations as well as opportunities of growth for families.

In Shajani and Snell (2019) specific family life cycles are associated to particular types of attachments that make up the developmental category of the Calgary Family Assessment Model (CFAM). To describe the diversity found in family development, the CFAM speaks on six types of family cycles that are labeled Middle-class North American, Divorce and post-divorce, Remarried, Professional and low-income, Adoptive, and Lesbian, gay, bisexual, queer, intersexed, transgendered, and twin-spirited (Shanjani & Snell, 2019). The focus this week is on the Middle-Class North American family life cycle which is further broken into six stages of family development. Each stage is associated with a task of completion that members might go through in the stage, looking at types of attachments found throughout that stage for family development. The six stages are launching of the single young adult, marriage: the joining of families, families with young children, families with adolescents, launching children and moving on, and families in later life. All the stages describe a period of transition which isn’t an identified traumatic experience, but as phases of development experienced by a family. The ideal goal is by understanding the family life cycle a provider would have a more patient specific concept of a family that would reflect how a patient’s culture, ethnicity, gender, race, and sexual orientation influence their family’s development.

An example of how important it is to account for cultural experiences of population groups on family development can be seen in Asian American communities in relation to homelessness. According to the 2019 U.S. Census Bureau there are nearly 18.9 million or 6 percent of the total population is Asian American, with California having the largest population concentration at 31 percent (U.S. Department of Health & Human Services, 2023). While the 2019 U.S. Census Bureau reported the Asian American median household income being near $93,759 per year, nearly 9.6 percent of Asian Americans compared to 9 percent of non-Hispanic whites live at the poverty level. The Asian American community is comprised of several subcultures that are often categorized together, however economic status can significantly vary from across the Asian American community.

In a recent article researching homelessness among Asian and Pacific Islanders (APIs) it was highlighted that while there is increasing attention to racial disparities in the homeless population, but research in homelessness among APIs is rare despite their rapidly growing populations (Chang et al., 2023). The purpose of the study was to look at the causes of death among APIs who were identified as being homeless in Santa Clara County compared to other racial groups. One associated cause to the lack of attention to APIs homelessness is due to the perceived low national numbers of homeless. However, it has been reported that in regions or cities that have large Asian and Pacific Islander populations the percentages of APIs who are homeless being higher than the national averages. According to the 2022 Point-in-Time-Count, which is a bi-annual estimate of homeless count and demographics, APIs account for 12 percent of the homeless population in San Francisco, and 9 percent in San Jose (Applied Research, 2022). In comparison to other ethnic groups, the number of APIs suffering homelessness has increased at an unprecedented rate nationally, with rates of Asian unsheltered homeless and API sheltered homeless groups expanding faster in recent years (United States Department of Housing Urban Development, 2017). Considering the wide range of subcultures that comprise fall into what is considered the Asian American community it is important to recognize that even with these identified rises in numbers there are limitations to how estimates are obtained from any homeless populations, as they are often relied upon by people who are homeless having contact with service providers (Chang et al., 2023). In conjunction with the homeless population, APIs who are unhoused suffer from lack of access to services, services available often don’t account for language barriers, and the community is less likely to receive welfare services as a community (Chang et al., 2023).

As of 2022 Los Angeles City and County has the largest homeless population in the United States with an estimated 65,111 individuals identified as homeless (Department of Housing and Urban Development, 2023). It is also important to note that the homeless population is further categorized by being sheltered and unsheltered homeless, which based off the individual’s access to a consistent sheltering.

Reading of how invisibility has played a role in resources being made available in the Asian America communities:

What other causes do you see playing a role in meeting the needs of the Asian American community or other minority communities?

How have you seen in your current experiences’ minority groups be underserved in healthcare?

What resources do you see yourself being able to give as an APRN to address disparities in healthcare that you see?

ANSWER

Addressing Healthcare Disparities in Minority Communities: The Role of an APRN

Introduction

In this discussion post, we will explore the causes of healthcare disparities in minority communities, with a particular focus on the Asian American population. We will discuss the factors that contribute to underserving minority groups in healthcare and the role that Advanced Practice Registered Nurses (APRNs) can play in addressing these disparities.

Causes of Healthcare Disparities in Minority Communities

Cultural and Linguistic Barriers: Language and cultural differences can create barriers to accessing healthcare services for minority communities. Limited English proficiency and unfamiliarity with the healthcare system may prevent individuals from effectively communicating their needs or understanding their treatment options.

 Lack of Culturally Competent Care: Healthcare providers may lack cultural competence, which is essential for understanding and respecting the unique beliefs, values, and healthcare practices of minority communities. This can lead to miscommunication, mistrust, and inadequate healthcare delivery.

Socioeconomic Factors: Socioeconomic disparities, such as lower income levels, limited access to insurance coverage, and inadequate healthcare infrastructure in underserved areas, contribute to healthcare disparities. Minority communities often face higher rates of poverty and limited resources, making it challenging to access quality healthcare services.

 Implicit Bias and Stereotyping: Implicit biases held by healthcare providers can lead to differential treatment and poorer health outcomes for minority individuals. Stereotypes and preconceived notions may influence the delivery of care, resulting in disparities in diagnosis, treatment, and overall healthcare experiences.

 Underserving of Minority Groups in Healthcare

In my current experiences, I have observed various ways in which minority groups are underserved in healthcare:
 Limited Access to Care: Minority communities may face geographical barriers, lack of transportation options, and shortage of healthcare facilities in their neighborhoods, leading to limited access to timely and comprehensive care.

Health Literacy and Patient Education: Language barriers and low health literacy levels can impede the understanding of health information, medication instructions, and self-care practices. Limited patient education resources tailored to specific cultural and linguistic needs can further contribute to disparities.

Disproportionate Disease Burden: Certain health conditions, such as diabetes, cardiovascular diseases, and certain types of cancers, disproportionately affect minority communities. However, access to preventive screenings, early interventions, and specialized care for these conditions may be limited.

APRN’s Role in Addressing Healthcare Disparities

As APRNs, there are several resources and strategies we can employ to address disparities in healthcare:
Culturally Competent Care: APRNs can undergo cultural competence training to better understand the unique needs, values, and preferences of minority communities. By providing culturally sensitive care, APRNs can establish trust, improve communication, and enhance patient outcomes.

Language Access Services: APRNs can advocate for the availability of professional interpretation services to ensure effective communication with patients who have limited English proficiency. Utilizing trained interpreters or culturally appropriate translated materials can bridge the language gap and improve patient-provider interactions.

Community Outreach and Education: APRNs can engage in community outreach programs to promote health education, disease prevention, and early intervention in minority communities. Partnering with community organizations, offering health screenings, and providing culturally tailored educational materials can empower individuals to take control of their health.

Collaboration and Advocacy: APRNs can collaborate with interdisciplinary teams, community leaders, and policymakers to address systemic barriers to healthcare access and advocate for policies that promote equity and eliminate healthcare disparities. This can involve participating in initiatives that increase funding for healthcare resources in underserved areas or advocating for health equity in legislative forums.

Conclusion

Healthcare disparities persist in minority communities, including the Asian American population. Understanding the causes of these disparities and recognizing the role of cultural, linguistic, and socioeconomic factors is essential. As APRNs, we can contribute to reducing healthcare disparities by providing culturally competent care, advocating for language access services, engaging in community outreach, and collaborating with stakeholders to address systemic barriers. By embracing a patient-centered approach and actively working towards health equity, APRNs can help improve the healthcare experiences and outcomes for minority communities.