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Transcription
The speaker discusses the disparity in healthcare experienced by Asian patients in hospitals. They highlight the contributing factors of social determinants of health, such as education access and quality, economic stability, neighborhood and built environment, healthcare access and quality, and social and community context. They provide data and statistics to support their points, emphasizing the importance of addressing these factors to reduce the disparity. They believe that improving health literacy and promoting open dialogue between patients and healthcare providers can lead to better healthcare outcomes. Hello, Dr. Bundy, and thank you for listening to my first-ever podcast. For information purposes, I used the NHQDR site as a source of data information for the disparity and also used information from the U.S. Department of Health and Human Services regarding social determinants of health found at health.gov. The measure I selected is adult Asian hospital patients who strongly disagree or disagree that staff took their preferences and those of their family and caregiver into account when deciding what the patient's discharge healthcare would be. Asians are 73% away from reaching the benchmark target of 62.7%, proving there's definitely an existing disparity. Let's go through the contributing factors of each of the five social determinants of health, starting with education access and quality, language, and literacy. In the U.S., the language barrier created by limited English proficiency is not just a hurdle but a daily struggle for individuals seeking healthcare services and understanding health-related information. Individuals with English as a second or third language, like my mom, face negative health impacts due to institutional barriers, such as a shortage of well-trained interpreters and culturally competent healthcare providers. It is so important to start learning language and reading skills from an early age, and the proportion of fourth graders with reading skills at or above the proficient level for Asian students in the U.S. was 58.7 in 2017, down to 56.7 in 2019. Economic stability. Having a stable job is really important to improve our overall health and prevent us from being poor. Even when people have a job, sometimes they still don't make enough money to cover all the health-related expenses they need. Helping people afford basic necessities like food, housing, healthcare, and education can go a long way in reducing poverty and improving overall health and well-being. As far as economic stability, data was not specific for Asians, but most recent data for employment and working-age people for 2022 is 71.3%, with a target goal of 75%. Neighborhood and built environment. In the U.S., a considerable number of individuals reside in communities that are plagued by elevated levels of violence, as well as unsafe air and water. Studies have shown that racial and ethnic minorities and individuals with low incomes are more likely to reside in areas that are at higher risk for various potential hazards. As far as reducing health and environmental risk from hazardous sites, most recent data from 2022 shows 85% of hazardous sites where human exposure is known to be under control, with a target goal of 87.3%. I believe addressing these last two social determinants of health would result in reducing the disparity. We'll start with healthcare access and quality, health literacy. Having a good understanding of your health and knowing how to take care of it is crucial for maintaining good health. By prioritizing health literacy, organizations can help create a level playing field in healthcare where individuals are empowered to make informed decisions about their health. According to Health.gov, in 2017, 35.2% of Asian reported their healthcare providers always involved them in decisions about their healthcare as much as they wanted, compared to 41.9% in 2020. This shows progress. However, the target is 62.7%, so there's a lot of room for improvement. In addressing the disparity, evidence shows that most people want to participate in making decisions about their health. Shared decision-making leads to higher patient satisfaction and better health outcomes. Social and community context, the connections and exchanges individuals have with their loved ones, colleagues, and community can significantly affect their overall health and happiness. In addressing the disparity, social support is when someone has people in their life they can talk to and get help from when they're going through a tough time. According to Health.gov, in 2017, 90.2% of Asians reported they talked to friends or family members about their health, but went down to 78.5% in 2020. To wrap this up, social support within the community can make individuals feel comfortable and inclined to discuss and share what's going on in their lives, not just with their family and friends, but with their healthcare providers as well. When a patient is able to share information about their health and concerns, the healthcare team gains a better understanding of the patient's needs. This open dialogue helps the patient and healthcare staff work together to achieve optimal health outcomes. That's why I believe to reduce the disparity, addressing the social and community context, and helping Asians talk more would improve health literacy, resulting in greater openness to healthcare staff, and that would result in improved healthcare access and quality.
