Today, in our world one of the biggest issues that have risen amongst health care activist in the United States is how health disparity and inequality has affected rural areas and culture. However, it is important to keep in the back of our minds that this is not a problem that only exists in the U.S., it is a worldwide concern. Health disparity is taking an in depth look at the differences in health status between different social groups, gender, race, ethnicity, education, income, disability, and sexual orientation. While on the other hand, health inequalities is taking a look at the unjust and unfair treatment one gets because of their socioeconomic status and demographic area in which they are part of. Having such a wide array of difference in health inequality and disparity is what also contributes to the United States ranking in the bottom of industrialized western nations when it comes to life expectancy rate, and infant mortality rate. Finding ways to close the gap between life expectancy from one race to the other may greatly contribute in making the U.S rank as one of the top nations in the western part of the world. The conditions in which people live have a profound influence on their health. Difference in health between individuals and population groups exist in all societies. For example younger age population generally have good health compared to elder population. This kind of health difference cannot be concluded as health inequality because it is natural. So the question is that when the difference in health becomes inequality? According to Graham the difference in health between population groups becomes inequality when it is linked to the inequalities in their position in society (2007: 99). World Health Organisation appointed Committee for the Social Determinates of Health (CSDH) also hold similar view as not all health inequalities are unjust or inequitable. If good health were simply unattainable, this would be unfortunate but not unjust. Where inequalities in health are avoidable, yet are not avoided, they are inequitable (2008: 14). So the differences in health between groups having unequal position in society become an ethical issue. Evidences of the existence of health inequality are abundant. If we consider life expectancy as an indicator, resent evidences show that there exist significant differences in health between world regions (see Appendix 1). Life expectancy at birth varies between 78.8 years in the higher income OECD countries to 46.1 years in Sub Saharan Africa. Life expectancy improvement over the period 1970-75 to 2000-05 shows that life expectancy has increased all regions in the world except the former Soviet Union countries. It can observe that the increase was not similar in all regions. Life expectancy increased almost 10 years in developing regions over that period while in Sub Saharan Africa the increase was only about 1 year. Inequalities in health not only exist between countries or regions. Even within the country health inequalities exist. A study in the Scottish city of Glasgow found that life expectancy of men in one of the most deprived area was 54 years while that most affluent area was 82 years (Hanlon, Walsh & Whyte 2006, cited in CSDH 2008). Men with the lowest life expectancy in the United States of America in 1997 2001 had lower life expectancy than that of Pakistan average in 1995 2000 (CSDH 2008). Studies show that socio-economic status affects health. Differences in life expectancy at birth by social class in England and Wales from 1972 to 2005 shows that it has improved for all classes during the period 1972 -2005 (both males and females). Surprisingly the same difference in life expectancy existed in 1972 between social class was found existed still in 2005 (see Appendix 2 and 3). Even in health behaviour difference exist between socio-economic classes. Percentage males and females smoke in England and Wales during 2001-07 period shows that smoking rate is comparatively higher among lower occupational classes (see Appendix 4). Whitehall II study which investigates the health of British civil servants between the age 20 and 64 found that mortality rate is high among low occupational classes (see Appendix 5). In some cases there have been findings that when it comes to certain diseases and long term hospitalization, infants whom their parents are of different social class or race are treated differently and are cared about differently than kids that are Caucasian, or not minorities. While doing my research for this project I was amused to find out the inequality and disparity comes down to this level that even infants are cared for differently because they belong to a certain minority group. As I have stressed out in my paper and continue to do so, I really believe that everyone should have equal access to health care regardless of their differences. In one of my articles it takes and in depth look at how children’s asthma hospitalization and urban areas in Texas are different. Grineski mentions, “It talks about how poor children are dispropriately affected as they have higher asthma prevalence rates (and more servere asthma) than non poor children.” I found this to be a very interesting finding that areas where poor children and non- poor children were living would affect their health. This could be because of several reasons, for one it could be because of the demographic area or the type of housing conditions in which these infants live in. All these factors could play a big part in contributing to the findings that kids in rural areas are more probable to get Asthma. However, there are also many other factors that also contribute to health disparities. There are socioeconomic factors that include the individual’s race, ethnicity, the kind of education they may have, and the kind of income they earn annually that also contribute to the individual’s health.As mentioned earlier, the individual’s health may allow him/her to receive a different treatment from another individual whom is of a different race. For example, John, an African American male, goes to see his doctor because he has been coughing for a week and wants to get checked out. Instead of giving John all the different tests, the doctor would just give him medicine and tell him he just has a cold or flu, yet if it is a white male they would probably give him a thorough check up to see what was really wrong with the individual, and then give that person the necessary medication they need. Also, ethnicity brings an additional dimension to health disparity. As mentioned earlier, when it comes to health care for minorities they generally have a harder time getting the kind of care they need, especially ones that live in the rural areas. Baer mentions that, “Health disparity research suggests that ethnic minority groups like African Americans, Latinos, and Native Americans suffer a triple burden in seeking health care: 1. They are significantly less likely to have health insurance than whites, and so accessing care is a major challenge, and while adequate acute care is hard enough to come by, preventive care is all but impossible for those who are insured” The kind of education one has also contributed to the gap between health inequalities between individuals. The more education one has the longer they live, and the healthier life style they have. This is mostly due to the fact that the higher education you have the higher income one may get, and the better education one may get the more likely the individual may have a good job with great security which helps to provide financially for their families. Individuals in rural areas have been accustomed to receive unfair health care attention that people that live urban areas in the United States are used to recieving. As mentioned earlier in my paper this not only a problem in the United States but a problem that is effecting millions of other continents around the world. Joyce and Bambra state that, “Despite overall improvements in health outcomes since the second world war, health inequalities between the best and worst of society are persistent in developed nations and in some in some instances are continue to widen” As a community how can we address health inequality and disparity in our communities to help this stigma get away? Studies have definitely shown that they are minor improvements that have taken place over the years, but never the less, as a community we have a lot of work to be done. Hartley mentions, ” Recent trends in rural health research and policy suggests that effective policy interventions must be based on differences among rural regions. “When arguing for progressive rhetoric for rural American, “rickets noted that Urban-Rural comparisons.” One of the first things I think we need to do as a community is first try to improve our rural areas. The next step I believe we should do as a country is have a universal health care program in place where everyone will be able to have insurance for every citizen in the United States. In making health insurance accessible to every one in the United States any person will be able to receive the health care they need. An additional thing we as a community need to do in order to address health inequality and disparity is to have more hospitals in the rural areas and not just in the urban areas. We need to have hospitals and clinics more accessible to them. So if they need to see the doctor they do not need to make a fifteen to twenty minute drive they can have it right in their neighborhood. I firmly believe education is the key to removing health inequality and disparity from our communities. The better we educate individuals that are of a different race, socioeconomic status, and ethnicity, the more adequate a person knows about how to live a healthy life style and eat properly. We need to get them to exercise more in order to live healthier, and also educate them about the effects of smoking cigarettes and what it causes. For example, have health fair programs that will tell them how smoking can cause lung cancer, and many other chronic diseases, and also better educate them how drugs and sharing needles can affect one’s life style and cause many diseases such as HIV-which is a very serious epidemic that is killing millions of people in our world today. Also having different organizations that are pro-health that would go into the different rural communities and talk and mentor individuals on what they can do to live a good and healthier life would be a great asset in educating individuals. Another way for us to draw the gap when it comes to health and inequality is to create more jobs for individuals, so that they will be able to work and support their families. In doing this it will give them something to stress less about, which in turn will help individuals to be stress free. As mentioned earlier in my paper, stress causes a lot of health issues which can lead to different cardiovascular heart problems, effect once growth, diabetes, and hypertension which are all various disease one can get from living a healthier life style. So hopefully creating more jobs in rural communities may be able to create a less stressful life for individuals. Improving the environment are also ways in which we can address health disparity in our communities and country. For us to take the next step in which we can overcome health disparity and inequality is to clean up the rural areas. They should be cleaned up, they should also have access to clean water to drink, and tap water should be sterilized to certain standards to meet the States regulations. Also fountains and lakes should be monitored and kept clean, having clean water is important in other for mosquitoes and other parasites to not take over rural communities.
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