Thesis on "Health Maintenance Organization Impact on the Minorities"

Thesis 50 pages (13949 words) Sources: 50

[EXCERPT] . . . .

HEALTH MAINTENANCE ORGANIZATION IMPACT ON THE MINORITIES COMMUNITY: HISPANICS, African-American AND LATINOS

The focus of this research study is the health maintenance organization impact on the minorities' community and specifically the communities of Hispanics, African-American and Latinos in the locations of New York City, New Jersey, Connecticut and Chicago. In recent years it has become increasingly clear that the U.S. .healthcare system is failing in making the same quality of care provision for ethnic minority populations as are made for the majority white population and the racial and ethnic disparities in accessing quality healthcare have been documented in research studies. It is reported that African-Americans experience the highest rates of mortality from heart disease, cancer, cerebrovascular disease and HIV / AIDS than any other U.S. racial or ethnic group." (Department of Health and Human Services and Institute of Medicine, 2003) In addition, Hispanic-Americans are reported to be "twice as likely as non-Hispanic whites to die from diabetes." (Department of Health and Human Services and Institute of Medicine, 2003) The reasons that these disparities in healthcare exist are stated to be "complex and poorly understood" yet reflected is socioeconomic differences, differences in health-related risk factors, environmental degradation and direct and indirect consequences of discrimination." (Department of Health and Human Services and Institute of Medicine, 2003) The purpose of this study is to examine the Health Maintenance Organization' impact on the Minorities Community: Hispanics, African-American and Latinos in the United States.

HEALTH MAINTENANCE ORGANIZATION IMPACT ON THE MINORITIES COMMUNITY: HISPANICS, African-American AND LATINOS

I. DESCRIPTION OF THE PROJECT

The focus of this research study is the health maintenance organization impact on the minorities' community and specifically the communities of Hispanics, African-American and Latinos in the locations of New York City, New Jersey, Connecticut and Chicago.

II. PROBLEM STATEMENT

In recent years it has become increasingly clear that the U.S. .healthcare system is failing in making the same quality of care provision for ethnic minority populations as are made for the majority white population and the racial and ethnic disparities in accessing quality healthcare have been documented in research studies. The Institute of Medicine reports that despite improvement at a steady pace in the overall health of the population in the U.S. "racial and ethnic minorities with few exceptions, experience higher rates of morbidity and mortality than non-minorities." (Agency for Healthcare Research and Policy, 2004)

It is reported that African-Americans experience the highest rates of mortality from heart disease, cancer, cerebrovascular disease and HIV / AIDS than any other U.S. racial or ethnic group." (Department of Health and Human Services and Institute of Medicine, 2003) In addition, Hispanic-Americans are reported to be "twice as likely as non-Hispanic whites to die from diabetes." (Department of Health and Human Services and Institute of Medicine, 2003) The reasons that these disparities in healthcare exist are stated to be "complex and poorly understood" yet reflected is socioeconomic differences, differences in health-related risk factors, environmental degradation and direct and indirect consequences of discrimination." (Department of Health and Human Services and Institute of Medicine, 2003)

III. PURPOSE OF THE PROJECT

The purpose of this study is to examine the Health Maintenance Organization Impact on the Minorities Community: Hispanics, African-American and Latinos in the States of New York, New Jersey, Connecticut.

IV. HISTORY AND BACKGROUND OF THE PROBLEM

African-Americans, Hispanics and Latinos have historically and traditionally failed to receive the same quality provision of healthcare that has been long afforded to white individuals. African-Americans and Hispanics are stated as less likely in receiving peritoneal dialysis and kidney transplantation and African-American and Hispanic patients with bone fracture seen in hospital emergency departments are less likely than whites to receive analgesia." (Department of Health and Human Services and Institute of Medicine, 2003) Racial and ethnic diversity in the United States increases constantly due to immigration and shifts in population making delivery of adequate health care to minorities difficult at best.

The work of Hilda L. Solis (2004) entitled: "Health Disparities: A Growing challenge in the Latino Community" states that an "alarming one in three Latinos is uninsured" and this is stated to be a higher percentage than any other racial or ethnic group." (Solis, 2004) It was reported in one study that more than 50% of all Latinos and nearly two out of five African-Americans had no insurance between 2001 and 2002 when compared to white individuals who were reported to be 25% without insurance. Solis (2004) states that as it would be expected "…being uninsured has serious consequences. Lack of insurance compromises the health of the uninsured because individuals receive less preventive care, are diagnosed at more advanced disease stages, and once diagnosed, tend to receive less therapeutic care and have higher mortality rates than individuals with health insurance. Uninsured individuals are less able to afford prescription drugs or follow through with recommended treatment. Predictably, the health status of the Latino population in the United States is greatly influenced by a lack of access to medical services." (Solis, 2004)

There are stated to be several diseases that "disproportionately impact Latinos" and these include:

(1) diabetes;

(2) HIV / AIDS;

(3) obesity;

(4) cardiovascular disease;

(5) cancer;

(6) asthma; and (7) others. (Solis, 2004) Obesity rates among Latinos in the U.S. are stated to have "more than doubled in 10 years…" (Solis, 2004)

Solis (2004) notes that the minority health disparities are complex and rooted in historical and contemporary inequities."

V. ORGANIZATIONAL CONTEXT/SCOPE OF THE PROBLEM

Disparities in health care as it relates to racial or ethnic minorities will be examined in this study which will be conducted through a qualitative process of reviewing literature in this area of study in order to better inform this study of the particulars of ethnic and racial healthcare disparities. This study will specifically examine the health organization impact on African-American, Latino and Hispanic communities and specifically in the states of New Jersey, Connecticut, New York.

VI. DEFINITION OF TERMS

(1) Health disparities - Differences in health across individuals in the population.

(2) Health Maintenance Organization - (HMO) A type of managed care organization that provides comprehensive medical care for a predetermined annual fee per enrollee.

(3) AAFP -- American Academy of Family Physicians

(4) CCOP -- Community Clinical Oncology Program

VII. SIGNIFICANCE OF THE PROJECT'

The significance of the research contained herein is the information and knowledge that will be added to the already existing knowledge base o research.

VIII. LITERATURE REVIEW

A. Disparities in Healthcare Provision

The Department of Health and Human Services and Institute of Medicine (2003)reports that some racial and ethnic minorities "experience higher rates of chronic and disabling illnesses, infectious diseases and mortality than white Americans." (Department of Health and Human Services and Institute of Medicine, 2003) In addition, Americans of racial and ethnic minorities are "significantly less likely than white Americans to possess health insurance. The problem is particularly acute among the working poor and individuals who have no employment-based insurance, and among whom minorities, particularly Hispanic-Americans are over-represented." (Department of Health and Human Services and Institute of Medicine, 2003)

The greatest barrier to care is posed by lack of private or employment-based health insurance and in fact it is held that insurance status is more likely than any other demographic or economic factor to determine the "timeliness and quality of healthcare, if it is received at all." (Department of Health and Human Services and Institute of Medicine, 2003) The work of the Department of Health and Human Services and the National Institutes of Health report entitled: "Minority-Based Community Clinical Oncology Program" (2004) states that when the African-American population is compared to the general population that African-Americans have "…an increased incidence of a number of malignancies and worse overall survival rates." (Department of Health and Human Services and the National Institutes of Health, 2004)

The report goes on to state that there is a need for "greater involvement in clinical trials research by Black, Hispanic, Asian-American, American Indian and other racial/ethnic minority patients…needed if the advances in clinical research are to be extended to all groups, and if the results of clinical trails are to be generalizable to the entire population. In general, there has been limited participation in clinical trials research by minority cancer patients." (Department of Health and Human Services and the National Institutes of Health, 2004)

The work of the AAFP entitled: "Principles for Improving Cultural Proficiency and Care to Minority and Medically-Underserved Communities" states that the managed care/health plan organization includes both public and private Health Maintenance Organizations (HMOs) should work in cohesion with physician and other health professional organizations "to ensure the development, evaluation, and diffusion of curricula, training, and education programs that address cultural proficiency, medically underserved communities, and health disparities." (AAFP, nd)

Health Maintenance Organizations are in need of cultural proficiency and the provision of high quality and easily accessible language services in order to enable access to and quality of services. In addition it is stated that "Both public and private HMOs and health plans should be asked to take explicit responsibility… READ MORE

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