health care in women

Healthcare Quality and Disparities in Women

Jing Tian
Mercy College
Undergraduate Program (RN to BSN)

NURS 362 JHA
Fall 2012

Abstract
Health disparities can be defined as inequalities that exist when members of certain population groups do not benefit from the same health status as other groups. Health disparities can usually be identified along racial and ethnic lines, indicating that African Americans, Hispanics, Asian Americans, and Native Americans have different disease and survival rates from other populations. Such disparities however can also extend beyond race to include areas such as access to healthcare, socio-economic status, gender, and biological or behavioral factors.

As reviewed from the Agency for Healthcare Research and Quality web site

http:// www.ahrq.gov/. This paper is going to describe the health care quality and

disparity in women versus men, relationship between these disparities. Health disparities

refer to differences between women versus men. These differences can affect how

frequently a disease affects on women and men, how many people get sick, or how often

the disease causes death. Many different populations are affected by disparities. AHRQ

includes women in their priority population, because women have unique health care

needs or issues that require special focus. In addition to analyses in the NHQR and

NHDR, AHRQ supports research on all aspects of health care provided to women,

including enhancing the response of the health system to women’s needs, understanding

differences between the health care needs of women and men, understanding and

eliminating disparities in health care and providing evidence to inform women in their

health care decisions.
Women and men have many of the same health problems, but they can affect women differently. The Agency for Healthcare Research and Quality (AHRQ) supports a vigorous women’s health research program, including research focused on CVD and other chronic illnesses. AHRQ supported projects are addressing women’s access to quality health care services, accurate diagnoses, appropriate referrals for procedures, and optimal use of proven therapies. Recent statistics show significant differences between men and women in survival following a heart attack. For example, 42 percent of women who have heart attacks die within 1 year compared with 24 percent of men. The reasons for these differences are not well understood. We know that women tend to get heart disease about 10 years later in life than men, and they are more likely to have coexisting chronic conditions. Research also has shown that women may not be diagnosed or treated as aggressively as men, and their symptoms may be very different from those of man who are having a heart attack. Women are more likely than men to experience delays in emergency department care for cardiac symptoms. Researchers examined time to treatment for 5,887 individuals with suspected cardiac symptoms who made a call to 911 in 2004. They found that women were 52 percent more likely than men to be delayed 15 minutes or more in reaching the hospital after calling 911. A delay of 15 minutes or more in heart attack treatment has been shown to result in measurably increased damage to the heart muscle and poorer clinical outcomes. Factors increasing the likelihood of delay included distance, evening rush hour travel, bypassing a local hospital, and transport from a more densely populated neighborhood. Also in another study, postmenopausal women with metabolic syndrome are at increased risk for a cardiovascular event. Researchers used data on 372 postmenopausal women to investigate the effects and usefulness of applying two competing clinical definitions of metabolic syndrome to identify women at high risk of future heart attacks or stroke. Overall, women who met at least one of the definitions for metabolic syndrome were significantly more likely to experience a cardiovascular event than those who did not, and there was no difference between the two definitions in their predictive ability. The task force has issued a recommendation that women between the ages of 55 and 70 should use aspirin to reduce their risk for ischemic stroke when the benefits outweigh the harms for potential gastrointestinal bleeding.
Underserved women face numerous barriers to develop effective health-promotion interventions for underserved women, barriers specific to the individual need should be addressed.
Influenced by individual characteristics, experiences, and culture, different types of barriers
(internal, interpersonal, and environmental) can overlap to impede healthy eating in underserved women. On the basis of literature review and qualitative research experiences with underserved women, 4 potential approaches for addressing barriers to health promotion were identified: (1) individualizing interventions; (2) developing collaborative partnerships within the community; (3) using positive deviance inquiry to build on community assets; and (4) changing public policy.
How is gender implicated in our exploration of health disparities? This review paper examines the ways in which gender intersects with other health determinants to produce disparate health outcomes. An overview of salient issues including the impact of gender roles, environmental exposures, gender violence, workplace hazards, economic disparities, the costs of poverty, social marginalization and racism, aging, health conditions, interactions with health services, and health behaviors are considered. This review suggests health is detrimentally affected by gender roles and statuses as they intersect with economic disparities, cultural, sexual, physical and historical marginalization as well as the strains of domestic and paid labor. These conditions result in an unfair health burden borne in particular by women whose access to health determinants is--in various degrees--limited. As a healthcare provider, I think that the Affordable Care Act will help reduce these health disparities by making improvements in 1) Preventive care, 2) Coordinated care, 3)
Diversity and cultural competency, 4) Healthcare providers for underserved communities, 5)
Ending insurance discrimination, 6) Affordable insurance coverage.
Summary
In order to prove quality and to reduce disparities require measurement and to reporting, but these are not the ultimate goals. The fundamental purpose of improvement in health care is to make all patients' and families' lives better. The NHQR and NHDR concentrate on tracking health care quality and disparities at the national level, but the statistics reported in the reports reflect the aggregated everyday experiences of patients and their providers across the Nation. It makes a difference in people's lives when breast cancer is diagnosed early with timely mammography, when medications are correctly administered; and when doctors listen to their patients and their families, show them respect, and answer their questions in a culturally and linguistically skilled manner.
AHRQ includes women in their priority populations, because women have unique health care needs or issues that require special focus. In addition to analyses in the NHQR and NHDR, AHRQ supports research on all aspects of health care provided to women, including enhancing the response of the health system to women's needs, understanding differences between the health care needs of women and men, understanding and eliminating disparities in health care, and providing evidence to inform women in their health care decisions.

Reference
Http://www.ahrq.gov/qual/nhqrurll/nhquwomen11.htm
Http://www.nlm.nih.gov/medlineplus/womenshealth.html/
Http://www.uspreventiveservicestaskforce.org/uspstf/uspsasmi.htm.