by Jennifer Rottenberg, BTC Student
At Community of Hope’s Family Health and Birth Center (FHBC), they are having an unusual problem. A birthing center for low-income families, FHBC has seen a rise in privately-insured women over the past three years, and has struggled to attract the low-income women it aims to serve. FHBC has negative birth outcomes that are half the national average. However, the African American women, particularly those of low income whom have the worst birth outcomes, are not taking advantage of the high-quality healthcare option being offered to them. The problem at FBHC highlights the issue of health care disparities that is very prevalent in the United States.
In this blog post, I propose creating a social media platform for hospitals in low-income and racially diverse areas, where people affected by health disparities could discuss patient care, services provided, and outcomes– first, an overview of the issue of health care disparities in the U.S.:
What are Health Care Disparities?
Health disparities are the gaps in the quality of health and health care between groups, whether they are racial, ethnic, or socioeconomic. These disparities can be at the level of the sickness itself, the care that is obtained, or the outcome of the treatment. In the United States in particular, health disparities have been noted across minority populations, who compared to whites have higher levels of chronic diseases, higher mortality, and inferior outcomes. Some statistics:
- Cancer is 10% higher in African Americans than whites (News Medical).
- Infants born to black women are 1.3 to 3 times more likely to die than those born to women of other races (Hansen, 2014).
- African Americans and Latinos have twice the risk as whites of developing diabetes (News Medical).
- African American children have a rate of hospitalization for asthma that is 4 to 5 times higher than the rate for white children (Kaiser, 2008).
These health disparities should not be viewed in the context of the biological health of different races, but rather the racial inequalities in the quality and quantity of healthcare.
Factors that contribute to Health Disparities
A study by Dr. Justin Dimick at the University of Michigan aimed to determine the cause of health disparities. Prior evidence had shown that care for black patients were concentrated at poor quality hospitals, which could be the cause of higher morality rates after surgeries. Dimick researched the reason behind why black patients ended up at these poor-quality hospitals, which was previously thought to be because of them living in neighborhoods with low level hospitals closest. Dimick found that contrary to popular opinion, black patients are actually more likely to live near high-quality hospitals, but they bypass these institutions to receive care at lower-quality hospitals. In other words, despite access to better quality healthcare, black patients tend to choose lower-quality hospitals due to familiarity and comfort level at receiving care at institutions they had gone to in the past. Imagine being told you need treatment for a condition—you would be nervous and scared. It is more comforting to go to the place you know, rather than a new and intimidating environment. In additions, doctors who work in black communities tend to refer patients to “minority-serving” hospitals. Disparity is also seen for low-income patients, who are not taking advantage of premium care that is being made available to them. Thus, Dimick’s study sheds light on why FHBC has struggled to attract low-income African American patients.
Addressing Health Care Disparities
In this past year, Washington, D.C. has introduced legislation that establishes a commission on health disparities in order to examine the problem and advise on how best to address the issue. Currently, there is little consensus on what to be done. On a policy level, suggestions include raising awareness so that service providers are aware of the problems, and expanding health insurance coverage in order to allow black patients to receive timely and routine care (AMA). Dimick suggested improving referral patterns, as evidence showed that doctors are referring black patients to low-quality hospitals (Jha, 2013). By making these doctors aware of the outcomes of these hospitals, they would be less likely to refer patients there, and thus the patients would receive better care. In addition, efforts can be made to improve the low-quality hospitals themselves, through standards of care and penalties through poor performances. Unfortunately, this option does not seem likely if the hospitals do not have the resources to improve their care.
Using Social Media to Solve This Issue
The methods described above focus on solving the problem of health disparity through policy, doctors, and hospitals—on the services, rather than the people. However, it is clear that the problem does not just lie with services—it lies with the people being directly affected by the discrepancy. In order to reach these people, social media can be utilized.
Take the example of FHBC: their birthing clinic is not attracting the low-income African American clients they aim to. However, if the clients were aware of the benefits of FHBC, they would be more willing to utilize it as a source for healthcare. Using social media, FHBC could reach out to their target clients using tweets, facebook posts, even emails that advertise their clinic. FHBC would be able to see a larger increase in the low-income patients they aim to serve, and these patients would see an increase in their health and healthcare.
A large part of the health disparities stems from racial inequalities that cause black patients to remain with traditionally minority serving hospitals that have poor-quality services. Using social media, these patients can be targeted to increase their awareness of their options by illustrating statistics, comparing hospitals in the area, and providing a network that would allow them to feel more comfortable in these new situations. Social media provides not only a means of distributing information, but also a means for people receiving the information to discuss it and communicate.
Therefore, I propose creating a social media platform for hospitals in low-income and racially diverse areas, where people affected by health disparities could discuss patient care, services provided, and outcomes. Specifically, a community Facebook page where people can share their experiences would be extremely helpful for those looking for hospitals where they can receive higher level treatment, along with feel comfortable through the support of others who had been at the hospital before. In addition, hospitals could use twitter accounts to become more involved and welcoming to the low-income communities around them. Using social media to both make people more aware of their options and be comfortable utilizing them would allow us to see quicker and more efficient changes than legislation and hospital improvements, which are timely and don’t directly engage the people.
It is possible for health disparities to be reduced, if the people being affected by these disparities are made aware of the resources available to them. Using social media, we can see a decrease in health disparities and an increase in the health of the nation.