Addressing Health Disparities: Evaluating Public Health Initiatives

Introduction

The experience by other classes of higher burdens of illness, injury, disability and mortality has been a poison to the efforts geared towards improving the outcomes of healthcare provision services. Such health disparities have not been clearly understood in terms of root-cause analysis and evidence-based strategies for curbing the same. Health disparities have seen a dramatic upsurge over the past few decades. Thus, it has become the concern of most federal governments across the globe to eliminate inequality in health care. As made clear earlier, various factors contribute to health disparities in different countries and different health care settings. For instance, various social disadvantages such as poverty, racial discrimination, and ethnicity are but a few of the causative factors (Bloland et al., 2012). Lately, it has come to light that various stakeholders equally have a hand in either contributing to or eliminating health disparities in the various health settings. Health systems can address this in various ways (Bloland et al. 2012). The link between societal classes and health disparities is not a new agenda. The various social disadvantages equally bring about balance in the community by creating different individuals (Bloland et al. 2012). The problem is not a matter of less concern. It thus needs the application of evidence-based suggestions that can be applied in curbing the problem. The identification of the root cause of health disparities calls for detailed research. There is also a huge gap of literature since most appropriate evidenced-based strategies for curbing health disparities lacks. However, the level of their vitality is unmatched. Consequently, this paper aims to discuss and appraise the role of the local, national, and international public health programs, health directives, and health initiatives in the context of inequality in health care provision.

Roles of local public health programs

Basically, health inequalities reflect the difference in access to a range of curative, promotional, preventive, and palliative health services. These are a result of multiple determinants. However, all of this is avoidable and preventable even though they are unjust and unfair. Different levels of the underlying social disadvantage under the subcategories of wealth, power, prestige, and even other social stratification matters have been identified as the primary cause of health inequalities (Sadana & Blas, 2013). In that effect, addressing health inequality would mean addressing social disadvantages. Local public health programs have a significant role in seeing the efforts of eliminating health inequalities a success. Consequently, they have a lot to address the problem of health inequalities turning to a global concern in health institutions. Firstly, local public health programs have a call to promote nondiscrimination and equal opportunity in access to health care services (Sadana & Blas, 2013). By doing so, they will need to outline clearly the right to access health care services equally by individuals regardless of race, gender, or ethnic differences.

Secondly, local health care programs have the role of linking health outcomes with SDH and other varied social goals (Sadana & Blas, 2013). The social goals should be ones that promote and encourage the well-being of the general population. Besides, the social goals should address duty-bearers and the government's responsibilities as the primary members of a nation. Also, intergovernmental organizations should be enhanced by the social goals linked to health outcomes (Sadana & Blas, 2013). Undoubtedly, local public health programs are vital to the elimination of health inequalities resulting from social disadvantages. Also, local public health programs can be aligned to incorporate the principles of equal healthcare and nondiscrimination into the frameworks and practice of public health (Sadana & Blas, 2013). They should also input uniform weight on achieving improvements for a nation's overall health regardless of the various social factors.

Local public health programs should ensure that health is distributed to measure the performance of the health systems in terms of equality. To attain fairness in healthcare provision, local public health programs should ensure documentation of the health care inequalities apart from just identifying them. After doing this successfully, the programs should then advocate for an appropriate corrective measure besides ensuring that the action is guided by evidence-but and health ethics (Sadana & Blas, 2013). Local public health programs should recommend providing essential health services such as medicines and antenatal care visits by every individual (Sadana & Blas, 2013). Basic public health interventions such as access to clean water and sanitation should be the goal of every local health program.

Eliminating health disparities calls for a conceptual framework that could shed light on the broader determinants of health and the various ways in which health is distributed. This should not be exclusion to local public health programs. Local public health programs have the role of illustrating pathways through which health outcomes and distribution are affected by the social determinants of health. Besides, they need to clarify the linkage between the various determinants of health and how they distribute to health inequalities within the distinct societal classes (Sadana & Blas, 2013). Local public health programs to operationalize the monitoring and assessment of health disparities. Local public health programs should ensure that individuals with different health services needs are accordingly and different from others with distinct needs. Besides, patients with equal health needs should be treated similarly (Sadana & Blas, 2013). They should be seeking government intervention in providing basic services, resource redistribution, and human rights protection such as the right to equal health services, sanitation, and safe water (Sadana & Blas, 2013).

Roles of national public health programs

Most of these programs base their focus on the treatment and vulnerability of distinct societal classes. The national public health programs should exploit the potential for synergies to intervene on common social determinants of health disparities. Besides, national public health programs need to improve the levels and distribution of health in general and for different conditions through an upstream action. Besides, these health programs should nationally identify the various factors that make a change in health disparities difficult (Sadana & Blas, 2013). Managerial challenges should also be identified by national public health programs through appropriate adjustments and redesigning. National public health programs should document the relevance of the social determinants approach to the prevention and control and the reduction of health inequalities.

National programs should identify knowledge gaps in society about health inequalities. Besides, they should commit to implementing policies that would reduce health inequalities (Sadana & Blas, 2013). By using the current knowledge in existence, national public health programs can yield improvements in reducing health disparities. They should synthesize research and apply observational evidence and already evaluated innovations to formulate the evidence-based and most appropriate interventions for reducing health inequalities (Sadana & Blas, 2013).

National public health programs should promote the education of healthcare providers. They are the key contributors to healthcare outcomes. As a result, their skillfulness and competency are very important. Consequently, national public health programs should make it their goal to provide training services to healthcare providers. In so doing, quality healthcare providers will be ensured in different contexts (Sadana & Blas, 2013). The socially disadvantaged individuals will not be left out either. Thus, national public health care programs have a vital role in the avoidance and elimination of already registered health inequalities.

Roles of international public health programs

These can be categorized as either being per a residual welfare state model, targeting the disadvantaged, or even a universal model that addresses the global population. International public health programs should use the structural fund's process to deal with health inequalities. In doing this, they should engage the health systems at all levels (Sadana & Blas, 2013). They should also ensure that health systems remain updated on evolving processes. Strengthening health systems is also a key to managing health disparities in health care institutions. This is the role of international public health programs (Sadana & Blas, 2013). From general programs like those of the millennium development goals to specific public health programs, they have a great duty in the context of health inequality. International public health programs should ensure that critical and strategic information on health disparities is available to assess the prevalence of the same globally. Scientifically relevant epidemiological information is vital to any health care improvement program (Sadana & Blas, 2013). Apart from ensuring care is provided to individuals, international public health programs should also ensure that the most appropriate kind of care is provided to the right people in the most appropriate way and of importance, at the right time (Sadana & Blas, 2013). Undoubtedly, these are governed by scientific evidence, which is the duty of international public health programs to ensure.

International public health programs should equally ensure the strengthening of important health institutions and public health infrastructure. This contributes significantly to the improvement of public health systems. These systems are the key to generating scientific data. As a result, ensuring its efficiency ensures the avoidance of health disparities (Sadana & Blas, 2013).

Disease treatment and prevention guidelines and responding to health emergencies equally in different sections of the world are greatly encouraged and promoted by various international public health programs. The CDC has strived to globally improve the health systems across the globe (WHO, 2010). This is an example of a public health program that is working to eliminate healthcare disparities as they offer health services to all classes of people worldwide regardless of the various distinctive social health determinants.

Most dedicated healthcare institutions worldwide are working together to ensure that health care services reach all walks of life. Public health has been termed to compose various programs that are overshadowed by the healthcare ministries' responsibilities across the world (Bradley et al. 2016). The various international public health programs need to establish clearly defined mandates of public health and focused objectives to eliminate inequalities in health care provision (Bradley et al. 2016). Also, the programs need to ensure the establishment of independent international level entities that cat in the interest of all regardless of social disadvantages. These will also adapt the diversities in health priorities, thus protecting the citizens from real health biases.

International public health programs should also assist various countries in preparing for public health emergencies in social disadvantage (Sadana & Blas, 2013). These areas are usually affected by natural and human-made disasters, outbreaks of diseases, and other diseases that are unnecessarily infectious. This is an area of great concern for public health. Infrastructural development in such areas should be among the top goals of international public health programs. For instance, they should establish a trained response staff, laboratory capacity, collection, and transfer system for biological samples.

Alongside the infrastructural development role, international public health programs should establish strong public health laboratory networks equally in a nation to ensure equal access to such health services (WHO, 2010). The laboratories are essential for conducting various surveillance essentials to the voidance of an increase in morbidity and mortality due to health inequalities due to social disadvantages (Sadana & Blas, 2013). Besides setting the laboratory network, the programs also need to offer maintenance of the laboratories. International public health programs should aim at attaining and maintaining quality and standard healthcare for all.

Healthcare providers are the cornerstone of attaining quality in healthcare provision. Consequently, international public health programs should target to build a skilled and capable workforce. Undoubtedly, the success of any health system is greatly reliant on the skillfulness of the workforce. The workforce should be competent and well trained. They should be equally distributed to different geographic locations to ensure equity in healthcare services provision (WHO, 2010). The program should also implement other important public health programs that would assist in achieving a common goal. These can be local, national, or even international public health programs. The programs can also support critical and applied research in the social determinants of health disparities.

Roles of health directives

Health directives allow legal decision making in place of another person. In the context of health inequality, health directives are useful in medical conditions whereby better health decisions can be made on behalf of socially disadvantaged individuals (Vergallo, 2020). These decisions usually involve dilemmas such as whether or not to undergo a surgical procedure, go into or out of a life-supporting unit, whether to be administered to some medications or not and other critical medical decisions (Vergallo, 2020). Social disadvantages such as illiteracy terms someone unfamiliar with various aspects of the medical field. Consequently, health directives play an important role as critical conditions can be made on behalf of such individuals.

Health directives are important in eliminating health disparities to disadvantaged individuals as better decisions are usually made on their behalf. An example of a health directive is the "do not resuscitate order." A person usually gave this directive if they do not want to be revived, for example, in a heart attack or comatose condition (Vergallo, 2020). There are also the advance directive registries where one can record a healthcare directive that can be put to practice in critical instances. Changing a healthcare directive is a possibility. Apart from the various public healthcare programs, healthcare directives are also important to avoid healthcare disparities in healthcare settings and on socially disadvantaged individuals (Vergallo, 2020).

Roles of health initiatives

Health initiatives greatly influence global health systems. Health initiatives are of different levels: these ranges from a local level to national and international health initiatives (WHO, 2018). Lately, various health initiatives have come into action. These have mostly been successful in achieving and marinating coordination in healthcare. The quantity of healthcare services being provided nationally and internationally has also been escalated by the emergence of various health initiatives (WHO, 2018). Undoubtedly, this is a big step to eliminating health disparities. Health initiatives thus a big role in ensuring that health inequalities are a thing of the past; health initiatives need to expand services by encouraging healthcare providers to work harder and longer hours. In so doing, many people are served equally, including those who are socially disadvantaged. These health initiatives also need to ensure sustainability and balance between support programs, care, prevention, and treatment.

Conclusion

Health inequalities have been an area of concern for many healthcare providers, as well as the patient. Various social determinants of health contribute directly or indirectly to the same. Various implications can be useful in eliminating these health inequalities. Various public health programs have been found to play a vital role in the context of health disparities. These include local public health programs, national public health initiatives, international health initiatives, health directives, and health initiatives. Local programs operate in small vicinity like a sub-district but can always be backed up by national programs. With the local programs, services are extended to socially disadvantaged individuals, thus curbing health disparities. Besides, national and international also influence the process of curbing health disparities, as discussed in this paper. Health directives and initiatives are not exclusion to having a role in curb health inequalities. More research should be done on the topic to adequately detail the roles that local, national and international public health programs, health initiatives, and directives play in the processes of eliminating health inequalities that are led to by social disadvantages.

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