Health Care

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Social Determinants of Health and Health Disparities African American Community

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Introduction

The African American community is among the less healthy communities in the United States with years of social and racial injustices and a great challenge to equitable health care. African Americans have been ranked as the second-biggest minority group in the United States. They have continued to live in unfavorable social and physical conditions that have failed to leaf healthy lives (Noonan, Velasco-Mondragon, and Wagner, 2016). African American society is exposed to difficult life experiences due to challenging environmental and social conditions that have a potential impact on their social and physical health. The health condition of African Americans shows a high prevalence of hypertension, diabetes, sexually transmitted infections, cardiovascular disease and diabetes. African American access to health services and health disparities are among the issues that are affecting the health condition of the African Americans. The African American experience is being influenced by the unaddressed social determinants which impact individual well-being among the African Americans. This paper will focus on the social determinants of health, the health inequalities, and interventions to reduce the well-being issues among the African American community.

Social-Ecological Model

The social-ecological model is considered a theory-based model for understanding, examine, and address the social determinants of health at different levels. The social-ecological model facilitates the move beyond focusing on individuals to understand a broad range of factors that impact the health outcomes of a society. This model offers an understanding of the social determinant of health and how to maintain health-associated problems. Therefore, the model can assist in offering interventions and a better understanding of the social problem across the various subsystems. Additionally, the social-ecological model illustrates the behaviors as well as the social influences that include the communities in which they live.

The conceptual model allows a relation of the social determinants with the individual determinants of health. The social-ecological model aims at transforming the reality that is reflected in the social and historical world for African Americans. These include the health condition of the population, the health issues, and the well-being outcomes that are effective in modifying the health policies and services among the health disadvantaged group.

Social Factors of Health

The social elements of health involve all the major factors that influence well-being disparities, which include racism, access to health care, socioeconomic status, Poverty, among others. Considerably, the social factors of health have impact the well-being needs and to health risks among the African American communities. The main social health determinants for the African American communities include racism, access to health care and healthy food, Poverty, and Violence.

Racism is considered as the belief that certain racial differences are the primary determinants of health capacities and traits and that the variations are brought about the inherent superiority of a specific race. For African Americans, racism is considered as an organized, systematic, and cultural concept through discrimination, prejudice, and exclusion as the source of health and social inequalities. Walker, Williams, and Egede (2016) conducted a meta-analysis to assess the social determinants and health disparities in the African American communities. The outcomes of the study indicated that race and ethnicity influence the health status of African Americans. Considerably, racism has been linked with substandard housing, employment, education, income as well as access to health services and lack of healthy foods.

Scott and Wilson (2011) conducted an ecological examination on social factors of health among the African American communities. The study results indicated Poverty had influenced the health disparities among African Americans as compared to other ethnic groups. Poverty is a primary reason for lacking basic human essential such as nutrition, adequate clean water, shelter, and clothing. African Americans are among the underprivileged indigenous set in the United States. Poverty among African Americans has been a strong social determinant of health since. Considerably, the lack of social capital has been one of the challenges since they are unable to access quality health.

Bambra et al., (2016) conducted a systematic review that revealed the social determinants of health and health inequalities. According to Bambra et al., (2016) shown how physical environmental factors have greatly impacted the health of various people. The physical environment includes air quality, topography, weather, and vegetation. The quality of housing and the environmental population have greatly influenced African American health and lives. For instance, asthma has been on the rise due to poor housing. Segregated housing has greatly impacted the cardiovascular disease. Relatively, the location has been a great social determinant of health among African Americans. They live in poor neighborhoods that have high rates of violence and homicide. Due to the poor neighborhoods, they lack benefits accrued, such as safety concerns in other neighborhoods.

Access to healthy food is a great social problem among African American groups due to the increased levels of Poverty. For in most African American neighborhoods, there are fewer supermarkets, thus a lack of fresh foods. Relatively, due to a lack of healthy food options, accessing fresh product has been a great challenge. For instance, vegetable and fruit consumption has fallen below the consumption level among the African American population due to the increased expense of accessing the health foods, lack of grocery service stores, and low income, which influence food purchase.

Health Inequalities

Diabetes is a serious health problem among African Americans. Diabetes complications have hit the African American communities harder with a large percent of people with diabetes in America being African Americans. More African Americans are developing Type 1 and Type 2 diabetes with a portion of older people diagnosed with diabetes increasing. 4.9 million African Americans or rather 19% of African Americans above the age of 20 have been diagnosed with diabetes (Chow, Foster, Gonzalez and McIver, 2012). The risk of diabetes among the African Americas is 77 percent higher than other non-Hispanic white Americans. There are various factors that contribute to increased diabetes rates, which include socioeconomic, psychosocial, biological behavior risk, and neighborhood factors. Over the years, African Americans have had high risks of type 2 diabetes. The prevalence of obesity, limited physical activity, genetic traits and insulin resistance, improper diet, socioeconomic position, and poor access to high-quality health care have increasingly contributed to the diabetes risk among the African American communities. African Americans have a higher risk of diabetic complications due to racial disparities and poor glycemic control.

Diabetes prevalence among African Americans was linked with the neighborhood and individual poverty status. Gaskin et al., (2014) examined the role of individual and neighborhood poverty as well as the racial composition to the prevalence of Diabetes among African Americans. The results of the study indicated that race-poverty had placed greater risks of health issues among African Americans. The study offered evidence that reveals the impact of racial composition and neighborhood poverty and their association with increased diabetes rates. Living in great poverty neighborhoods impacts the general health status and intensifies the odds of having Diabetes. The African Americans indicated high levels of Diabetes as compared to the white. Considerably, living in poor neighborhoods has increased the risks of Diabetes among African Americans. The African American neighborhoods have been characterized with low quality housing, lack of accessibility of physical and nutritional resources such as healthy food and risk factors such a food deserts. The neighborhood difference and racial compositions have increasingly facilitated Diabetes.

Intervention to Reduce Health Disparities

The opportunities for healthy choices among neighborhoods, homes, schools, and workplaces can have an effective impact on the improvement of health among African Americans. Interventions to reduce the health disparities among African Americans should be focused on the social factors of health among the African American community. Such strategies and interventions will improve population health and low health disparities. Interventions that target African Americans should include improve lifestyle behaviors, lower the socio-contextual barriers such as the convenience of healthy foodstuff, and access to resources and employment (Thornton et al., 2016). For instance, delivery health tailored programs to specific individuals to address access to care, discrimination, and quality care will be essential approaches that will reduce social determinants such as increased Poverty.

Interventions that address social determinants such as policies and social structures, including early childhood education, community development, policy development, and implementation, will address the health disparities among African Americans. For instance, policies such as the Patient Protection and Affordable Act need to be established to increase the affordability, accessibility and increase in health care. Such policies can improve health protection among African Americans by decreasing healthcare costs and enhancing the quality of care. Educating and informing the African Americans will also enable the community to use the health services better. This is because having good health literacy enables them to make appropriate health decisions, reading the medicine instructions, completing insurance and medical forms as well as communicating with the health providers.

Several strategies that encourage increased access to healthy foods and equitable access to food alternatives such as opening supermarkets and attracting them to the underserved neighborhoods and selling healthy foods at lower prices will facilitate access and enable healthy eating patterns among the African Americans. For instance, distance and transportation impact access to healthy foods among low-income communities. Therefore, having large chain supermarkets can reduce the health disparities among the African American communities.

Conclusion

In summation, African Americans are experiencing significant health disparities due to poor health, racial discrimination, and environmental exposures. The social-ecological models have illustrated how the social factors of health are connected to the health disparities among the African American communities. Special emphasis has been made on the social determinants of health, such as Poverty, physical environment, racism, lack of access to healthy food, and Diabetes as a major health disparity among the African American communities. To reduce the health disparities among African Americans, interventions, and strategies such as policy development, improvement of social structures and community development have been considered as inherent superiority in improving the health conditions among African Americans.

References

Bambra, C., Gibson, M., Sowden, A., Wright, K., Whitehead, M., & Petticrew, M. (2010). Tackling the wider social determinants of health and health inequalities: evidence from systematic reviews. Journal of Epidemiology & Community Health, 64(4), 284-291.

Chow, E. A., Foster, H., Gonzalez, V., & McIver, L. (2012). The disparate impact of diabetes on racial/ethnic minority populations. Clinical Diabetes, 30(3), 130-133.

Gaskin, D. J., Thorpe Jr, R. J., McGinty, E. E., Bower, K., Rohde, C., Young, J. H., … & Dubay, L. (2014). Disparities in Diabetes: the nexus of race, Poverty, and place. American journal of public health, 104(11), 2147-2155.

Noonan, A. S., Velasco-Mondragon, H. E., & Wagner, F. A. (2016). Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public health reviews, 37(1), 12.

Scott, A., & Wilson, R. F. (2011). Social determinants of health among African Americans in a rural community in the Deep South: an ecological exploration.

Thornton, R. L., Glover, C. M., Cené, C. W., Glik, D. C., Henderson, J. A., & Williams, D. R. (2016). Evaluating strategies for reducing health disparities by addressing the social determinants of health. Health Affairs, 35(8), 1416-1423.

Walker, R. J., Williams, J. S., & Egede, L. E. (2016). Influence of race, ethnicity, and social determinants of health on diabetes outcomes. The American journal of the medical sciences, 351(4), 366-373.