Effective Disease Control and Prevention Initiatives for the Marginalized Groups

Effective Disease Control and Prevention Initiatives for the Marginalized Groups

In most societies, marginalized groups bear the greatest burden of disease. They experience higher infection, hospitalization, and mortality rates compared with other major groups (Baah     et al., 2019). These poor health outcomes can be attributed to social disadvantaging that makes it difficult for them to access various healthcare services. Advancement in healthcare research and recent healthcare reforms have done little in improving the treatment and prevention of disease among the marginalized communities (Ward et al., 2018; WHO, 2021). This is due to the fact that these efforts are disproportionately distributed among the groups. Under such circumstances, it is necessary to put in place effective measures that can help to prevent and control diseases among the marginalized. Such initiatives will play an important role in improving the health outcomes of these people.

Setting

The United States is home to various marginalized groups. These include racial minorities, the elderly, the disabled, mentally challenged, military veterans, GLBTs, commercial sex workers, drug users, refugees, rural populations, and the socio-economically disadvantaged (Pega et al., 2017; O’Donnell et al., 2018; Baah et al., 2019). All these marginalized groups are vulnerable to poor health outcomes. This is mainly due to the fact that many of them live in impoverished areas that are underserved by healthcare services and healthcare professionals (Pega et al., 2017). As a result, they rarely benefit from preventive and quality care services. A good example of these is the rural residents. It is also important to note that some of the marginalized people are sometimes discriminated against (Schimitz et al., 2019). An appropriate example is the GLBTs who normally face discrimination in the society as a result of their sexual orientation and gender identity.

Problem or Intervention

Majority of the marginalized populations suffer from chronic health conditions such as high blood pressure, diabetes, cancer, and stroke (Lopez III et al., 2021). They also get affected by infectious diseases such as human immunodeficiency virus (HIV) (Lopez III et al., 2021). Some grapple with untreated mental health problems such as depression and bipolar disorder (Schimitz et al., 2019). These health problems often intersect with social problems such as poverty, high level of illiteracy, and language barrier (Braveman et al., 2018; Lopez III et al., 2021). Since many of the marginalized people are poor, they cannot afford medical insurance that is required in order for them to access quality healthcare services. On their part, language barrier and illiteracy make it difficult for many people from these groups to follow important health information aimed at promoting prevention of various diseases that affect them.

Effect of the Problem/Intervention

The health disparities that marginalized groups encounter have adverse effects on their health outcomes and wellbeing. To begin with, their conditions subject them to severe medical problems and complications (Schimitz et al., 2019). This explains why there is a high mortality rate among these populations. Lack of health insurance prevents many from accessing basic medical services (Schimitz et al., 2019). This means that they are unable to access health services of high quality. Some marginalized groups are discriminated against in the healthcare system (Baah        et al., 2019). For example, most healthcare workers are often reluctant to provide healthcare services to GLBTs. Such a situation subjects these people to poor health outcomes. It is also important to note that some of the marginalized people reside in areas that lack enough healthcare workers and healthcare facilities (Robards et al., 2018). An example is those who live in remote regions. These people may not access even the most basic health services.

Significance and Implications for Nursing

The health of marginalized populations matters just like that of the rest of the Americans. Every person has the right to access basic healthcare services for better health outcomes (Stillwell et al., 2010; Arzouman, 2015). Therefore, it is important to address the issue of disease among the marginalized groups. This can be achieved through putting in place important initiatives that can help to prevent and control the various diseases that are common among these people. Such measures have important implications for nursing practice. Nurses have the mandate to ensure that every patient receives quality care services for improved health outcomes (Healthy People, 2020). Therefore, discriminating against marginalized populations is a demeaning factor that is likely to affect the profession of nursing in a negative way.

Solution and How It will Affect Nursing Practice

There are various strategies that can be used to promote disease control and prevention among the marginalized communities. To start with, establishing more healthcare facilities in the marginalized areas can help to improve access to healthcare services (Wheatley et al., 2017; Ward et al., 2018). The same case applies to deployment of enough healthcare personnel in these regions (Wheatley et al., 2017). Providing affordable health insurance can help to ensure that many people are covered (Braveman et al., 2018). This can in turn ensure that they benefit from quality services. It is also important to provide relevant health education which specifically targets the marginalized groups (Braveman et al., 2018; Ward et al., 2018). This can enable them to access vital healthcare information. Generally, making an effort to prevent diseases among the populations that are marginalized is an important task in nursing (Wheatley et al., 2017). Nurses have the responsibility to promote the health of diverse populations.

References:

Arzouman, J. (2015). Evidence-Based Practice: Share the Spirit of Inquiry. Medsurg Nurs, 24 (4):209, 211.

Baah, F. O., Teitelman, A. M., & Riegel, B. (2019). Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health – An integrative review. Nurs Inq., 26 (1): e12268. doi: 10.1111/nin.12268.

Braveman, P., Arkin, E., Orleans, T., Proctor, D., Acker, J., & Plough, A. (2018). What is health equity? Behavioral Science & Policy, 4 (1): 1-14. doi:10.1353/bsp.2018.0000.

Healthy People. (2020). Educational and Community-Based Programs. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/educational-and-community-based-programs

Lopez III, L., Hart, L. H., & Katz, M. H. (2021). Racial and Ethnic Health Disparities Related to COVID-19.  JAMA, 325 (8):719-720. doi:10.1001/jama.2020.26443

O’Donnell, P., Tierney, E., O’Carroll, A., Nurse, D., & MacFarlane, A. (2016). Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study. Int J Equity Health, 15 (197). https://doi.org/10.1186/s12939-016-0487-5

Pega, F., Valentine, N. B., Rasanathan, K., Hosseinpoor, A. R., Torgersen, T. P., Ramanathan, V., Posayanonda, T., Röbbel, N., Kalboussi, Y., Rehkopf, D. H., Dora, C., Montesinos, E., & Neira, M. P. (2017). The need to monitor actions on the social determinants of health. Bulletin of the World Health Organization, 95 (11), 784–787. https://doi.org/10.2471/BLT.16.184622

Robards, F., Kang, M., Usherwood, T., & Sanci, L. (2018). How Marginalized Young People Access, Engage With, and Navigate Health-Care Systems in the Digital Age: Systematic Review. Journal of Adolescent Health, 62 (4): 365-381. https://doi.org/10.1016/j.jadohealth.2017.10.018

Schimitz, R. M., Robinson, B. A., Tabler, J., Welch, B., & Rafaqut, S. (2019). LGBTQ+ Latino/a Young People’s Interpretations of Stigma and Mental Health: An Intersectional Minority Stress Perspective. Society and Mental Health. https://doi.org/10.1177/2156869319847248

Stillwell, S.,  Fineout-Overholt, E., Melnyk, B. M., & Kathleen, W. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question: A Key Step in Evidence-Based Practice. American Journal of Nursing, 110 (3): 58-61.  doi: 10.1097/01.NAJ.0000368959.11129.79

Ward, M., Schulz, A. J., Israel, B. A., Rice, K., Martenies, S. E., & Markarian, E. (2018). A conceptual framework for evaluating health equity promotion within community-based participatory research partnerships. Evaluation and Program Planning, 70: 25-34. https://doi.org/10.1016/j.evalprogplan.2018.04.014

Wheatley, L., Doyle, W., Evans, C., Gosse, C., & Smith, K. (2017). Integrated Comprehensive Care – A Case Study in Nursing Leadership and System Transformation. Nurs Leadersh, 30 (1):33-42. doi: 10.12927/cjnl.2017.25107. PMID: 28639549.

World Health Organization (WHO). (2021). Health promotion and disease prevention through population-based interventions, including action to address social determinants and health inequity. Retrieved from http://www.emro.who.int/about-who/public-health-functions/health-promotion-disease-prevention.html