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Health disparity in cardiovascular diseases.

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Assignment 2

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Health disparity in cardiovascular diseases.

Health disparity is the difference in the quality of health and health care between different groups of people. The differences include the number of people with the disease, the severity of the disease, how frequent the disease results in complications, the mortality rate of the disease, health care access, and how many people can access screening for the condition. The different groups of people are on the basis of race, ethnicity, disability, gender, geography, income, level of education, and immigrant status. Cardiovascular diseases (CVD) are one of the areas experiencing health disparity. CVDs are a group of disorders that affect the heart and blood vessels like coronary heart disease, cerebrovascular disease, and rheumatic heart disease, just to mention a few. Determinants such as poverty, stress, and hereditary factors influence cardiovascular disease. Healthcare providers need to understand the diverse groups and the factors associated with the distinguishing difference like culture and ethnic groups. Additionally, understanding the health care literacy challenges concerning CVD patients can impact the treatment approach required.

The determinants of health entail the conditions that people are born into grow work, live, and age that shapes up their lives and impact their health. According to the World Health Organization (WHO, 2020), determinants of health encompass the social, physical, and economic environment and the persons’ behavior and characteristics. The main determinants of cardiovascular diseases are social, economic, and hereditary. These factors influence the risks and health disparities attributed to cardiovascular diseases. They particularly impact the number of people with CDV, the mortality rate, and the development of complications resulting from the conditions.

The social determinant of cardiovascular diseases includes race, ethnicity, social support, residential environment, and culture. There exists a variation of the rates of heart diseases among people from various backgrounds. The primary drive for the race and ethnic influence CVD is the burden of poor health services among minorities. Studies indicate that blacks are more prone to succumb to CVD compared to their white counterparts. Additionally, evidence point to the bias of healthcare providers that contributes to the problem. The professionals’ exhibit attitudes with racial bias that influences the type of services and care processes offered to CVD patients, impacting the quality of care given to minorities. Social support entails the exchange of positive emotions between the patient and the health care provider. The role of social support is to ensure better services. Diseases vary across time, place, and person.  Studies show a link between social support and mortality rates of CVD. Several show a connection of CVD outcomes to the residential environment of a person. The physical environments with features like proper access to resources and sound transportation systems have higher CDV instances compared to disadvantaged neighborhoods. They are thus indicating the impact of residential areas on the risks of developing CDV.

The economic determinants that influence the risk of developing cardiovascular diseases include the level of education, income, and employment. The level of education determines several CVD outcomes for a particular individual. Studies show that lower levels of education result in a high prevalence of cardiovascular risk leading to higher mortality rates from CVD. Low levels of literacy among persons with lower education levels are one of the reasons as to why there are higher CVD rates among them. The low health literacy indicates that the persons have no information on risk factor control and self-care behavior that would result in better health outcomes. The impact of income on CVD development is that high levels of income reduce CVD mortality rates by 40% to 50%. Families with higher income can access better medical care and afford to buy quality foods that reduce the risk factors of developing cardiovascular diseases. Finally, occupational status significantly influences the levels of blood sugar, cholesterol, and blood pressure, all of which are vital in the development of CVD. Studies show that people with higher status jobs stood at a lower risk of developing heart diseases compared to small status jobs. Moreover, involving duties is also associated with a lower risk of CVD.

Lastly, the characteristics of the individual are the most significant determinants that influence the risk of CVD development. Heredity of the individual determines the development of several disease outcomes. Hereditary factors like diabetes, obesity, and high blood pressure influences the risks for cardiovascular diseases by increasing the susceptibility of the individual. These factors play a synergic role with social and economic factors to result in an elevated risk for CVD. Hereditary factors are not specific for a particular race or ethnic community. They are embedded in all the other determinants and can present a challenge in determining their influence on the development of CVD in individuals. However, they present a very vital factor that influences the occurrence of heart diseases.

Cardiovascular diseases are the leading cause of morbidity and mortality in industrialized countries, accounting for higher than 33% of total deaths. Predictions of the prevalence of CVD in the United States prognosticates to rise by 10% between 2010 and 2030. The burden of CVD is significantly high in several countries across the globe, with a notable loss for most countries, especially industrialized countries. The estimated cases of CVD in 2015 were 422 million, with 18 million deaths globally. The leading deaths resulted from ischemic heart disease, followed by a stroke. The mortality rates are higher in men compared to women. In 2017 in the United States, approximately 2 813,503 resulted from CVD. About, 82million people are living with one form of cardiovascular disease. The diseases affect persons age 15 and above. The disease burden has decreased over the years among different populations and communities. However, the presence of health disparities significantly impacts the efforts directed towards controlling and treating CVD.

Cultural considerations are an aspect of social determinants for CVD. The implications of culture tie-up with linguistics and result in poor cardiovascular health in disadvantaged groups. Most immigrants and refugees have limited proficiency in English, impacting their communication on health-related services. Culture is a belief system based on a particular way of living that is unique for a precisely definable group of people and passes down generationally. With that definition in mind, it is essential to note that cultural inclinations impact the aspect of prevalence and treatment of illness differently.  For instance, it is common to find Mexican American farmworkers with uncontrolled type 2 diabetes mellitus due to their cultural beliefs. Some of them believe that God is preventing the progression of the disease, while others are firmly devoted to the practice of family or communal eating despite their dietary regulations. Their belief in folk illness terms like susto, a term that indicates a startling experience that caused the asustado to lose his vitality and fall ill or coraje are the primary factors that increase their susceptibility and serve as determinants that influence the development of CVD.

Health care literacy is the ability to obtain, internalize, and interpret necessary health information with an understanding that can result in making proper health decisions.  The health care literacy challenges faced by persons affected with CDV serves as a foundation for the increased susceptibility.  Only 36% of adults in the United States have basic and below basic health literacy concerning cardiovascular diseases, and it cuts across different ages, races, ethnicity, and gender. The challenges segment into the various aspects of health literacy, including challenges associated with obtaining information, processing and understanding information, and utilizing the gathered information. The difficulty of obtaining information could result from an inability to perform basic reading tasks, interact and appropriately communicate about health and failure to seek health-related information. Individuals experience difficulty in accessing healthcare services due to insurance papers and multiple documents they have to access and analyze given their necessary literacy skills.

Moreover, the affected individuals with low literacy levels cannot easily access health education materials available on the internet. Processing and understanding information could be a challenge mainly due to the medical jargon. Physicians communicate to patients using medical terminology that is, at times, confusing to people with higher levels of education. A person with little literacy skills will not be in a position to ask for clarification basing on their limited understanding. Comprehending multiple sources of medical information can prove complex for cardiovascular disease patients, especially if the information does not present consistency. The final challenge on interpretation and utilization is specifically tricky as the affected population could lack the need to feel obligated to make a health-related decision.

Additionally, they may lack the confidence and guidance to navigate through the health systems to achieve successful self-care. They also cannot comprehend the scheduling and dosage details that are vital for treatment due to the complex information and use of numeric values. The impact of health care illiteracy is significant as it undermines the efforts dedicated to achieving adequate and quality health services.

Lowering health disparity is an essential goal for every health care system providing services to patients. The impact that results from focusing on eliminating health disparities will result in a reduction of cardiovascular disease burden. Although more research to further the understanding of the role of some determinants in promoting the risk factors for CVD, the need for treatment regimes that focus on attaining health care literacy is necessary. The epidemiology of CVD and the high mortality rates serve as a significant burden that needs elimination. It is paramount for health care service providers to seek out new ways that will tackle the significant challenges that result from health care illiteracy to ensure better services for all. The areas to concentrate on include physician-patient communication, verification of patient understanding, and use of interpreters to mitigate the language barrier. The role of culture in influencing risk factors for CVD needs mitigation via the creation of awareness and educating communities on health care and its importance. Generally, eradicating health disparities require adamant and aggressive efforts that will yield better services to underserved and at-risk populations and communities.

 

 

 

 

 

 

Graham, G. (2015). Disparities in cardiovascular disease risk in the United States. Current cardiology reviews11(3), 238-245.

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Magnani, J. W., Mujahid, M. S., Aronow, H. D., Cené, C. W., Dickson, V. V., Havranek, E., … & Willey, J. Z. (2018). Health literacy and cardiovascular disease: fundamental relevance to primary and secondary prevention: a scientific statement from the American Heart Association. Circulation138(2), e48-e74.

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