Chronic Illness in Minorities and Low-income Communities in The United States

Introduction

As of 2005, there are 133 million Americans who had at least one chronic illness (Bodenheimer, Chen, Bennett 2009). This number is overwhelming and has only been increasing to this day. One’s quality of life exponentially decreases when battling a chronic illness as they are in constant pain. Not only do these people suffer physically but mentally as well with the accompanying factors related to their disease. Those who do not speak fluent English may not be able to fully understand how to help prevent some diseases even if a medical professional is talking to them. There can be stigmas attached to certain diseases, such as HIV, which may prevent those from getting early treatment. The experience of those with chronic disease, including those around them, can have an effect on them personally and can significantly affect how they proceed in managing the associated disease

The encumbrance of chronic illness is getting worse and is more prevalent in minority and low-income communities. Their situation can put a great burden on those who not as fortunate to have good health care if any health care at all. There need to be policies established to help these people cope with whatever disease that they have. Prevention and management of chronic illness is an important factor in maintaining a good quality of life. In this paper we will go over studies and experiences related to chronic illness in minorities and low-income communities (Mosack, Abbott, Singer, Weeks, Rohena 2005).

Method

I chose this topic because for the past year my mother has been battling a chronic illness, transverse myelitis, which is an inflammation of the spinal column. One day, she suddenly began to loose feeling below her shoulders and was rushed to the hospital. After a month in the hospital and rehab she came home. A year later she is doing much better but she still cannot not walk correctly and has constant nerve pain. I see her struggling every day even though she is fortunate enough to have excellent health care and support.

This lead me to think about how those who do not have great health insurance, or any at all, deal with such crippling illnesses. There is a serious correlation between minorities/low-income communities and chronic illness. This can be related to the lack of prevention knowledge and management of the disease. The process of finding information on the topic was easy as there are many articles and studies based on it. With minorities and low-income communities often being immigrants, they may not be informed about how we treat diseases in their illness in the United States, as they are not fully assimilated yet. Some of these articles their experiences make it obvious that there is a significant problem with how they deal with chronic illnesses (Charmaz 2006).

The studies that are observed for this paper include those that use tools to analyze the distribution of environmental hazards and which populations are the most vulnerable among those who live in California (Cushing, Faust, August, Cendak, Wieland, Alexeeff 2015). This can be useful when attempting to determine if low-income or minority communities truly are more at risk than others. Another study compares the experiences of three immigrant groups and evaluates their health-seeking behaviors (Choi 2003). This can be used to determine how different groups of people see primary and preventative care, to ensure that everything is being done to make sure they are taken care of. Another study attempts to get every policy field on board with promoting health (Gelormino, Melis, Marietta, Costa 2015).

Other studies try to assess the individual feeling of vulnerability that is associated with familial risk (Walter, Fiona, Emery, Jon, Braithwaite, Dejana, Marteau, Theresa 2004). The experience of the family members of those with chronic diseases affect how the relatives cope with the risk that they have a chance of being in the same position. Another study studies the World Health Organization and their description of environmental disparities and the associated health outcomes (Kruize, Droomers, Van Kamp, Ruijsbroek 2014).

Literature Review

When one is diagnosed with a chronic disease the first thing people usually do is look for meaning in their condition. One study addresses how people who have chronic diseases may see their situation and comparative health (Charmaz 2006). This information is gathered from 165 people who have a chronic disease, by measuring their different activities as an indicator of physical status. It is determined that that the people who are interviews scrutinize their feelings toward the disease, making it difficult to get certain things done.

In the next study an environmental justice-screening tool was used to compare the distribution of environmental hazards and the vulnerable populations among California inhabitants (Cushing, Faust, August, Cendak, Wieland, Alexeeff 2015). Seventeen indicators were created from 2004 to 2013 publicly available data into a relative collective impact score. They compared cumulative impact scores across California zip codes based on their location, urban or rural atmosphere, and ethnic/racial makeup. They evaluated which indicators were most unequally distributed with respect to ethnicity/race and poverty. The results show that environmental health threats burden communities of color in California more than other communities. Trying to reduce disparities in pollution affliction can use simple screening tools to determine which areas need the most help.

Now lets determine how different immigrant groups may see health differently. In this study, the author investigates how health-seeking actions of immigrants are changed during the acclimatization process by comparing the experiences of three Asian Pacific immigrant groups in Hawaii: Filipinos, Koreans, and Marshallese (Choi 2013). A total of 91 participants were interviewed. All three of the groups faced substantial changes in their health-seeking behaviors, but in different ways varying from group to group. Koreans tended to experience a reduction in pursuing both primary and preventive healthcare after immigration. Filipinos and Marshallese actually boosted their health-seeking actions. The previous health care experiences in their home country, combined with individual characteristics, the social framework of the host country, significantly influenced the formation of health-seeking behaviors after immigration. The study concludes that interventions should depend on the individual and take into account the foundation of behavioral modification and troubles that each immigrant population experiences.

From here we need to determine how policies can be changed to promote health. This study attempts to just that. If the marginalized groups are not health oriented, they tend to be affected more by possible negative effects of policies. By examining urban/medical literature since 2000, a review of evidence on the built environment and its health equity impact was completed (Gelormino, Melis, Marietta, Costa 2015). This review analyzed socioeconomic inequalities that are related to different workings of the built environment. As a result, the authors suggest an agenda, which assumes that key features of built environment, “identified as density, functional mix and public spaces and services,” may impact individual health through their impact on natural environment, behaviors, and social context. These consequences might be unevenly strewn depending on the social position of individuals. Generally the expected connections proposed by the foundation are well documented in the literature, yet proof of their impact on health disparities remains unreliable due to impenetrable factors, variety of study design, and difficulty to oversimplify evidence that seem to be dependent to local contexts.

Environmental health hazards can lead to chronic illness. In this next study we will determine where this hazards are most present. An environmental justice-screening tool called CalEnviroScreen was used to compare the distribution of environmental hazards and vulnerable populations among California inhabitants. Seventeen indicators were created from 2004 to 2013 publicly available data into a relative collective impact score. They compared cumulative impact scores across California zip codes based on their location, urban or rural atmosphere, and ethnic/racial makeup. They evaluated which indicators were most unequally distributed with respect to ethnicity/race and poverty. The results show that environmental health threats burden communities of color in California more than other communities. Trying to reduce disparities in pollution affliction can use simple screening tools to determine which areas need the most help.

Discussion/Analysis

How do chronic illnesses affect minorities and those in low-income communities? It is determined that from the Cushing study, from 2015, that environmental factors, which can cause chronic illness, is most prevalent in minority and low-income communities. This puts them at greater risk than the rest of the population. A reason that they might not be taken care of as much is shown in the Choi study from 2013. It is shown that each group sees health differently so there is no blanket policy that can help everyone. On the topic of policies, the Gelormino study from 2015 covers how the built environment

Conclusion

The plight of those with chronic illnesses is apparent. The constant, intense pain they go through is difficult to understand, as it is not always obvious. Minorities and low-income communities are at a great disadvantage compared to the rest of the country and measures need to be taken, in health care policies, to alleviate their physical and mental pain. The issue of chronic illness is incredibly significant to those who work in the health care field, as they will be the ones who might be able to help draft future policies. We need to be asking ourselves questions. Is it right that minorities and low-income populations have a harder time dealing with chronic diseases? As future health science professionals, what can we do to help these people?