21 Jul Navigating the Complexities of Health in America
Longstanding disparities in where people live, work and play have a lasting effect on a wide array of health risks and outcomes – this phenomenon is known as social determinants of health.
Community and faith-based organizations, healthcare systems and providers, employers, public health agencies and others all play an integral role in addressing these issues.
Education
Current healthcare environments can leave patients overwhelmed by a bewildering array of specialists and treatment plans, medical bills and coverage confusion, and increasing anxiety about managing their condition. Many put off seeking medical help or even forgo it altogether when experiencing serious symptoms; their level of education plays an integral part in this regard, ultimately impacting health outcomes.
Education can offer individuals many skills that contribute to improved health, such as higher cognitive ability and increased health literacy. These capabilities may increase patient understanding of their medical needs and treatments options as well as inform choices about lifestyle behaviors and personal medical care decisions. Research has indicated that higher degrees of education correlate to better disease management among those from lower socioeconomic status levels, resulting in New Jersey becoming the 10th healthiest state.
Education also impacts the social and physical environments in which individuals live and work. Individuals with less education are more likely to reside in neighborhoods with high crime rates, inadequate sidewalks and parks for safe walking/cycling routes, substandard housing conditions, low wages with minimal benefits (or none at all), hazardous jobs with no job security – factors which have detrimental effects on their health, well-being, intergenerational connections that impede improvements.
Environment plays a growing role in health. Researchers are beginning to recognize that differences between countries in morbidity, mortality, and risk factors can often be traced back to non-health care or social factors that influence them negatively.
Health services researchers are increasingly turning to complexity theory to better understand relationships among health services entities, but generalizability from studies that incorporate it remains difficult due to heterogeneous reporting and methodologies used. Further research, debate, and exploration regarding complexity theory as applied to health services research should occur – and should include clear definitions and descriptions of complexity as applied to each phenomenon being researched as an initial starting point.
Technology
Health care can be complex, but with the right tools and collaborative stakeholders it can be manageable. COVID-19 has shed light on many systemic flaws; there are technology solutions that may help alleviate some of its barriers, from clinician education to telehealth services.
These tools have the power to transform healthcare, but their effect on workers and careers will depend on how they are deployed; specifically whether they are utilized toward fulfilling value-based care, under the auspices of policymakers and managers open to experimentation, and through adopting a work-centric approach. In order to do so successfully, technology must be combined with deep healthcare expertise that understands its capabilities in meeting both administrative and clinical challenges effectively.
Telehealth technology could significantly cut costs and improve outcomes by decreasing emergency department visits; however, its legal and ethical implications need to be explored carefully before being adopted in practice. Companies known for collecting consumer data for marketing purposes could track people, while it’s essential that navigation platforms anticipate what consumers need while unifying information from different stakeholders into one central database.
Navigating can work proactively on behalf of consumers to remove obstacles and anticipate needs, providing health care access that satisfies America’s complex landscape. Though challenging, such an endeavor must take place if America wishes to maintain healthy levels. Without the proper navigation partner, consumers may experience an ineffective, inefficient system which costs too much but offers little value in return. Achieve an exceptional consumer experience requires proactive, personalized and effective navigation partnerships; At its core, healthcare in America can be complex. If we make it easy for consumers to locate and use trusted healthcare partners, then we can take the high road in creating an equitable healthcare system for all people everywhere.
Processes
Healthcare systems are complex and fragmented systems, and failure to establish clear patient-centric links among them may result in duplication, missed opportunities for care coordination and unintended consequences. According to Deloitte’s new report on this matter, failing to address such barriers may cause America’s healthcare costs to exceed $1 trillion by 2040 unless adequate action is taken against these obstructions.
Health system leaders face the daunting challenge of transitioning their healthcare delivery system into an adaptive learning system that facilitates effective care coordination and linkage. This transformation requires identifying specific areas where system complexity impedes progress and creating solutions based on engineering principles. Amy L. Deutschendorf, Senior Director for Clinical Resource Management and Principal of Clinical Resource Consultants noted an escalation in patient-centric complexities due to an array of factors in healthcare today – a surge of data, new technologies, an increase in regulatory oversight and an aging population are just a few. As such, disorganization, fragmentation and discontinuity in care has arisen across healthcare.
Deutschedorf also highlighted the criticality of processes in transitioning towards a learning healthcare system. She pointed out that healthcare education teaches health professionals only how to access current facts and use scientific methods for discovery; not how to apply what they’ve learned to the real world or chart a course between points A and B. For true transformation to occur, changes will need to take place across roles, education, decision making structures and payment arrangements as well as in how success is measured.
Culture is another key challenge to overcoming healthcare barriers. William W. Stead, chief information officer of Vanderbilt University Medical Center, described health care culture as a clash among competing forces – healthcare professionals seeking autonomy and high margins; providers pursuing efficiency gains; suppliers prioritizing intellectual property protection over volume sales; consumers seeking accessible services; payers looking for ways to select risk while controlling costs; and purchasers wanting more value for less money.
Emerging initiatives that seek to address social determinants of health both inside and outside the healthcare system include multi-payer federal/state programs, Medicaid initiatives and provider activities that focus on identifying and meeting non-medical social needs.
Culture
Sociologists define culture as an expansive and multifarious set of intangible aspects of human behavior, comprising all manners of behaviors, beliefs and attitudes as well as customs such as codes of dress, language use and art creation or religion practices.
Sociologists employ sociology to understand a particular culture by assessing its values, social structure and ways of thinking. But to truly comprehend it all, sociologists also examine less-than-obvious parts of culture that lie below its surface – such as an iceberg’s hidden parts. Navigating these parts is key when working with culturally diverse populations.
Effective strategies to address health disparities lie in fostering health and well-being in all communities through cross-cultural competence development. This process includes education and training of health care providers on how to recognize all factors which influence patient health as well as identify any barriers preventing access to services then devising plans to overcome such hurdles.
Building cultural competence involves making an effort to understand other cultures. This starts at the top, where executives should make efforts to understand their community’s culture; then it reverberates down through all levels of staff who interact with patients.
An active commitment to understanding other cultures should include an examination of one’s own unconscious biases. This can be especially crucial in healthcare settings where cultural differences may lead to poor communication and miscommunication between providers and patients.
An organization committed to cultural competence will also seek to assess and adapt its systems as the needs of their community change. For instance, if a hospital serves a population that has recently changed in terms of ethnicity or language use, its materials and procedures would need to be modified in order to best accommodate new demographics. Furthermore, local groups offering interpreter services will be identified so they can support patient health needs more effectively. Ultimately, the goal is ensuring all people can access quality health care – this requires engaging all stakeholders, particularly those from disadvantaged neighborhoods who face barriers in terms of accessing this vital service.