Health disparities are a particular challenge for women living in poverty. Issues such as Breast Cancer and sexually transmitted diseases, which may potentially impact women from any class or context, require regular screening and attention. Our discussion finds, though, that such screening is often not available to women living in areas or circumstances of poverty.
To this end, we find as a theoretical basis therefore that there is a direct relationship between low-income subsistence and the quality or extensiveness of the medical care which a woman may receive. Another group which is often afflicted by disparity is the African American race. Thus, a cross-section between African American ethnicity and female gender will have specific health consequences that generally promote disparity.
Here, the direct correlation between racial characteristics and socioeconomic disparity illustrate that there indeed a condition in our healthcare distribution which subjects African Americans to a higher balance of exclusion, non-coverage and shortfalls on knowledge of available treatment opportunities.
In the examination by O’Malley et al (2003), there is evidence to suggest that, especially for younger patients, lacking access to a private doctor or HMO healthcare provider will have a significant impact on one’s access to quality care.
Measuring a 14 point scale by which to examine the screening consistency of patients from both low and acceptable income standards, the study finds that “among the population over age 50 living below 200% of the poverty threshold, those using community clinics were more likely to be younger, a racial or ethnic minority, less formally educated, in poorer health, uninsured and to face time, transportation or cost barriers to obtaining health care than their counterparts using private doctors’ offices/HMOs.” (O’Malley, 2003, p. 190)
This is a useful range of conditions for a theoretical examination of our subject. The basic argument is that there is a certainty of a relationship between low-income and diminished health standards and treatment opportunities. Thus, the close association between low-income and ethnic otherness has a direct bearing on our conception of disparity.
According to the Health Belief Model, we must approach healthcare disparities, according to the understanding that “how people use healthcare and how patients make decisions about whether to follow medical advice are influenced by individual beliefs and perceptions in combination with environmental resources or barriers.”
(Ell et al, 2002, p. 640) The study goes on to explain that, for example, in the instance of a Pap smear screening test, the actions which a women will pursue thereafter based upon the findings of the test will be contingent upon her comprehensive recognition of the test’s meaning and upon her conception of the realistic threat of health abnormality.
These ideas of understanding and attitude influence health beliefs, which will in turn produce specific health behavior responses, are subject to variation based on the relationship of a women’s ethnicity to this system.
Thus, the distance and mistrust often persisting between Africa American women and institutional healthcare settings bears a negative pressure on the ability or willingness of the specified group to access available healthcare options.
2. We also find that for Latinos living in the United States, medical disparity is an always pertinent issue. The illegal or immigrated status of many individuals of this ethnic descent makes it particularly difficult for members of this demographic to gain access to medical facilities.
In particular, for those whose status of citizenship may be unclear or illegal, a fear of being caught and deported is likely to overwhelm a choice to access medical treatment, even when such is needed to great severity and with the threat of very serious immediate health consequences.
But within the context of this group, there is yet another level of obstruction to equal treatment. This idea of culture as playing a direct and crucial role in the way that some women approach screening opportunities, mentioned in the first account as well, is an important one which we find repeated throughout our studies on disparity, often almost in direct complement to observations regarding both socioeconomic and racial barriers.
Accordingly, Loerzel & Busby (2005) contend that “vulnerable women . . . have many barriers that may prevent them from taking advantage of cancer screening tests, such as mammography and Pap tests, that are instrumental for detecting breast cancer and cervical cancer at early and more treatable stages. In many instances, cultural beliefs and values have a role in health-seeking behaviors.
For example, Latino women are more fatalistic about the outcome of finding a cancer than other racial and ethnic groups and this may prevent them from seeking services.” (p. 79)
This suggestion, which we have recognized above in this review should itself be subjected to a more nuanced reflection that divides considerations along such lines as communities and national identities within the “Latino” catch-all. Still, the overall premise here is consistent with that which has emerged as crucial to our discussion, insofar as cultural views constitute an important effecter in some capacity regarding medical disparity.
However, it is also clear the more pertinent than this are institutional obstructions such as immigration laws, racial bigotry and a general medical hierarchy ruled by white Americans and generally, those of middle, upper-middle or upper class social orientations.
Ell, K.; Vourlekis, B.; Muderspach, L.; Nissly, J.; Padget, D.; Pineda, D.; Sarabia, O. &
Lee, P. (2002). Abnormal Cervical Screen Follow-Up Among Low-Income Latina: Project SAFe. Journal of Women’s Health & Gender Medicine, 11(7), 639-651.
Loerzel, V.W. & Busby, A. (2005). Interventions that address cancer health disparities in women. Family Community Health, 28(1), 79-89.
Masi, C.M.; Blackman, D.J. & Peek, M.E. (2007). Interventions to enhance breast cancer screening, diagnosis, and treatment among racial and ethnic minority women. Medical Care Research and Review, 64, 195-243.
O’Malley, A.S.; Mandelblatt, J. (2003). Delivery of Preventive Services for Low-Income Persons Over Age 50: A Comparison of Community Health Clinics to Private Doctors’ Offices. Journal of Community Health, 28 (3), 185-197.