Introduction: Welcome to My Blog!

Hello everyone. My name is Jenny Lo. For my blog, I researched about lack of quality healthcare access for minorities. My critical thinking question is: Why are minorities experiencing health disparities in healthcare? Many immigrants and low-income families lack access to basic healthcare plans due to financial burden and lack of resources. I believe that having quality healthcare for all people is essential to lowering illness and injury rates.

Without sufficient funds from the government to support minority groups, it's a struggle to obtain quality health care. All people should be able to access at least a basic health care plan. As an inspiring nurse, I want to be apart of this journey to help patients access quality healthcare, regardless of class and income. This is an ongoing problem that requires immediate attention to improve better healthcare access for everyone.

Growing up from a low-income and immigrant family, I witnessed my own family struggle to seek medical care. Understanding these struggles inspired me to obtain the necessary skills to ensure that minorities are receiving the healthcare they need.

When reading about my blog, you'll encounter various discussions of my research on minority healthcare. My blog will show research from various articles, a video that documents this issue, a book review on minority healthcare, an interview from an experienced expert with minority patient care and my observation at a clinic dealing with minority healthcare. I'll provide a personal statement reflecting my goals and ambitions regarding this issue. I'll also reflect on how my critical thinking question evolved as well as my thinking process and what I've learned about this issue after conducting my research. My hopes for this blog is to bring forth the problem of lack of healthcare access for minorities and improve the healthcare system by ensuring everyone, especially minorities, are able to access the healthcare they need for their survival.

Please watch this video for a guided tour of my blog. Enjoy!

Initial Blog Reflection

When creating this research blog, I wanted to track an issue in the healthcare field. I specifically wanted to address the issue of minority healthcare disparities. Disparities in minority healthcare is a problem that I've experienced many times as a child and it's still an ongoing problem that requires immediate attention. The question that I chose to guide my research was, "Why are minorities experiencing health disparities in healthcare?" My initial thoughts in response to this question is that health disparities in the minority population exists due to lack of health care access for minorities. Minorities are discriminated because they have lower SES and don't have the income to be qualified for quality health insurance. I believed that only people with good health insurance are eligible for good healthcare, resulting in those without good health insurance or lack of it will be out of luck.

When my parents immigrated to America about 30 years ago, they struggled to acculturate to the American culture. They worked multiple jobs to sustain their basic needs to survive in the United States. Long hours of work and lack of rest led to more frequent illnesses. They avoided seeking medical care because they were not fortunate with health insurance. When some of their illnesses got too severe, the medical staff at their local hospital did not provide quality care in serving their medical needs. Our low-income family suffered from lack of access to a basic healthcare plan due to lack of resources and governmental support. Understanding their struggles in lack of quality healthcare provided me the background information to start researching further on this blog.

My understanding of the health care system evolved from my personal experiences at medical offices during my family's doctor visits. These experiences shaped my feelings on how minorities are being treated. Their lack of quality care in health care made me believe that minorities are their lowest priority and not treated the same as other patients. I've learned from my previous experiences that inequality in healthcare is existent mostly towards the minority population. I wonder what other choices are left for minorities in order to be treated equally and overcome healthcare barriers. I hope that my research will help to explain the reasons for the minority healthcare disparities and reveal the opportunities that will make changes in ensuring that minorities receive the quality care that they deserve.

Final Blog Reflection

Coming into this research project with a mindset that minorities are not treated fairly in the healthcare system, I strived to find the answers to why this is the reason and what can be done to eliminate this. My initial reaction to my research topic was mainly based on my personal experiences with minority healthcare. After researching more about the issue of disparities in the healthcare system, it validated my strong perspective on the negative impact of social factors creating unequal treatment in care towards the minority population. Through my research, I discovered that minorities are underrepresented and not blessed with quality healthcare, regardless of their socioeconomic status, income, education levels or access to resources. 

As I read through Thomas LaVeist's Minority Populations and Health: An Introduction to Health Disparities in the United States, he provided the basic knowledge I needed to understand minority health disparities and his proposal on solutions to eliminate this issue motivated me in realizing that there are people who are trying to make changes like myself. As I developed more knowledge in my research through my interview and observation process, I witnessed the real life situations that impacted the minority population. Their real life experiences inspired me to keep looking for answers to solve this major issue. All research conducted helped me to learn that although minorities are unfortunate with lack of access to quality healthcare, it's important for the public to step in and provide the extra hand in making changes for the better. 

The healthcare system is constantly evolving to a new level. There are ongoing advancements in medical technology and it is up to the public to create positive changes in our healthcare. Providing ways for patients to receive the best possible care are the top priorities for all healthcare providers. Being able to strive for good health and fighting against medical problems are the main goals for medical practices. I've developed a knowledge that healthcare problems can be eliminated when unity exists in all individuals who believe in making positive changes. When people of all different racial background unite as one, a powerful change will happen in our culture: a change for the equality, for the better, for the future. The healthcare system and its negative effect on the minority population will not be gone forever, but the opportunities for change is happening and we must have faith in hopes of one day, inequality in healthcare will not be a problem anymore. Ultimately, I am truly honored to present this topic with the public and I'm excited to uncover what the future will hold for me in the healthcare field. 

Interview with Minority Patient Care Expert: Manith Thaing

In order to get a better idea of minority patient care, I interviewed Manith Thaing. She is a registered nurse and program coordinator at Asian Health Services. Being a nurse, she regularly works with minority patients at her clinical site. At a healthcare facility like Asian Health Services, this clinic primarily serves low-socioeconomic Asian and minority community who lacks health insurance. She works closely with other nurses and doctors in serving low-income minority patients. As a program coordinator at Asian Health Services, she works closely with these patients to ensure they are receiving the best possible health care. She has years of experience working with minority patients at this clinic.

Interview Questions & Responses:

Why is it difficult for minority patients to get quality healthcare?
It is difficult for minority patients to get quality healthcare because of cultural and language barriers. Language barrier is one of the main problems that cause minorities to not be able to access quality care.

How can we help minorities get quality healthcare?
- Hire interpreters, people who patients are comfortable with and people who they can relate to (i.e. family members)
- People who can understand where the patient is coming from (i.e. same culture, grew up together)
- Providers/nurses who speak the same language (for easier communication)

What are the barriers for minorities to access better quality healthcare?
- Language barriers
- Access to transportation
- Access to technology (phone calls, internet/websites)
- Lack of access to information (brochures, leaflets), being able to understand them because of low literacy rates, not being empowered enough
- Feeling intimidated on how to access care

How are minority patients treated compared to other patients with the same health insurance?
Minorities are not given same opportunities/access because of their low socioeconomic status. For people who has access to resources, they can go online and find their provider/information on health issues. However, low-income people usually can't access a computer due to limited access for these resources, so they are out of luck.

Why are minorities more likely to suffer from different illnesses and diseases compared to Whites?
- Because they're not provided information that this can happen to them
- Not translated to different languages
- Low educational status, hard to comprehend illnesses
- Low levels of prevention, lack of understanding prevention. Not enough health education programs out there

Are healthcare providers biased towards minority patients? Explain.
At Asian Health Services, healthcare providers are not biased towards minority patients. They understand the cuture; they have interpreters; they have health coaches to teach patients to advocate and empower themselves on their personal health.

Do you think that our healthcare system is discriminating against minority patients? Explain.
Yes, low-income families tend to go to county hospitals, and county hospitals are understaffed with long wait times. Patients have to wait hours to receive care. For example, a youth who walks in with baggy pants gets labeled as a gang member and healthcare workers may feel threatened/hesitant to want to work with that specific patient due to personal biases learned from the society.

What problems are minorities facing as a result of disparities in minority healthcare?
Minorities wait until it's too late before they come in to see a doctor because of lack of education and lack of access to care.

What possible solutions are there to improve minority healthcare?
In order to improve minority healthcare, there should be more cultural competent providers and more community health education. This will greatly benefit the minority population in accessing better healthcare.

What does the future hold for minority patients and our healthcare system?
For our future healthcare system, the Affordable Act or Obamacare is a newly signed law to increase the quality and affordability of health insurance for everyone. This allows the minority population to take advantage of this new resource and it gives everyone an opportunity for having health insurance.

Summary:
In my interview with Manith, she stated that minorities are faced with barriers, social discrimination and lack of resources to acquire quality care. From her experience of working with minority patients, she believes that minorities are not given the same opportunities/access to quality care because of their lower socioeconomic status. Their lower SES decreases their chances of getting quality healthcare, even with same health insurance as other patients. Regardless of income status, educational background and same health insurance as others, they are at a disadvantage. In order to improve minority healthcare, Manith stated that having people who speak the same language (i.e. family member, provider, nurses) will help minorities in receiving quality healthcare. She believed that communication is key to building a strong relationship between the patient and provider, so having interpreters and healthcare staff who speak the same language as the patient is recommended.

Analysis:
Manith's experience with minority patients provide good background of real life minority patient care at a clinical site. Her experiences with minority patients at Asian Health Services primarily serves low-socioeconomic Asian community with lack of health insurance. Because she mostly treats minority patients of Asian descant, the information provided is solely based on only one group in the minority poplation. This interview disregards the other minority groups- Blacks, Hispanics, Native Americans, etc. Despite this, all the information provided through the interview gave good information on supporting how minority healthcare is like at this clinic. Overall, we get the image that minorities are lacking support to get quality care and her conclusions support most research out there.

Response:
I agree with Manith's perspective on minority healthcare and I believe that her interview is credible. Minorities are not given the same opportunities because they don't have the resources, the income, the knowledge of the information provided to them, and the language to effectively communicate with healthcare providers and staff. They suffer from their low SES and fail to get quality healthcare mostly due to lack of health insurance. They are forced to choose receiving care at county hospitals where those sites are understaffed, leading to long wait times. I've experiened these same assumptions with my own family. I do believe that they tend to place minority patients as the lowest priority for receiving care because they usually don't have health insurance or don't view their health issues as severe enough for immediate care. This results in inequality in the healthcare system.

Open Letter

December 6, 2013

To the Public,

I am a student at Peralta Community Colleges to complete prerequisites for applying to nursing programs. As an aspiring nurse, my goal is to provide the best possible care for all patients to be healthy. Having the available resources are essential in providing everyone with the quality healthcare. I created this research blog to address the issues in minority healthcare and its current effects on our minority population.

In my opinion, the most critical problem with health care is the lack of quality care for minority patients. Growing up from an immigrant family, I understand that it's difficult to seek patient care for non-English speakers. I've witnessed this struggle with my own parents during their doctor visits. The minority population is constantly faced with societal pressures and environmental factors that negatively impact their health. Minorities struggle with low socioeconomic status, low income, low education levels and poverty everyday of their life and these challenges negatively impact their overall health. In addition to these stressors, minorities don't have the income and health insurance to access good quality healthcare. Some healthcare providers hold biases when clinically treating their minority patients, which create disparities in minority healthcare. Studies have showed that minorities are less likely to receive medications and treatments than their Whiter counterparts. Studies have also showed that disparities in healthcare exist partly because of health insurance. Lower end health insurance limits minorities to harsh medical services that's impacted and understaffed, which ultimately leads to lower quality healthcare.

It's important that we address the issue of minority healthcare disparities. Minorities are human beings just like everyone else. They should be treated with the same respect like every other individual. Despite their lower socioeconomic status, income, education levels and health insurance, there should be equality in the health system with every patient. The role of doctors are to provide equal care for their patients without racial discrimination. Addressing inequality and disparities in healthcare is my main motivation for this letter.

I would appreciate your support and encouragement in helping minority patients fight health disparities and provide equal quality healthcare for the minority population. Nothing is more rewarding than taking the time in making life meaningful by providing a simple helpful hand. It simply takes a small change to create a large impact in improving the wellbeing of our society.

Sincerely,

Jenny Lo

Personal Statement with Reflection

In my traditional Asian household, my parents had high expectations for me to be successful and be the best because they were not privileged with educational opportunities in Vietnam. Knowing the hardships of being financially unstable and the difficulty of moving forward in American without an educational background, they had high hopes for their children to have a better life. Their unconditional support encouraged my hard working ethnic and drive to surpass all obstacles that came my way. Wanting to excess their expectations, I registered for a large workload every semester while being employed as a part-time worker. My hard work paid off when I was granted successful admission to my dream college: UC Berkeley. Being a part of this university, I was able to grow bonds with other science major students. Taking many different science courses with my fellow classmates enhanced my interest in being a part of the healthcare field.

My main motivation to become a nurse began as a result of an accident that led to my grandfather's stroke and brain injury. Following this event, my boyfriend Phillip, had a work injury. It left him with a bulging intervertebral disc on his lower lumber spine. They were two of many important men in my life and I felt in sync with their souls when they were injured. Their emotions, pain and feelings left me feeling the same way, if not more. Their suffering made me want to help them get through this hard time. Having experienced these two major injuries made me want to help other people who may be suffering from the same pain that I did. After these experiences, it was validated that I had a drive to provide patient care. 

During my early adolescent years, my grandfather and I developed a close relationship. I would help to monitor his health and diet. My grandfather had slightly high cholesterol and blood pressure, but these conditions were stabilized with medication. Overall, he was considered healthy. Mobility was never a problem, as he was able to walk long distances at a reasonable pace. Knowing that my grandfather was taking his medication as prescribed by his physician, there was never a doubt in my mind that his life would change overnight. Following a normal nightly routine, my grandfather accidentally slipped in his bathtub and hit his head on the shower faucet. The paramedics brought him to the emergency room, where their initial findings showed he could possibly have a stroke. They quickly moved him to the intensive care unit after taking an MRI of his skill, which revealed that all the blood vessels surrounding his brain ruptured and confirmed that he had a stroke. The physician placed him on life support, but his major brain injury led to his paralysis and eventual pain. I felt completely helpless when my grandfather was on the life support machine, knowing that there is nothing that either the healthcare professionals or my family could do to sustain his life. Although our family struggled to get back to reality after my grandfather's death, we had to be strong to get through this heartbreaking experience. Witnessing how my grandfather suffered this brain injury compelled my interest to acquire the necessary skills to become a proficient nurse to serve those in need. It is because of this incident that made me realize that there are other patients suffering the same health problems as my grandfather and I'm interested in being apart of an inspiring movement where I can assist these patients during these tough times.

In addition to my grandfather's sudden death, my passion for care giving validated after a work injury that resulted in my boyfriend Phillip's bulging intervertebral disc on his lower lumbar spine. His bulging disc compressed on surrounding nerve tissues that connected to his legs, which lead to his discomfort and lack of mobility. After a year of constant lower back and leg pain, Phillip decided that he was going to proceed with surgery. Following a week of post-surgery hospitalization, it was up to me to tend to his every need. He required my help to assist with his basic needs and essentially, being his second pair of hands for anything he needed. In addition to his physical needs, he required mental and emotional support to help him through his recovery. I was able to give him the motivation and encouragement that aided in more willpower to become his old self again. Although there were times when he wanted to give up on himself, we overcame these obstacles by being hopeful and believing that our positive thoughts will be worthwhile. His physical recovery improved with the help of physical therapy. Following six months of his post-surgery recovery, it was confirmed that I had a passion for care giving and wanted to pursue nursing as a profession.

My recent experiences working at an orthodontic office was my introduction to patient care in the pursuit of a nursing career. This orthodontic practice tends to serve primarily low socioeconomic, first generation Asian community whom often face financial and cultural hardships in life. However, working with these patients allowed me to relative to the patients and meet their needs. Being patient and understanding helped me to communicate effectively with the patients. My interest to helping others in need of medical attention makes me a strong candidate for entering the healthcare field. After my experiences working with these patients, I came to realize that having a normal life is not a given. Therefore, we shouldn't take life for granted. Rather, we should grasp every opportunity to make life meaningful by helping others. Knowing that there are so many people who are in need of patient care, I want to provide nursing leadership and expertise to these patients in helping to increase more healthy individuals in the world. This knowledge will help me to develop effective methods in managing the different medical situations at a hospital clinical site. I believe that nursing is the right profession for me to start this meaningful journey.

Living a life with purpose gives us strength to move on with our future. Becoming a nursing leader in improving the health of all diverse populations is one of my purposes in life. Re-evaluating my academic and personal experiences, my pathway to a meaningful life revolves around making a change in another person's life. A nursing career will help me to value life with great pride and joy.

Reflection

Revising my personal statement was one of the more difficult assignments for this blog project. Describing the breakthrough moments that affected my career choice was very difficult for me because it forced me to reflect back on my grandfather's death and my boyfriend's major surgery/recovery. These were moments that caused me to break down multiple times and it's difficult to share these experiences with an outside audience. It's hard to reflect back on moments that had a strong impact on my life, but these experiences are what made me a stronger person and gave me motivation for my future goals and ambitions. 

The process of revising my personal statement gave me a chance at reflecting on my reason for life. These experiences inspired my interest in healthcare and I'm definite that nursing is the career choice for me. I understand that it's a competitive field and there will be many more challenges that will come my way, but if I keep my goal in mind and continue to strive for my goals, there's nothing that I can't accomplish. After writing this personal statement, I've learned about more about myself than I ever did before. It's this process of self-learning that will strive me forward to a bright future. 

Book Review- Green Level

In Thomas LaVeist's "Minority Populations and Health: An Introduction to Health Disparities in the United States," the author discusses the social determinants that results in the health disparities of racial and ethnic minorities in the United States. The studies on the epidemiological profile of racial/ethnic minorities show that African American, Native American and Hispanic/Latinos have the worst health profiles and Asians/Pacific Islanders and Whites have the best health status. Research has showed that racial and ethnic minorities have reduced access to healthcare compared to their White counterparts. Even when the minorities have equal access to care, they usually receive less quality care. Socioeconomic status is a major factor in predicting health status because minorities are affected by low socioeconomic status and this ultimately leads to worse health conditions. Racial/ethnic difference in health behavior is also a factor in health disparities in minorities. Issues relating to prevention and risk behavior stated that minorities are more likely to be physically inactive, have poor nutrition, be overweight/obese, more likely to smoke, more likely for alcohol abuse and illicit drug use. The minority population is more likely to delay seeking for treatment compared to their White counterparts.

The author further discusses specific health issues relating to each racial group. African Americans have the highest mortality rates, high death rates from homicide and HIV/AIDS, high rates of obesity, and more likely to face discrimination in a healthcare setting. American Indian and Alaska Natives have high mortality rates relating to accidents and alcohol abuse. The Asian/Pacific Islander population is known as the "model minority" group because they have the fewest health risks, lower mortality rate and have the longest life expectancy than the other racial groups. The API population has many diverse subgroups that make it difficult to study the underlying health issues specific to each group. Similar to the API group, the Hispanic/Latino population has many variations among their subgroups, so it's difficult to draw conclusions on their health status too. This group is the largest minority group and has good overall health status from their low socioeconomic status, lack of insurance coverage and difficulty in accessing quality healthcare. The author also proposes models and solutions in addressing these disparities and improving the overall health system for the different racial and ethnic minorities. In order to eliminate the health gap and reduce health disparities, he proposed three points of intervention for health disparities: socioenvironmental, individual-level and the health care system. Socioenvironmental factors to improve health disparities include "eliminating exposures to environmental hazards, improved housing, reduced availability for alcohol, tobacco and other drugs, etc." (LaVeist, 292) Individual-level factors to improve health disparities include "improve education, improve health literacy, reduce inactivity, increase health eating, improve health screenings and English proficiency." (LaVeist, 292) He stated that, "increas[ing] availability of health services, provid[ing] universal access to health care and pharmaceuticals and increas[ing] number of health care providers who are proficient in a second language" (LaVeist, 292) and increased cultural competency will help to reduce health disparities in the health care system.

Thomas LaVeist's idea of inequality in health revolves around the impact of social factors result in health disparities of minorities in the United States. He argues that factors like socioeconomic status, education, poverty, stress, housing, nutrition, substance/alcohol abuse, etc influences the minority health profile and this ultimately creates the health disparity in health care access, utilization of medical services and quality of care for the minority population. His analysis on how different health issues affect each minority group is credible and shows intellectual knowledge on the topic. LaVeist provides a comprehensive overview of the issues in health care affecting the minority populations in the United States by explaining his ideas with 14 chapters, numerous charts, tables and figures. The structure of the book creates a logical analysis of how the author addresses the problem of health disparities. First, he provides historical context from the early slavery period and their development on the minority population, then he goes in depth into more specific topics relating to minority health care and finally provides solutions in addressing the disparities in health and health care. This book has a well-formatted outline to help the audience engage into important healthcare concepts that developed into its current status. He avoids using logical fallacious in his proving his arguments. He also supports his concepts with credible data that proves his perspective on why health disparities came to be and what he believes will help to reduce the racial/ethnic gap in health care.

This book does a great job at analyzing health disparities in minority populations. I would assume that this book is mostly for undergraduate and graduate students, but I would recommend this book to teachers, professors, healthcare professionals, student activists and all other people who wants to better understand how health disparities was developed and their impact on minority populations. Because health disparities are existent in our society, it is important to understand how these disparities influence our healthcare system and their influence on our overall health. Educated individuals, like teachers, professors, healthcare professionals and student activists are important people who specialize in specific studies and strive to gain better understanding of the entire world. Important issues like healthcare disparities is relevant in gaining perspective in our healthcare system, so I would recommend this book for this category of people. Everyone else who is passionate about equality in healthcare for all people should also read this book because it addresses the problem of healthcare disparities and proposes solutions to eliminate the inequality in healthcare.

The book has helped me to understand the research topic in many ways. This book provided historical context on our largest minority population as former slaves and the development of the other racial minority groups. Distinguishing certain definitions of health care was important in helping me better understand my research topic. The author distinguishes the difference between health care disparities and health status disparities. He stated that, "The term health care disparities refers to differences in the access, use, quality, or outcomes of health care services received by racial/ethnic minorities. In contrast, the term health status disparities refers to differences among racial/ethnic groups in health status (that is, morbidity, mortality, functional status, or disability)." (LaVeist, 108) Being able to tell the difference between health care and health status disparities is critical because "it is crucial to understanding the nature of the causes of health status and health care disparities." (LaVeist, 109) This book also discussed in depth on specific health issues for the different racial/ethnic groups. Because each racial/ethnic minority group is unique in their culture and beliefs, the impact of socioenvironmental factors affect each group differently and understanding these differences will allow us to develop methods to addressing their disparities.

Some of the quotes in LaVeist's book made a strong impact on my current knowledge of minority healthcare. He stated that, "Nonminorities receive better quality care than racial minorities. The differences between the quality of care received by minorities and nonminorities fall into two broad groupings: health care disparities and health care dissimilarities. Health care disparities are racial/ethnic differences in the outcomes of quality of care that are indicative of injustice within the health care system or in the behavior of health care providers. Health care dissimilarities refer to racial/ethnic differences that are not caused by underlying inequities; for example, differences produced by patient cultural preferences or patient choice." (LaVeist, 109) After reading this quote, I was able to learn about the differences between health care disparities and health care dissimilarities. The main difference between the two terms is that one is caused by injustice and the other is not. It's important to distinguish the differences between both of them in order to determine the quality of health care towards minorities and nonminorities. He also stated that, "differences in access to and use of health care services are largely caused by socioeconomic inequities, such as discrimination or differences in health coverage. However, differences in use of health care services are also influenced by differences in need for services and in patient preferences." (LaVeist, 111) I agree with how these factors contribute to the access and use of health care services. Health care disparities are mostly affected by health care coverage and health care dissimilarities are mostly affected by cultural reasons or patient's choice to use health care services. These quotes helped me to learn about the different terminology in healthcare and how it's important to differentiate them from each other when learning about similar concepts.

In conclusion, this book displayed a collection of information in discussing health issues affecting the minority population. The knowledge that I gained from this book gave me more understanding of the healthcare system and this knowledge will carry on to my future career in the healthcare field.

Works Cited

Headen, Sandra. "Footnotes." National Center for Biotechnology Information. U.S. National Library of Medicine, 15 Sept 2005. Web. 06 Dec. 2013.

LaVeist, Thomas Alexis. Minority Populations and Halth: An Introduction to Health Disparities in the United States. San Francisco: Jossey-Bass, 2005. Print.