Nurses hold a crucial role in understanding, identifying and addressing barriers that arise from a patient’s medical background and environment. These barriers can result in health disparities.

A health disparity refers to “the inequalities in health and healthcare between different population groups.” Most commonly affected are ethnic minorities, immigrant and low-income families, people living in rural areas, and those without access to healthcare.

The terms health disparities and health inequities are often used interchangeably. Health disparities refer to outcome differences between groups. In contrast, health inequity focuses on the causes of those differences. Nurses need to know both to assess, plan and implement measures to help high-risk patients.

What Factors Cause Health Disparities?

Nurses need to be aware of the impact of social determinants of health — factors other than medical care and genetics — on overall health outcomes. Social determinants of health account for about 80% of patient outcomes and include the following:

  • Air and water quality
  • Income and economic stability
  • Education
  • Geographic location and environment
  • Healthcare access
  • Housing and neighborhood safety
  • Insurance issues
  • Nutritious food
  • Social, cultural and community context
  • Socio-economic status
  • Transportation

In addition to social determinants of health, a patient’s genetic and medical background can also contribute to inequities. Diseases like cancer, diabetes and hepatitis C tend to be more prevalent in minority communities. For example, there is an underrepresentation of marginalized communities in clinical trials, so participation does not reflect the diversity of the population. In cancer care, genetic differences impact drug responses. For example, the drug 5-FU for colon cancer has different side effects. Patients who avoid medical care for preventive health and minor illnesses/injuries can have more morbidity and mortality than those who participate in regular preventive visits.

What Are Specific Examples of Health Inequities?

According to the Centers for Disease Control (CDC), health inequities are “preventable differences in the burden of disease, injury, violence or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” Health inequities revealed themselves during the coronavirus pandemic, with Black and Hispanic patients facing a higher incidence of COVID-19, more hospitalizations and a greater mortality rate than white patients.

Health disparities can take many different forms in the United States. Consider the following barriers:

  • Rural patients must travel long distances for appointments.
  • Poor or rural patients might not have access or knowledge of telehealth services.
  • Uninsured or underinsured patients may avoid the doctor for preventive healthcare or not have access to procedures or medications.
  • Food insecurity and poor diet contribute to obesity, which disproportionately affects
  • Patients whose first language is not English may struggle to find providers fluent in their native language or secure appropriate interpretation services.

How Can Nurses Help Address Health Inequities?

“Health equity means increasing opportunities for everyone to live the healthiest life possible, no matter who we are, where we live, or how much money we make,” according to the Robert Wood Johnson Foundation.

Nurses are vital to this change using the following actions:

  • Therapeutic Relationship: As trusted healthcare professionals, nurses are key to making meaningful changes toward health equity. Nurses who share a cultural or linguistic background with their patients may have a more in-depth knowledge of factors that impact health outcomes, and they can make adjustments accordingly.
  • Cultural Sensitivity: Nurses who practice culturally competent care are aware of nuances like beliefs, values and attitudes that may impact a person’s relationship with healthcare.
  • Workplace Diversity: A diverse nursing workforce is another step to addressing health disparities. Racial and ethnic minority nurses are more likely to work in underserved areas. Hence, boosting workplace diversity can help address health disparities.
  • Advocacy: Nurses can advocate for their patients, whether pushing for materials in other languages, making arrangements for interpreters or lobbying for policies to increase access to healthcare. Nurses are often leaders creating change in their institutions, so advocating for reduced health disparities is vital.

As our nation becomes increasingly diverse, nurses are crucial to identifying and addressing health disparities in patient populations. Nurses who participate in an RN to BSN program learn skills and strategies to improve health and healthcare among different racial, ethnic and socio-economic groups.

Learn more about Eastern Michigan University’s online RN to BSN program.