User:Angelica.gnlz/Health equity

Legend:

- Mainspace prose: Plain Text

- Copyedit Prose: underlined text

- My Prose: Bold text

Plans for achieving health equity[edit]

There are a multitude of strategies for achieving health equity and reducing disparities outlined in scholarly texts, some examples include:

• Advocacy. Advocacy for health equity has been identified as a key means of promoting favourable policy change. EuroHealthNet carried out a systematic review of the academic and grey literature. It found, amongst other things, that certain kinds of evidence may be more persuasive in advocacy efforts, that practices associated with knowledge transfer and translation can increase the uptake of knowledge, that there are many different potential advocates and targets of advocacy and that advocacy efforts need to be tailored according to context and target. As a result of its work, it produced an online advocacy for health equity toolkit.
• Provider based incentives to improve healthcare for ethnic populations. One source of health inequity stems from unequal treatment of non-white patients in comparison with white patients. Creating provider based incentives to create greater parity between treatment of white and non-white patients is one proposed solution to eliminate provider bias. These incentives typically are monetary because of its effectiveness in influencing physician behavior.
• Using Evidence Based Medicine (EBM). Evidence Based Medicine (EBM) shows promise in reducing healthcare provider bias in turn promoting health equity. In theory EBM can reduce disparities however other research suggests that it might exacerbate them instead. Some cited shortcomings include EBM’s injection of clinical inflexibility in decision making and its origins as a purely cost driven measure.
• Increasing awareness. The most cited measure to improving health equity relates to increasing public awareness. A lack of public awareness is a key reason why there has not been significant gains in reducing health disparities in ethnic and minority populations. Increased public awareness would lead to increased congressional awareness, greater availability of disparity data, and further research into the issue of health disparities.
• The Gradient Evaluation Framework. The evidence base defining which policies and interventions are most effective in reducing health inequalities is extremely weak. It is important therefore that policies and interventions which seek to influence health inequity be more adequately evaluated. Gradient Evaluation Framework (GEF) is an action-oriented policy tool that can be applied to assess whether policies will contribute to greater health equity amongst children and their families.
• The AIM framework. In a pilot study, researchers examined the role of AIM—ability, incentives, and management feedback—in reducing care disparity in pressure-ulcer detection between African American and Caucasian residents. The results showed that while the program was implemented, the provision of (1) training to enhance ability, (2) monetary incentives to enhance motivation, and (3) management feedback to enhance accountability led to successful reduction in pressure ulcers. Specifically, the detection gap between the two groups decreased. The researchers suggested additional replications with longer duration to assess the effectiveness of the AIM framework.
• Monitoring actions on the social determinants of health. In 2017, citing the need for accountability for the pledges made by countries in the Rio Political Declaration on Social Determinants of Health, the World Health Organization and United Nations Children's Fund called for the monitoring of intersectoral interventions on the social determinants of health that improve health equity.
• Changing the distribution of health services. Health services play a major role in health equity. Health inequities stem from lack of access to care due to poor economic status and an interaction among other social determinants of health. The majority of high quality health services are distributed among the wealthy people in society, leaving those who are poor with limited options. In order to change this fact and move towards achieving health equity, it is essential that health care increases in areas or neighborhoods consisting of low socioeconomic families and individuals.
• Prioritize treatment among the poor. Because of the challenges that arise from accessing health care with low economic status, many illnesses and injuries go untreated or are not given sufficient treatment. Promoting treatment as a priority among the poor will give them the resources they need in order to achieve good health, because health is a basic human right.
• Implementing medical pluralism. Extreme differences that underlie urban and alternative medicine approaches emphasize the need for a system that represents the duality of the populations it intends to serve. Urban medicine generally believes that technological advancement is the best way to help treat illness as it allows for a more “sophisticated” mode of care; alternative medicine is more traditional in relying solely on herbal and natural remedies believing that the elaborate institutions of urban care are not best suited for serving individual needs. Medical pluralism, hence, is an adaptive tactic most effective for communities that include Indigenous people, and mixed rural-urban populations . Medical pluralism acknowledges the needs of a variety of people and is a step closer to health equity. Medical pluralism “avoids the extremes'' of most current healthcare delivery approaches and provides a middle-ground perspective on tackling health issues that are not solved by urban or rural health alone . By practicing integrative medicine, chronic and unresolved health issues are better treated, borrowing from the technological and philosophical approaches of both models of care. Aimed at embracing both medical techniques, medical pluralism is currently being considered in nations with diverse communities; it is manifested in the practice of integrative medicine which is a deliberate execution of that approach. There are currently ongoing efforts to implement this dual model of healthcare delivery regionally in nations comprised of very diverse communities, and such is the case in many Latin American countries such as Ecuador that have a large indigenous population. The process of successfully implementing an integrative healthcare system is discussed as having six main steps that pose different challenges. Guito et al.'s guidelines for each steps describes the first as being 'imperceptible integration" to the sixth being "total integration" .