Minority health: the importance of patient navigation and access to timely care.
By: Karen Mancera-Cuevas, DrPH, MS, MPH, CHES, Senior Director of Health Equity
Navigating through the health care system can be very daunting for diverse patients. Hurdles are often set up along the way impeding access to care, that include understanding the realities of the health care system and obtaining a general grasp of provider instructions due to health literacy challenges.
According to the U.S. Department of Health and Human Services Healthy People 2030 report, factors that influence health care disparities include social, economic, and environmental disadvantages.1 These multi-faceted influences make the patient navigation process an unpredictable experience for many.
Such challenges in the patient navigation journey include receiving inappropriate access to care services that lead to detrimental consequences such as delayed treatment and in some cases diagnoses that reveal biomedical severity such as stage 3 or 4 cancer, advanced untreated diabetes that led to limb loss, or even organ damage that requires acute care.
Similar patient experiences are supported by the 2003 Institute of Medicine’s (IOM) findings in Unequal Treatment that documented disparities in clinical interventions.2 Unfortunately, health outcome indicators are still demonstrating inequities.
It is important to note that the issue of public awareness of structural barriers to good health were most recently propelled to the national forefront in 2020 due to the murder of George Floyd and inequities faced by diverse communities during the COVID-19 pandemic.3 Although these factors caused drastic change in the societal lens, more work is needed to intersect these sentinel events with improved social determinants of health outcomes moving forward.
Consequently, as we reflect and commemorate April as National Minority Health Month, we must acknowledge the challenges that diverse populations face when accessing services and how factors such as cultural differences can impact quality of care and patient advocacy for underserved and under resourced communities.4
Solutions are on the horizon, as one of the foremost recommendations is improving access capability that includes meeting people with health care in their communities.5 Structural barriers exist for many patients such as transportation, childcare issues, and scheduling future appointments with a provider.
This can be remedied through patient navigators that understand the realities of a challenging system which requires a multi-faceted toolbox for clinical adherence. Fortunately, alternative conversations are occurring on how supportive navigation can aim to reduce long-term morbidity and mortality in diverse patient communities.
References
- Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services. Healthy People 2020. https://www.healthypeople.gov/. Accessed April 24, 2023.
- Institute of Medicine (US) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Smedley BD, Stith AY, Nelson AR, editors. Washington (DC): National Academies Press (US); 2003. PMID: 25032386.
- Lavizzo-Mourey, R., Besser, R., Williams, D. Understanding and Mitigating Health Inequities — Past, Current, and Future Directions., New England Journal of Medicine May 6, 2021. https://doi.org/10.1056/NEJMp2008628.
- Institute of Medicine (US) Committee on the Consequences of Uninsurance. Care Without Coverage: Too Little, Too Late. Washington (DC): National Academies Press (US); 2002. DOI: https://doi.org/10.17226/10367.
- Mayo Clinic, Exploring Health Care Disparities in Minority Populations. Exploring health care disparities in minority populations – Mayo Clinic News Network. Accessed April 24, 2023.
