History/Overview

“Medically disadvantaged,” “medically underserved” and “American underclasses” are populations that face large disadvantages, specifically in accessing opportune and obligatory health care services.

Black Americans are not only more likely to be economically underprivileged than White Americans they also experience shorter life expectancies as well. Approximately twenty percent of Hispanic Americans in 2004 lived below the federal poverty line. Not only are they more likely to be uninsured and underinsured, they may not meet Medicaid qualifications making it harder to access medical care. Being foreign born and unable to speak English also creates barriers to access. Asian Americans (people from Far East, Southeast Asia, or the Indian subcontinent) make up one of the fastest growing population segments. Korean-American men have a fivefold incidence of stomach cancer and an eightfold incidence of liver cancer. Beliefs and values of this culture may prevent women from obtaining regular breast cancer screenings and prenatal care. The incidence and prevalence of certain diseases for American Indians/Alaskan Natives such as diabetes, hypertension, infant mortality/morbidity, chemical dependency, and HIV/AIDS related morbidity are all high enough to create concern. Native Americans see seven times more death due to alcohol and 3.5 times more death due to suicide.
The uninsured represent a large, growing portion of Americans. The uninsured tend to be poor, less educated, working in part-time jobs, and/or employed by small firms. They face huge barriers to accessing healthcare. Almost half of the uninsured postponed seeking medical attention because of the cost. Lack of insurance results in a decreased use of preventative services and an increased use of tertiary services.
Millions of children lack appropriate health care. Children who come from low income families (those below the federal poverty line) have lower vaccination rates than those at or above the poverty line. Due to lack of adequate health care, children’s ability to learn can be hindered. Children’s voices are not heard and they are not as well informed as adults.
Even though women have a higher life expectancy than men, they still have higher rates of certain health problems that can result in short and long term disabilities. The main source of insurance coverage for both men and women comes from employment and because women are more likely to work part time, receive lower wages, and have interruptions in their work histories, this places them at a higher risk of being uninsured.
Throughout their lives, people living in rural areas have a higher tendency to not seek health care services. Rural areas don’t provide cost-efficient options for physicians to establish practices; therefore people living in these rural areas face the pressing challenge of fitting health care delivery into their communities.
An estimated 3.5 million people each year will experience homelessness. The economic status of homeless persons is terrible, which means that they lack both the educational and financial resources needed to access health care.
People who are chronically ill or disabled face great challenges when it comes to health care access. In 2005, about ninety million people were suffering from a chronic illness and of those ninety million, 11.9 percent of them had limited access to health care. 75 percent of the total medical costs come from those who are chronically ill or disabled. Chronic illness sometimes leads to disability, and close to 50 million Americans have some sort of disability.
The number of people living with AIDS in the U.S. has been on the rise. 341,332 individuals increased to 425,910 from 2001 to 2005. AIDS is believed to be caused by the human immunodeficiency virus (HIV). With a weakened immune system these individual are prone to opportunistic infections. In 2003, HIV infection was the sixth leading cause of death among person 25 to 44 years of age. The course of AIDS is illustrated by a continual decline in the patient’s physical, cognitive, and emotional function and well being. Therefore, this type of disease requires a range of care that can be quite lengthy and costly.

We believe this population is important because sometimes the voices of special populations aren’t heard. Their vulnerability rests on unequal social, economic, health, and geographic conditions, creating barriers in access to care, financing of care, and racial or cultural acceptance. With health costs are on the rise, the priority of special populations slowly seems to disappear. The care of these individual’s is of utmost importance especially since treatment occurs when the option of primary and secondary prevention does not exist, resulting in increased cost for treatment.


Sources:

(2009, January 15). Specific Populations. Retrieved February 18 2009, from U.S. Department of Health & Human Services Web site: http://www.hhs.gov/specificpopulations/

Office of Information Services, (2009, February 18). National Center for Health Statistics. Retrieved February 19, 2009, from Centers for Disease Control and Prevention Web site: http://www.cdc.gov/nchs/

Office of Management and Budget. Retrieved February 18, 2009, from Department of Health & Human services Web site: http://www.whitehouse.gov/omb/budget/fy2009/hhs.html

Shi, L., & Singh, D. (2008). Delivering Health Care in America: A Systems Approach (4th ed.). Sudbury, MA: Jones and Bartlett Publishers.

U.S. Department of Health & Human Services, HIV/AIDS. Retrieved February 18, 2009, from AIDS.gov Web site: http://www.aids.gov/