StudentsHealthcare Equity - (1).pptx

Healthcare Equity Presented by: Ayat Elayan Supervisor: Dr. Waddah  Outlines:  Healthcare Equity, Healthcare inequity, and Healthcare disparities.  Social determine of health and its relation to the health equity.  Translating health care equity to a health care system, provider...

Healthcare Equity Presented by: Ayat Elayan Supervisor: Dr. Waddah  Outlines:  Healthcare Equity, Healthcare inequity, and Healthcare disparities.  Social determine of health and its relation to the health equity.  Translating health care equity to a health care system, providers, and staff  Key Steps to Advancing Health Equity.  The role of nurses in advancing health equity.  Healthcare equity in Jordan.  Summary  References  Objectives: 01 Define the Healthcare Equity, Healthcare inequity, and Healthcare disparities. 02 Understand the social determine of health and its relation to the health equity. 03 Understand how to translating health care equity to a health care system, providers, and staff. 04 Identify the key Steps to Advancing Health Equity. 05 Understand the role of nurses in advancing health equity 05 Understand and discuss the healthcare equity in Jordan. What is healthcare equity?  Health equity: This means efforts to ensure that all people have full and equal access to opportunities that enable them to lead healthy lives.  Health Care Equity: Equitable access, experience, and outcomes for every patient. Health Care Equity + Equity in Social Determinants of Health ➜ Health Equity  Health inequities: Differences in health that are avoidable, unfair, and unjust. Health inequities are affected by social, economic, and environmental conditions.  Health disparities: Differences in health outcomes among groups of people. What are the Social Determinants of Health?  Social determinants of health (SDOH) are the conditions in which people are born, grow, live, work, and age that shape health.  They include factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks, as well as access to health care. Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity | KFF ocial determine of health Findings about the SDOH Economic Community Stability and social Education context Health care Neighborhood Food system and physical environment The determinants of health are interrelated and interconnected. The goal of addressing SDOH is to ultimately achieve health equity. COVID-19 and SDOH Why is Health Equity Important? Health equity is important for one big, obvious reason: unequal access to healthcare. However, there are several other reasons achieving health equity is crucial. For example, between 2019 and 2020, the average American life expectancy declined by 1.9 years. While COVID-19 can partially be blamed, this decrease was eight times higher than in other developed countries. 1. Health inequity is the cause of health decrease in many ways. For example, many people find themselves with a scarcity of hospitals nearby, an inability to pay for treatments, and a lack of education on how to maintain their health. 1. Studies have also shown that low income contributes to poor health, and poor health contributes to lower incomes. 2. For example, people with disabilities may find themselves unable to live independently or be discriminated against professionally. It’s a vicious circle that continues to impoverish countless communities across the nation. What is health equity’s impact on our economy? 1. The truth is there’s a serious economic cost to health inequity. 2. * One study estimated that inequities cost the U.S. economy $54 billion to $61 billion annually and proved the endless cycle: poverty increases healthcare inequities and health inequities worsen poverty.  Examples of Healthcare Equity: All health equity examples focus on removing barriers to care. Examples of services that promote health equity: Providing low-cost, basic healthcare services to low-income neighborhoods. Mobile health screenings to provide treatment to those without transportation. Offering free health seminars targeted toward the health issues of minority groups. Providing health appointments after hours so that employees can see a doctor without taking time off work. Offering better employer-funded healthcare programs.  Health care disparities  Reverend Martin Luther King is often quoted as saying that of all the forms of inequality, injustice in health care is the most shocking and inhumane (1966). Healthcare disparities  “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage” (OMH, 2018).  These differences are often related to unequal distribution of power, money, and resources, which more often impact the most vulnerable populations.  Eliminate health disparities Investigate Achieve and act health upon the equity SDOH Translating health care equity to a health care system, providers, and staff  Roadmap to Health Equity: Step 1: Linking Quality and Equity.  Step 2: Creating a Culture of Equity.  Step 3: Diagnosing the Disparity.  Step 4: Designing the Activity.  Step 5: Securing Buy-In.  Step 6: Implementing Change.  Creating a Linking Quality Diagnosing the Culture of Equity and Equity Disparity  Creating a Linking Quality Diagnosing the Culture of Equity and Equity Disparity - Developing Mission, Vision and Values Statements. - Community Advisory Boards. - Assessing Organizational Culture.  Creating a Linking Quality Diagnosing the Culture of Equity and Equity Disparity - Developing Mission, - Involving Patients, Families, Vision and Values and Communities in Care. Statements. - Conducting Focus Groups - Community Advisory Discussing Sensitive Topics. Boards. - Getting Patient Feedback - Assessing Organizational Culture. Designing the Implementing Securing Buy-In Activity Change  Methodology Designing the Implementing Securing Buy-In Activity Change Intervention Design and Implementation Designing the Implementing Securing Buy-In Activity Change Intervention Building Design and Partnerships with Implementation Stakeholders Designing the Implementing Securing Buy-In Activity Change Intervention Building Program Design and Partnerships with Evaluation Implementation Stakeholders   Advocating for policy change  Public policies have a major influence on health care providers, systems, and the populations they serve. Accordingly, nurses can help promote health equity by bringing a health lens to bear on public policies and decision-making at the community, state, and federal levels.  Informing health-related public policy can involve communicating about health disparities and SDOH with the public, policymakers, and organizational leaders, focusing on both challenges and solutions for addressing health through actions targeted to achieving health equity. Key Steps to Advancing Reassess strategies Evaluate and Health Change monitor efforts Equity Identify policies important health disparities The goal: Equity in health and it’s determinants * Identify important health disparities that are of concern to key stakeholders, especially those affected. * Identify social inequities in access to the resources and opportunities needed to be healthier that are likely to contribute to health disparities. Change policies, laws, systems, environments and practices to eliminate inequities in the opportunities and resources needed to be as healthy as possible. Evaluate and monitor efforts using short-term and long- Reassess term measures. strategies Evaluate and monitor Change efforts Reassess strategies to plan next steps. Identify policies important health disparities How do we Improve Equity in the Health System? Ensure equitable provision of high-quality healthcare regardless of circumstances and make sure that all individuals and communities get the care they need. We can do this by: Building health equity into all health planning and delivery doesn’t mean all programs are all about equity but all take equity into account in planning their services and outreach Targeting some resources or programs specifically to address disadvantaged populations or key access barriers looking for investments and interventions that will have the highest impact on reducing health disparities or enhancing the opportunities for good health of the most vulnerable Health equity impact assessment (HEIA)is a structured method to include equity in health planning and decision making HEIA is a practical tool for assessment and decision support. It helps to address and anticipate any unintended health impacts that a plan, policy, or program might have on vulnerable or marginalized groups within the general population. It builds on existing work and creates greater consistency and transparency in the way that equity is being considered across the health system. The end goal of HEIA is to achieve health equity and eliminate health disparities.  HEIA has five primary purposes for users: 1. Help identify potential unintended health impacts (positive or negative) of a planned policy, program, or initiative on vulnerable or marginalized groups within the general population. 2. Help develop recommendations as to what adjustments to the plan may mitigate negative impacts as well as maximize positive impacts on the health of vulnerable and marginalized groups. 3. Embed equity across an organization’s existing and prospective decision-making models, so that it becomes a core value and one criterion to be weighed in all decisions.  HEIA has five primary purposes for users: 4. Support equity-based improvements in program or service design, i.e., through considerations such as “How must this program be adjusted to meet the needs of specific populations?”. 5. Raise awareness about health equity as a catalyst for change throughout the organization, so decision-makers develop ‘stretch goals’ through considerations, such as “How can we include more people in this program, especially those often missed?” or “What barriers should we look for?” and “Are we as effective as we could be, especially those with the greatest health needs? When should the HEIA tool be used? How to advance health equity?  * Shifting our work Have you heard the definition of ‘insanity’ >> Doing the same thing over and over again and expecting different results? These practices are really meant to help us shift our work. If you hear the Commissioner talk, if you look at the data, these gaps, these inequities, aren’t changing and they aren’t going to change>> unless we take a different track - How do we do our work differently, so we get a different result Six public practices to advance health equity 1. Equip our staff: we have to give them the skills, knowledge and tools to do their work differently 2. Authentic community engagement: We have to engage – not just engage, but authentically engage—with communities, especially those communities that may be experiencing inequities in your jurisdiction – it could be populations of color, but it could also be the working poor, elderly citizens, laborers 3. Collect data for change: this is about collecting data differently and using the data with the community to make change. Six public practices to advance health equity 4. Show organizational commitment: We have to make sure our organization shows its commitment to health equity through actions – this is the “walk and talk.” We have to get out there and we have to start talking. 5. Spread the word about what creates health: We have to spread the word about what creates health, and we need to influence public policies 6. Influence public and private policy: we can influence policy conversations by connecting those policies about housing to health outcomes. We may not have the authority to change economic policy, but we can provide the health perspective and advocate for health to be considered in policymaking. We can connect with other coalitions in our community to share what we know  Where we are headed *HealthPeommu Co p le is everywh co nities n sidwill ered ere hin uave n thders th e detan evelo p ower d that pmen toh ealth t an ape co sh d imp mes th fromlemen eir own th etatio co h ealthy nndoitio f all fu n stu poores flicies o;u r – n ot njueigh co smmu t thob onsrh ities e os pecific o ds will, whhto ave athkealth thein dres sooor fuhrces ealth, ab care, ility obtopp utmake op rtu o licies nities decisiniowe tran ns h, ave sand po for rtatio th eedpnucatio ower , h outons ing, create an d ed ange emp ch u catio loy thment, nat, emp will anloydallow the menmany tht, emp u an both lic derth s afety facto eir rso rthat enviro sh families ape nomental utor dthrive ailyp rotectio lives an d.b en.h ealthy. * Com mun ities will be plac es of carin g and conn ectio n, the kind s of plac es wher e ever yone is inclu ded and no one faces struc tural barri ers to their healt h and well- bein g. The role of nurses in advancing health equity Nurses are in a position to improve outcomes for the underserved and can work to address the structural and institutional factors that produce health disparities in the first place. Nurses can use their unique expertise and perspective to help develop and advocate for policies and programs that promote health equity.  Nurse will help advance health equity Support for and the willingness of the nursing workforce to take on new roles in new settings in the community. Consistency in nurses’ preparation for engaging in downstream, midstream, and upstream strategies aimed at improving health equity by addressing issues that compromise health, such as geographic disparities, poverty, racism, homelessness, trauma, drug abuse, and behavioral health conditions.  Nurse will help advance health equity More experiential learning and opportunities to work in community settings throughout nursing education to ensure that nurses have skills and competencies to address individuals’ complex needs and promote efforts to improve the well-being of communities. Nursing education that goes beyond teaching the principles of diversity, equity, and inclusion to provide sustained student engagement in hands-on community and clinical experiences with these issues.  Nurse will help advance health equity Funding to support new models of care and functions that address SDOH, health equity, and population health. Evaluation of models to build the evidence needed to scale programs and the policies and resources necessary to sustain them.  Health care Equity in Jordan  Healthcare landscape in Jordan Within the healthcare landscape of Jordan, a multifaceted tapestry of service providers takes center stage, encompassing the public, private, international, and charitable sectors. The public sector, a cornerstone of the nation’s healthcare apparatus, comprises the Ministry of Health, the Royal Medical Services, university hospitals, and the Center for Diabetes, Endocrinology, and Genetics.  Healthcare landscape in Jordan The Jordanian government’s healthcare policy involves its mooring a system categorized into three hierarchical service levels, encompassing primary healthcare and tertiary care.  Major challenge for the health system Major challenge for the health system in general and the MoH in specific as it seeks to meet increasing expectations of the population which include:  Increasing demand on health services due to population growth.  Epidemiological transition in Jordan (which means lower NCD rates and higher CD rates).  The presence of refugees.  The projected population growth especially among young and elderly persons.  Increasing health care costs in light of the economic conditions and numerous financial and economic crises.  Benchmarked against international standards According to the World Health Organization (WHO), the global average stipulates a minimum of 28 beds for every 10000 individuals. In 2020, Jordan’s healthcare landscape featured 14 beds per 10000 people (Obeidat, & Alourd, 2024).. National goal according to Jordan 2025 vision: Improve the quality of services provided to citizens and equity in their distribution. Strategic Objective: Provide equitable and high-quality health care services Specific objectives determined for primary health care, and the programs dedicated for each objective: 1- Improving the quality of primary health services 2- Controlling communicable diseases. 3- Controlling NCDs 4- Promoting mental health and addiction control services. 5- Promoting reproductive health, family planning and child health services. 6- Limiting environment related health risks. 7- Promoting all components of school health services. 8- Promoting healthy practices in the community. 9- Promoting occupational health programs. Social determinants of access to healthcare as indicator of health equity among patients with chronic diseases in Jordan: a cross-sectional study Rula Al-Rimawi, Jafar Alasad Alshraideh, Mahmoud Al- Hussami and Madi Jaghbir  Social determinants of access to healthcare as indicator of health equity among patients with chronic diseases in Jordan: a cross-sectional study (Al-Rimawi et al., 2021) Background: The study aims to describe and predict the social determinants of accessing healthcare as an indicator of health equity among patients with chronic diseases. Methods: A cross-sectional structured face to face interview survey of 320 patients selected from three hospitals. Hierarchical regression was used to predict the social determinant of accessing healthcare system in Jordan.  Social determinants of access to healthcare as indicator of health equity among patients with chronic diseases in Jordan: a cross-sectional study (Al-Rimawi et al., 2021) Results: Seven predictors were statistically significant, R = 0.368, R2 = 0.135, adjusted R2 = 0.116, F(7,309) = 6.91, P < 0.001. The variables predicted approximately 12% of the variance in accessibility scores. The strongest unique predictive contribution was from household income and gender. Higher income and being female predicted higher scores on accessibility. Whereas, faraway distance between place of residency and hospital predicted lower scores on accessibility. Conclusion: There is inequity between patients in accessing public healthcare system in Jordan based on income, gender and place of residency. Summary: Healthcare Equity, Healthcare inequity The role of nurses in Healthcare advancing disparities. health equity. Key Steps to SDOH and Advancing its relation Health to the health Equity. equity. Roadmap to Health Equity.  References Al-Rimawi, R., Alshraideh, J. A., Al-Hussami, M., & Jaghbir, M. (2020). Social determinants of access to healthcare as indicator of health equity Al-Rimawi, R., Alshraideh, J. A., Al-Hussami, M., & Jaghbir, M. (2020). Social determinants of access to healthcare as indicator of health equity among patients with chronic diseases in Jordan: a cross-sectional study. International Journal of Environment and Health, 10(1), 24-37. mong patients with chronic diseases in Jordan: a cross-sectional study. International Journal of Environment and Health, 10(1), 24-37. Mason D., Dickson E., McLemore M.., Perez A. (2020). Policy and politics in nursing and health care.8th ed. Elsevier/Saunders. Mason D., Dickson E., McLemore M.., Perez A. (2020). Policy and politics in nursing and health care.8th ed. Elsevier/Saunders. Ministry of Health, M. The Ministry of Health Strategic Plan 2018- 2022. 2018.https://moh.gov.jo/ebv4.0/root_storage/en/eb_list_page/the_ Ministry of Health, M. The Ministry of Health Strategic Plan 2018- 2022. 2018.https://moh.gov.jo/ebv4.0/root_storage/en/eb_list_page/the_ ministry_of_health_strategic_plan_2018-2022.pdf. ministry_of_health_strategic_plan_2018-2022.pdf. Obeidat, B., & Alourd, S. (2024). Healthcare equity in focus: bridging gaps through a spatial analysis of healthcare facilities in Irbid, Jordan. Obeidat, B., & Alourd, S. (2024). Healthcare equity in focus: bridging gaps through a spatial analysis of healthcare facilities in Irbid, Jordan. International Journal for Equity in Health, 23(1), 52. nternational Journal for Equity in Health, 23(1), 52. Wakefield, M., Williams, D. R., & Le Menestrel, S. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. National Wakefield, M., Williams, D. R., & Le Menestrel, S. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. National Academy of Sciences. Academy of Sciences. Thank you