Name
Chamberlain University
NR-717: Concepts in Population Health Outcomes & Health Policy
Prof. Name
Datea
Health disparities remain a pressing issue in African American communities, especially in underserved regions such as Jackson, Mississippi. One of the most critical concerns is the disproportionately high rate of hypertension, which frequently progresses into heart disease. This disparity has long been recognized at the policy level. For example, House Resolution 238 of the 114th Congress (introduced April 30, 2015) emphasized the goals of National Minority Health Month by addressing inequities faced by African Americans, American Indians, Alaska Natives, Asian Americans, Hispanic Americans, and Native Hawaiians or Pacific Islanders.
Despite such recognition, systemic inequities continue to persist. African Americans often experience adverse health outcomes influenced by social determinants of health such as structural racism, economic hardship, and restricted access to quality healthcare. Furthermore, higher rates of uninsured status exacerbate barriers to preventive services and timely care (Artiga et al., 2024). These inequities not only reflect healthcare system gaps but also the cumulative effects of historical injustices and societal disadvantage.
The primary concern is the persistence of health disparities among African Americans, despite federal and local initiatives to improve equity. High rates of hypertension remain a leading contributor to cardiovascular morbidity and mortality. Beyond biological predispositions, these disparities are reinforced by systemic barriers such as financial strain, lack of culturally competent care, and generational inequities. This cycle of disadvantage creates consistent challenges in achieving equitable health outcomes for African Americans.
National health goals reflect the severity of the issue. According to Healthy People 2030 (n.d.), the prevalence of hypertension in African American adults continues to exceed national averages. The program’s target is to reduce adult hypertension from a baseline of 45.0% to 41.9%, emphasizing the importance of targeted interventions.
A systematic review by Del Pino et al. (2019) highlights how ethnicity and social conditions intersect to worsen health outcomes among Afro-descendant populations across the Americas. They found that structural inequities consistently lead to adverse health indicators compared to other groups.
Table 1 summarizes the determinants and their impacts:
| Determinant | Impact on Health |
|---|---|
| Poor living conditions | Greater exposure to inadequate housing and poor nutrition increases chronic disease risks |
| Poverty | Restricts access to preventive and primary care, leading to late diagnoses |
| Environmental exposures | Pollutants and toxins disproportionately affect African American neighborhoods |
| Systemic discrimination | Fosters mistrust in healthcare and lowers participation in preventive measures |
| Community disadvantages | Reduced availability of healthcare facilities and health-promoting resources |
This evidence makes clear that disparities are not solely medical but are deeply rooted in social and environmental contexts.
Addressing these disparities requires culturally grounded, community-driven interventions. Some effective alternatives include:
Community Health Workers (CHWs): Serving as liaisons between healthcare systems and marginalized populations to foster trust, deliver education, and improve adherence to treatment.
Cultural Competency Training: Ensuring providers can deliver care with respect for cultural values, communication styles, and patient preferences.
Community-Based Programs: Building partnerships between hospitals, local organizations, and faith-based groups to provide free screenings, health fairs, and preventive education.
Health Education Initiatives: Expanding education beyond individuals to entire families and communities, empowering collective action for disease prevention.
The effectiveness of interventions can be assessed using the following criteria:
| Criteria | Description |
|---|---|
| Efficiency | Determines if resources are maximized to reach priority populations |
| Cost-effectiveness | Evaluates whether health benefits justify program costs |
| Population health benefits | Assesses improvements in hypertension outcomes and overall wellness |
| Equity in healthcare | Measures progress in narrowing disparities and ensuring fair access |
By applying these criteria, interventions can be tailored to ensure sustainability, affordability, and cultural responsiveness.
Expected outcomes include measurable improvements in both health and equity. CHW-led programs, for example, are cost-effective compared to physician-only interventions but achieve meaningful community impact. Community-based surveys and interviews can assess satisfaction and identify barriers to care. Expanding insurance access and offering preventive programs are also expected to reduce hypertension-related emergency visits and hospitalizations, thereby narrowing disparities.
Interventions require balancing affordability with comprehensiveness. While CHWs provide affordable and accessible support, they lack the specialized expertise of physicians. Expanding insurance coverage improves healthcare utilization but demands substantial state-level funding. Policymakers must carefully weigh the sustainability of initiatives while ensuring underserved populations benefit from meaningful change.
Key recommendations include:
Expanding insurance access: Medicaid expansion and similar initiatives improve access to preventive and primary care.
Strengthening community partnerships: Collaboration between local organizations and healthcare providers ensures cultural sensitivity and accessibility.
Investing in CHWs and provider training: Building community trust while enhancing culturally competent care can lead to long-term improvements in health equity.
Effective communication requires leveraging trusted community platforms. Disseminating findings through faith-based organizations, local forums, digital media, and mobile health tools ensures accessibility and inclusivity. Research supports that community-based participatory approaches, particularly when supported by digital health interventions, significantly improve cardiovascular health outcomes in minority groups (Buis et al., 2019; Haynes et al., 2022).
Artiga, S., Hill, L., & Presiado, M. (2024, February 22). How present-day health disparities for Black people are linked to past policies and events. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/how-present-day-health-disparities-for-black-people-are-linked-to-past-policies-and-events/
Buis, L. R., Dawood, K., Kadri, R., Dawood, R., Richardson, C. R., Djurić, Z., Sen, A., Plegue, M. A., Hutton, D., Brody, A., McNaughton, C. D., Brook, R. D., & Levy, P. D. (2019). Improving blood pressure among African Americans with hypertension using a mobile health approach (the MI-BP App): Protocol for a randomized controlled trial. JMIR Research Protocols, 8(1), e12601. https://doi.org/10.2196/12601
Del Pino, S., Sánchez-Montoya, S. B., Guzmán, J. M., Mújica, Ó. J., Gómez‐Salgado, J., & Ruíz-Frutos, C. (2019). Health inequalities amongst people of African descent in the Americas, 2005–2017: A systematic review of the literature. International Journal of Environmental Research and Public Health, 16(18), 3302. https://doi.org/10.3390/ijerph16183302
Haynes, N., Kaur, A., Swain, J. D., Joseph, J. J., & Brewer, L. C. (2022). Community-based participatory research to improve cardiovascular health among U.S. racial and ethnic minority groups. Current Epidemiology Reports, 9(3), 212–221. https://doi.org/10.1007/s40471-022-00298-5
Healthy People 2030. (n.d.). Health equity in Healthy People 2030. U.S. Department of Health and Human Services. https://health.gov/healthypeople/priority-areas/health-equity-healthy-people-2030
