NUR 550 Discuss the role of translational research in advancing equitable access to health care and preventative services and policies based on population health

NUR 550 Discuss the role of translational research in advancing equitable access to health care and preventative services and policies based on population health

Health disparities impact several communities in the United States (especially those of the marginalized and underprivileged minority communities), whereby the majority of these communities face major social disadvantages (Tucker et al., 2019). Translational research is a beneficial platform to aid in transporting scientific evidence-based practice into clinical practice which can aid in advancing equitable access to healthcare and in establishing preventative policies based on population health.

    According to Tucker et al., (2019), researchers should partner with marginalized groups such as ethnic minorities, gender minorities, and other health disparity groups to ensure that they are included and represented in research studies which could also positively impact them. Accordingly, translational research may also help to cultivate equitable access and improve healthcare for these specific underrepresented groups.

    Since research begins with a scientific question, it is important to identify why a health disparity may exist. As I have experienced in my working environment, many times some minority postpartum mothers share that they would love to come to visit their premature infants in the neonatal intensive care unit (NICU), but they lack the financial means, childcare, and transportation to do so. Therefore, researchers must consider these barriers when considering how to better manage and deliver care in a more equitable manner.

    A major health disparity that exists is the massive pregnancy-related mortality rates for Non-Hispanic Black women in the United States. According to Carvalho et al., (2021), Black women have experienced mortality rates three to four times more often than those of White women, no matter their educational level. Moreover, in Massachusetts, Black women have been twice as likely as White women to experience pregnancy-associated mortalities, whereby the majority of these deaths were considered as preventable (Carvalho et al., 2021). As a result of these racial disparities, a national law titled Preventing Maternal Deaths Act of 2018 has been passed to address the interpersonal and institutional racism that is correlated with maternal health and racial disparities among these minority, maternal groups.

    This Act seeks to address the Black maternal health disparity by identifying disparities, creating improvements in data collection, forming maternal mortality review committees (MMRC) across the country, and by creating a global Maternal Mortality Review Information Application (MMRIA) via the Centers for Disease Control and Prevention program (Carvalho et al., 2021). These efforts are proposed to standardize the process of reporting by analyzing maternal death across the United States, researchers can identify communities that are in the most need of assistance.

References

Carvalho, K., Kheyfets, A., Maleki, P., Miller, B., Abouhala, S., Anwar, E., & Ndidiamaka Amutah-Onukagha. (2021). A Systematic Policy Review of Black Maternal Health-Related Policies Proposed Federally and in Massachusetts: 2010–2020. Frontiers in Public Health, 9https://10.3389/fpubh.2021.664659

Tucker, C. M., Kang, S., & Williams, J. L. (2019). Translational research to reduce health disparities and promote health equity. Translational Issues in Psychological Science, 5(4), 297-301. https://10.1037/tps0000215

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 I agree with you that involving marginalized groups in the research about health disparity is a good idea. Marginalized populations understand their challenges and the entire experience of limited access to healthcare services. As a result, underprivileged population can inform critical clinical choices (Brosnahan et al., 2020). Translational research create room for partnership between marginalized groups with researchers. Besides, this research acknowledges the role of the partnership in increasing healthcare equity. Health disparities interfere with the provision of quality healthcare services (Chowkwanyun & Reed Jr, 2020). Therefore, healthcare stakeholders rely on researchers to inform on significant decisions. Translational research helps to cultivate equitable access to quality healthcare services for the underprivileged groups. Financial constraint is a major cause of healthcare disparities. Unfortunately, underprivileged population has struggled to pay for quality healthcare services. Due to financial challenges, other health complications have escalated. Different stakeholders have been involved in increasing accessibility and affordability of healthcare services to all groups. Improved access to healthcare services reduces health disparities.

References

Brosnahan, S. B., Jonkman, A. H., Kugler, M. C., Munger, J. S., & Kaufman, D. A. (2020). COVID-19 and respiratory system disorders: current knowledge, future clinical and translational research questions. Arteriosclerosis, thrombosis, and vascular biology, 40(11), 2586-2597. https://doi.org/10.1161/ATVBAHA.120.314515

Chowkwanyun, M., & Reed Jr, A. L. (2020). Racial health disparities and Covid-19—caution and context. New England Journal of Medicine, 383(3), 201-203. DOI: 10.1056/NEJMp2012910

Translational research is being used to address health disparities in the interest of improving population health. One example of this is the utilization of translational and clinical research in the publication by researchers from the National Institute on Minority Health and Health Disparities (NIMHD), “The Science of Health Disparities Research”. This resource covers the spectrum of research on health disparities (NIMHD, 2021). Translational research is a vehicle for bringing knowledge about health disparities and ways to improve equity from theory into practice to impact the health and wellness of a population.

The Department of Health Care Services (DHCS) in California has recently enacted an initiative to transform the way Medi-Cal delivers healthcare services. This new program, called CalAIM, is shifting Medi-Cal toward a population health approach that focuses on prevention and caring for the whole person by extending supports and services beyond formal healthcare settings directly into California communities. “CalAIM will offer Medi-Cal enrollees coordinated and equitable access to services that address their ​physical, behavioral, developmental, dental, and long-term care needs, throughout their lives, from birth to a dignified end of life” (DHCS, 2023). ​​​​​​​​This initiative is a direct approach to improving equitable healthcare services to all Californians in need.

References:

Department of Health Care Services (DHCS) (2023). CA.gov. CalAIM Our Journey to a Healthier California for All. https://www.dhcs.ca.gov/calaim#initiatives

National Institute on Minority Health and Health Disparities (NIMDH) (2021). The Science of Health Disparities Research.https://nimhd.nih.gov/about/publications/the-science-of-health-disparities-research.html

 I concur with you that healthcare stakeholders have continued to show their commitment in addressing health disparities. Addressing this health issue is part of the efforts to improve healthcare services. However, tackling the issue of health disparities require informed clinical choices (Martin et al., 2019). Translational research informs important decisions on health disparities. Therefore, healthcare stakeholders benefit by the use of translational research. Besides, this research is a vehicle for bringing knowledge about health disparities and ways to improve equity from theory. Health disparity is a serious health issue that affect healthcare service delivery. Therefore, researchers partner with minority groups when researching about health disparities. The partnership is always aimed at creating space for public participation. Getting first-hand information from the marginalized population boasts the accuracy of decision-making process (Fang et al., 2020). Translational research provides critical information about the underprivileged population. Hence, effective use of translational research influences important decisions on handling health disparities.

References

Fang, E. F., Xie, C., Schenkel, J. A., Wu, C., Long, Q., Cui, H., … & Woo, J. (2020). A research agenda for ageing in China in the 21st century: Focusing on basic and translational research, long-term care, policy and social networks. Ageing research reviews, 64, 101174. https://doi.org/10.1016/j.arr.2020.101174

Martin, A. R., Kanai, M., Kamatani, Y., Okada, Y., Neale, B. M., & Daly, M. J. (2019). Clinical use of current polygenic risk scores may exacerbate health disparities. Nature genetics, 51(4), 584-591.

Because traditional research takes year to reach application, therefore it is no longer the only or the most effective way to address public health; translational research is helping bridge that gap between research and application. Translations research, also known as implementation science, tests implementation interventions as well as clarify “…what implementations work for whom” (Titler, 2018). The wait time between evidence-based research and application contributes to poor health outcomes; translational research integrates evidence-based research into practice to improve health care delivery and improve the burden of global disease (Titler, 2018).

Insurances are now mandated to cover more preventative services than in the past. One example of how the focus on preventative services is the US Department of Health and Human Services (HHS) creating academic research centers that “…conduct community based applied public health research to address chronic disease…causes of death and disability in the United State” (CDC, 2022), as chronic disease is the most costly within the United States, and it is preventable.  An Arizona policy addressing preventative services is 411 – Women’s Preventative Care Services through Arizona Health Care Cost Containment Services (AHCCS) which defines preventative care as an annual well-woman visit that addresses the following issues, 1) risk factors for disease, 2) identifying existing health problems, 3) and promotion of healthy lifestyle choices. Some of the specific services included are breast exams, family planning services, sexually transmitted disease screenings, mammograms and preconception counseling (azahcccs.gov, n.d.)

References

azahcccs.gov. (n.d.). AMPM policy 411 – azahcccs.gov. AMPM Policy 411 – AHCCCS. Retrieved March 10, 2023, from https://www.azahcccs.gov/shared/Downloads/MedicalPolicyManual/400/411.pdf

Centers for Disease Control and Prevention. (2022, November 10). Prevention Research Centers. Centers for Disease Control and Prevention. Retrieved January 29, 2023, from https://www.cdc.gov/prc/

Titler, M. G. (2018). Translation Research in Practice: An Introduction. Online Journal of Issues in Nursing, 23(2), 1. https://doi-org.lopes.idm.oclc.org/10.3912/OJIN.Vol23No02Man01

 It is true that managing chronic health problem is costly and tedious in the United States of America. Unfortunately, underprivileged households struggle to access quality healthcare services. Financial constraints have complicated the management of chronic health complications among middle and low-income earners in the U.S. (Vardell & White, 2020).      Healthcare stakeholders have conducted various health reforms aimed at increasing accessibility, availability, and affordability of healthcare services to all Americans. The Affordable Care Act was a health care reform that allowed insurers to offer their services to many uninsured Americans. Most uninsured Americans were struggling to access quality healthcare services (Li et al., 2022). The implementation of the Affordable Care Act transformed healthcare service delivery. This health reform increased access to healthcare services for vulnerable groups. Financial constraints stopped to be a problem to many Americans who obtained health insurance. Translational research is helpful in guiding efforts to eradicate health disparities. Translational research findings are significant in informing decision-making process.

References

Li, G. M., & Pasek, J. (2022). Do you prefer Obamacare or the affordable care act? Simulating an informed public to improve survey measurement. International Journal of Public Opinion Research, 34(3), edac029. https://doi.org/10.1093/ijpor/edac029

Vardell, E., & White, D. (2020). Exploring affordable care act and health insurance information seeking with google trends. Journal of Consumer Health on the Internet, 24(3), 269-277. https://doi.org/10.1080/15398285.2020.1791669