Applying Research Skills – Healthcare Disparities

Health disparities are the measurable differences in health outcomes notable across various population groups. Such differences in health outcomes may occur across racial groups, individuals with disabilities, and/or populations from low socioeconomic status (SES). This article presents an annotated bibliography of articles focused on various aspects of healthcare disparities. It also identifies the professional relevancy of health disparities, the process of article identification and selection, and the assessment of the credibility of the selected sources of evidence.

Professional Experiences and Relevancy

It is a common thing for a nurse to come across cases of health disparities, especially among individuals from low SES populations and certain racial groups. As a nurse, I have seen and experienced cases of health disparities mostly driven by the inability of certain individuals with similar health conditions to have varied outcomes due to the inability of some of the individuals to afford better quality and costlier care for the condition. From a professional perspective, the topic of health disparities is relevant in nursing as it is a major problem that a majority of nurses will come across, and out of experience, it has major mental health consequences on the nurse. Understanding health disparities is also important in nursing, and as discussed by Kett et al. (2022), nurses can lead efforts to address health disparities by training healthcare departments at local health centers. Nurses with a wider knowledge of health disparities can also provide evidence-based contributions to policy changes and policy-driven interventions.

Identification and Selection of Academic Peer-Reviewed Journal Articles

A search for peer-reviewed academic and journal articles was conducted in two databases: PubMed and ProQuest. The keywords used for the search included “socioeconomic status,” “health disparities,” “health inequities,” “health equity,” “community health assessment,” “community health improvement plan,” “strategic planning,” and “local health departments.” Boolean tools such as “AND,” “OR”, and “NOT” were also used to improve the search results. All returned results were filtered using the publication year and type of article, with all articles limited to articles published between 2020-2024 and all articles being peer-reviewed journals, including systematic reviews.

Assessing Credibility of Sources

The credibility of the articles was assessed based on the CRAAP (Currency, Relevance, Authority, Accuracy, and Purpose) test. It was ensured that all articles were published within the last five years, that the articles’ topic was related to health disparities, and that the authors had practice or experience qualifications in the topic of focus. Credibility was also considered regarding the accuracy of the methods of research and data presented, as well as the purpose of the paper. Four papers that passed the CRAAP test were analyzed and reviewed, and an annotated bibliography was developed.

Annotated Bibliography

Bell, C. N., Sacks, T. K., Thomas Tobin, C. S., & Thorpe, R. J. (2020). Racial non-equivalence of socioeconomic status and self-rated health among African Americans and Whites. SSM – Population Health, 10, 100561. https://doi.org/10.1016/J.SSMPH.2020.100561

This article study aimed at exploring and determining the mediating role of racial non-equivalence of SES on racial inequities in self-rated health by education and sex with a focus on African Americans and White populations. The authors reviewed and analyzed data from the 2007–2016 National Health and Nutrition Examination Survey in the United States with a focus on data identifying household income, federal poverty line, homeownership, investment income, and levels of education, including college graduates and non-college graduates, and sex. The authors concluded that SES indicators were notably associated with self-rated health among African Americans compared to Whites. The article also concluded that racial non-equivalence of SES had implications for health inequities. This article is included in the review as it provides insights on various non-equivalence of SES and their contribution to health disparities, especially self-rated disparities. The article can guide the development of targeted EBP interventions to address the health disparities between African Americans and Whites and promote health equity regardless of SES.

Hardman, R., Begg, S., & Spelten, E. (2020). What impact do chronic disease self-management support interventions have on health inequity gaps related to socioeconomic status: A systematic review. BMC Health Services Research, 20(1), 1–15. https://doi.org/10.1186/S12913-020-5010-4/TABLES/5

This article presents a systematic review of current evidence aimed at assessing the moderating effect of SES on self-management support (SMS) interventions on the basis of participation, retention, and post-intervention outcomes. The authors argue that the social gradient in chronic disease (CD) is clearly identifiable within populations with diverse SES and hypothesize that the effectiveness of self-management of CD is moderated by SES regardless of support. Self-management is noted as a critical element in reducing the risk of morbidity and mortality from CD. Based on a review of 19 articles, the authors found that health disparities were reduced with prolonged and supported interventions that were tailored to individuals. The article concludes that support interventions improve self-management in CDs and reduce health inequity gaps associated with SES by improving skills of self-care, better outcomes, and better access to support resources. This article is relevant and was selected as it provides evidence-based strategies to reduce health inequity gaps related to SES, such as self-management support interventions for chronic conditions.

Nelson, H. D., Cantor, A., Wagner, J., Jungbauer, R., Quiñones, A., Stillman, L., & Kondo, K. (2020). Achieving health equity in preventive services: A systematic review for national institutes of health pathways to prevention workshop. Annals of Internal Medicine, 172(4), 258–271. https://doi.org/10.7326/M19-3199

This article presents a systematic review of national institutes of health pathways to prevention workshop examining the effects of barriers contributing to health disparities in 10 recommended preventive services for adults. It also evaluates the effectiveness of the interventions in reducing these barriers and health disparities. The authors argue that disadvantaged populations, whether socially, physically, and or economically, in the U.S. are prone to disparities when it comes to the utilization of preventive health services. Based on a review of 18 studies, the authors noted that the major barriers among disadvantaged populations include low and lack of insurance coverage and the absence of a regular primary care provider for preventive services. The article concluded that overcoming the health disparities among disadvantaged populations requires focusing on the social determinants of health to improve healthcare access and delivery. It also recommends the implementation of culturally tailored interventions to help achieve health equity in preventive services. This article was selected as it focuses on strategies for addressing health disparities and promoting health equity in preventive services among disadvantaged populations. Besides, the authors have noted that findings on this topic are mixed and inconclusive, creating a basis for future research.

Rigolon, A., Browning, M. H. E. M., McAnirlin, O., & Yoon, H. (2021). Green space and health equity: A systematic review on the potential of green space to reduce health disparities. International Journal of Environmental Research and Public Health 2021, Vol. 18, Page 2563, 18(5), 2563. https://doi.org/10.3390/IJERPH18052563

This article presents a systematic review exploring the potential of green spaces in improving physical health outcomes among disadvantaged populations as compared to privileged groups. The authors argue that disadvantaged groups around the world, like low SES and racial minority groups, experience worse health outcomes than more privileged groups. Based on a comprehensive review of 90 articles that met the authors’ inclusion criteria, the systematic review found that lower-SES populations had better benefits from green spaces than wealthier people. However, green differences did not have notable effects or differences in health outcomes based on race. The article concludes that green spaces have the potential to advance health equity and provide ways. Notably, the article is selected and is relevant as it provides insights into the use of and importance of green spaces such as parks in urban planning in addressing health equities, especially those related to SES.

Summary and Reflections on Developing the Annotated Bibliography

The development of this annotated bibliography, from the search, selection, analysis, and writing of the annotated bibliography, was a great learning experience. First, I have further improved my skills in literature search across various databases. This includes the use of various tools, such as Boolean functions and filtering functions provided by the databases. Secondly, I have learned how to critically review and analyze literature to identify evidence to guide practice. Thirdly, I have gained new and valuable insights on health disparities, including how various factors, such as socioeconomic, racial, and geographic factors, contribute to the development of health. I have also learned how health disparities impact various communities and the nation socially and economically. Finally, I have gained new knowledge that I can incorporate with clinical knowledge to address health disparities.

References

Bell, C. N., Sacks, T. K., Thomas Tobin, C. S., & Thorpe, R. J. (2020). Racial non-equivalence of socioeconomic status and self-rated health among African Americans and Whites. SSM – Population Health, 10, 100561. https://doi.org/10.1016/J.SSMPH.2020.100561

Kett, P. M., Bekemeier, B., Herting, J. R., & Altman, M. R. (2022). Addressing health disparities: The health department nurse leads the executive’s relationship to improved community health. Journal of Public Health Management and Practice, 28(2), E566–E576. https://doi.org/10.1097/PHH.0000000000001425

Nelson, H. D., Cantor, A., Wagner, J., Jungbauer, R., Quiñones, A., Stillman, L., & Kondo, K. (2020). Achieving health equity in preventive services: A systematic review for a national institute of health pathways to prevention workshop. Annals of Internal Medicine, 172(4), 258–271. https://doi.org/10.7326/M19-3199

Rigolon, A., Browning, M. H. E. M., McAnirlin, O., & Yoon, H. (2021). Green space and health equity: A systematic review on the potential of green space to reduce health disparities. International Journal of Environmental Research and Public Health 2021, Vol. 18, Page 2563, 18(5), 2563. https://doi.org/10.3390/

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Question

Health care problem 1:
Healthcare Disparities
o Description: Differences in health outcomes and care quality experienced by
certain populations due to socioeconomic, racial, or geographic factors.
o Interventions: Federal goals, policy changes, Triple Aim for populations,
community health improvement plans, patient advocacy efforts, cultural
competency training.

Applying Research Skills – Healthcare Disparities

o Keywords: Socioeconomic status, health disparities, health inequities, health
equity, community health assessment, community health improvement plan,
strategic planning, local health departments

1. Write a brief overview of the selected healthcare problem or issue. In your overview:
o Summarize the health care problem or issue.
o Describe the professional relevance of this topic.
o Describe any professional experience you have with this topic.
2. Identify peer-reviewed articles relevant to this healthcare issue or problem.
o Conduct a search for scholarly peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used. You will select four current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic.
o Use keywords related to the health care problem or issue you are researching to select relevant articles.
3. Assess the credibility and explain the relevance of the information sources you find.
o Determine if the source is from an academic peer-reviewed journal.
o Determine if the publication is current.
o Determine if information in the academic peer-reviewed journal article is still relevant.
4. Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format. Provide a rationale for the inclusion of each selected article. The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic. In your annotated bibliography:
o Identify the purpose of the article.
o Summarize the information.
o Provide a rationale for the inclusion of each article.
o Include the conclusions and findings of the article.
o Write your annotated bibliography in paragraph form. The annotated bibliography should be approximately 150 words (1–3 paragraphs) in length.
o List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.
o Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.
5. Summarize what you have learned while developing an annotated bibliography.

Applying Research Skills – Healthcare Disparities