This blog has focused on varied population health and access to care challenges for racial and ethnic minorities, among other vulnerable and marginalized communities. Recent blogs addressed the dismal state of Maternal mortality and mental health, escalating women’s reproductive health crisis, and disappearing birthing centers across rural regions. The impact of systemic racism and other realities, such as trauma, on quality of care has also been of note. Considerable research identifies their influence on exacerbation and emergence of chronic physical and mental illness; every age group, gender, and individual across the cultural landscape is at risk.
The 2020 International Health Policy Survey from the Commonwealth Fund and Organisation for Economic Co-operation and Development (OECD) highlights a plight worthy of notice: health care habits of American Men faced with financial insecurity. The report compares the access to, use, and affordability of care for males in the U.S. compared to 11 high-income countries.
The report summary focused on overall demographics by gender versus among racial and ethnic groups. The wholistic health triad of physical, behavioral, and psychosocial health gets primary attention yet again with troubling outcomes:
- At least, 16 M men in the US lack health insurance:
- Affordability of health plans remains the primary reason
- 45% of men have problems paying medical bills:
- 67% of these men are frequently stressed about employment and/or financial security
Men in the U.S with income insecurity:
- Are least likely to have a regular physician
- They have the highest rates of Emergency Department use, especially for conditions that could have been treated in the Doctor’s office (e.g., asthma, diabetes, hypertension)
- Skip necessary care due to costs
- Incur medical bills at the highest rates
- Are least likely to access preventative care
- Have the highest rates of avoidable deaths: 337/100,000
- Are more likely to have integrated health issues, especially chronic conditions
- Almost 30% have two or more chronic illnesses
- Have significantly higher rates of smoking and alcohol use, and increased likelihood of having multiple chronic conditions:
- 4X greater likelihood of being in fair or poor health
- Have among the highest rates of mental health care needs: 35% of men
The Bottom Line and Mandate
At this point in time, the data affirms that rates of avoidable deaths, chronic conditions, and mental health needs for U.S. men remain the highest in the world; wholistic health equity quality is at a crossroads. Decreased access to routine preventative primary physical and behavioral health care is compromised by financial insecurity, as readily as traditional behavioral or cultural norms; this includes male resistance to appear vulnerable, weak, or infirmed. The cycle of reactive, emergent, and costly care has an identifiable cause that can be mitigated through a proactive means, encompassing:
- Expanded access to affordable, comprehensive health coverage.
- Targeted person-centric and concordant care, including but not limited to:
- increased access to racially, culturally, and ethnically-diverse providers and practitioners, as well as those trained in and sensitive to LGBTQIA wholistic health
- Increased emphasis on integrated care frameworks that leverage patient engagement through comprehensive visits, concordant treatment approaches, and clinical expertise
- Funding and reimbursement are also enhanced
- Implicit bias training to debunk stigma and systemic racism, and also builds patient-provider trust
- Collective efforts of providers, health plans, systems and organizations, and communities to promote preventive care and healthy behaviors, through targeted population-based engagement, psycho-education, and outreach
For my fellow wholistic health equity quality warriors, we’ve got miles to go before we sleep. Feel free to add further strategic recommendations and resources below.