The paper discusses for Wellness education program proposal to provide better health care facilities to Hispanics

Wellness education program proposal

Introduction:

A total of 52 million (16.7% of total American population) Hispanics are living in United States (US) as per the census of 2012.  Out of 52 million, 47 million are US citizen. Hispanics are second largest ethnicities of US. Death rates in Hispanics are 24% lower than normal white Americans. At the same time death rate is 50% higher in Hispanics due to diabetes, heart diseases and liver diseases than white Americans. Kidney diseases are also an important cause of death in Hispanics. Hispanics are more vulnerable for not receiving appropriate medical interventions than white Americans. Factors responsible for this are lack of insurance, low finances, lack of education and language skills. Lack of language proficiency is one of the most important reasons behind inability to access health education and it also prevents regular delivery of medical care from healthcare workers. The present proposal focused upon developing a wellness education program for Hispanic population of US.

Problems and Needs: Vulnerability of Hispanics of not receiving proper health care education which will lead to high death rates due to deadly diseases like heart disease, diabetes, cancer and liver diseases is the problem we are going to address. A comprehensive health education program is required to provide better health care facilities to Hispanics. While making proposal we will consider their inclination towards comprehensive and alternative medicines (CAM). Other things that need to keep in mind are ethical, legal and economic principles of disease protection and health promotion.

Proposed solution: A comprehensive health education program for Hispanic population would address the discrepancies of health care facilities experienced by them. Integration of language, cultural elements, CAM, and spiritual care would provide holistic care. The plan should be considered physical and mental status of Hispanics. Following considerations should keep in mind:

Cultural consideration: People of every ethnicity follow some customs, beliefs, social structure, and value systems. Providing health care that is competent to cultural believes of individuals, families and communities is the most important priorities. A trans-cultural care model was prepared by Dr. Marilyn A. Ray. This trans-cultural care recognizes values, attitude and belief of target population by considering their surroundings, economic conditions, cultural and technological points. This model contains four specific concepts of care: ethics of trans-cultural caring, spirit of care, trans-cultural framework, and global sources.  Trust, unbiasness, responsibility, self-determination, reverence, human rights and human rights are the components of trans-cultural caring. Spirit of caring involves concept of affection, compassion, consideration, cordial conversation and availability. Considerable factors of trans-cultural framework are perspective, individuals though process, and cultural values of population. The global sources consist of traditions and religious ceremonies of particular ethnic group (Bailey, 2015).

Consideration of various forms of medicines: Most of the Hispanic population believes in the alternative forms of medicine due to spirituality and unavailability of prevalent medicines. Most of the Hispanics wish that the physician should prescribed massage, healthy eating, instructions related to diet supplements, nutrition and herbals etc. (Ho et al. 2015). Various studies reported 50-90% of Hispanics believe in the use of CAM. General medical practitioners are not familiar with the CAM therapies used by Hispanics.  CAM therapies includes practicing yoga, tai chi, meditations, taking massage for relaxation of mind and body, acupuncture, homeopathic medicines, and other forms of unconventional therapies. Healthcare professional must understand the motivation and rationale behind prevalence of CAM among Hispanics in order to enhance trans-cultural care (Ortiz et al. 2007).  The reason behind high acceptability of CAM are acceptance by large number of people, none of complicated modern technology is required, flexibility, diversity, accessibility, affordability, and safety. As we all know many things available at our kitchen can be used as CAM. There are almost no side effects of using CAM.

Language consideration: Every person found comfort in making conversation in their own language; this urge of own language is increases when a person is sick or in pain. Most of the Hispanics prefer conversation in Spanish but rarely medical facilities are provided in Spanish. The language is a barrier between health care providers and concerned population which ultimately leads to poor quality of care to Hispanics. In 1999, a survey made by NHANES reported people who speak Spanish are found with higher prevalence of type II diabetes and hypertension then those Hispanics who speaks English. The reason behind the higher incidence of diseases is lack of information about the risk at pre-diabetic stage or hypertension. They are also not prescribed for mandatory diagnostic tests and appropriate medicines (Cersosimo & Musi, 2011). Community based wellness programs for Hispanics should be organized. One such program is Spanish chronic disease self- management program which is conducted once in a week and lasts for six weeks.

Economic status consideration: Most of the Hispanic people with type II diabetes do not have insurance coverage while white Americans with type II diabetes have full insurance coverage. However after the age of 65 the medical coverage is identical for both Hispanics and non-Hispanic white Americans. Health conditions of older adults of more than 75 years of age of both Hispanics and non-Hispanics are similar which indicates accessibility to quality health care improves health status (Cersosimo & Musi 2011). Older Hispanic adults get more coverage (82% of total medical care expenditure) than non-Hispanic white older adults (65% of total medical care expenditure). Adult work-age Hispanics preferring Spanish language have less medical expenditure on prescribed drugs than Hispanics who prefer English language. Hispanic citizens of US spends double amount of money then non-citizen Hispanics. Hispanic children also have lower medical care expenditure than the non-Hispanic white but Hispanic children have more medical care expenditure than black children (Escarse & Kapur, 2006).  

Action plan for implementing wellness education programs to Hispanics: Certain strategies should be followed by health care providers for persuasive implementation of health care plans to Hispanics.

?             Promotions: Promoting health care education by advertisements on TV and radio. Social media platform can also be used for such kind of promotions. The advertisement must be in Hispanic language so the population can feel a connect to it.

?             Creation of national plan for Hispanic’s health: A national plan should be made for Hispanic population and this plan should include extension of diverse work force in health care, increase health care insurance policies for Hispanics, and health literacy policies should be made.

?             Establishing direct connection between health care providers and target population: Spreading awareness by directly approaching the target population about health concerns and symptoms of diseases that can be developing in a short span of time along with the change in habits and practices that can help population in staying healthy (Valdez & Posada, 2006).

Expected benefits of wellness education plan: There are several benefits of wellness education plan for the Hispanics. Short term benefits include a better trans-cultural care, decrease in language discrimination, immediate interventions to people suffering with chronic diseases etc. The long term benefits involves healthier life style, better accessibility and affordability of care, better understanding of preventive measures, regular health checkups, and early diagnosis and treatment of  a medical condition. Some other benefits are emergency treatment cost reduction and better treatment from the white health care providers. Incorporation of such wellness programs to healthcare organization will enable them to provide quality care to people with various ethnicities and languages.

Ethical principles and wellness care program: Ethical principles of a community must be considered before implementing wellness care program to avoid any religious and emotional conflicts. Some of the ethical principles are following:

•             Freedom of decision making: A person should not force to make any decision related to his/her health or other family member’s health. This will allow Hispanics to believe that their concerns are considered and they have complete authority to take own decisions.

•             Benefits without carelessness: According to this principle a patient should provide care in order to deliver care for the benefit of patient and there should be no carelessness in providing care. Patient will feel safe and protected in such environment and that should be priority of care givers.

The health care organizations should maintain ethical transparency to enhance impacts of these organizations in positive way. By maintaining transparency healthcare providers can inform patient about various inevitable risks related to medical procedure. There should be certain laws for care providers and patients both to maintain ethical principles of each other.

Impact of laws on wellness care program: Along with ethical principle, various laws are also having impacts on health care plans. Affordable care act (ACA) is one of those laws which was implemented by Government of US in 2010 to ensure cost-effective health insurance to more number of people. ACA includes treatment for chronic disease, addictions and mental illness. Even after pre-existing conditions insurance companies cannot deny coverage and cannot raise premiums. ACA eliminates limits for annual coverage and life time coverage. Till the age of 26 children can stay on policies of their parents.  A total number of uninsured Hispanics decreases from 45% in 2010 to 25% in 2016. Hispanic people with small business are also became eligible to buy ACA insurance policy policies (Pereyra &Meth, 2012)

Even after so many benefits it has some negative impacts also. It demands taxes from those who are not participating in it. People with high income have to pay more income tax. With the enforcement of ACA many people comes under the coverage and this increases waiting time in rural and small healthcare settings which leads to demand of expansion in staff and infrastructure. It also requires annual enrolment.   

Economic impact of wellness care program: This program will increase economic burden along with increased demand for community health care workers and other medical staff. Although the prevention policies for disease like diabetes, liver and kidney illness are cost effective because the prior knowledge reduces the cost of medical emergencies. So prevention is economically beneficial for Hispanics than cure. HIV is prevalent among Hispanic population of HIV. Awareness about HIV infection reduces the number of HIV incidences. Hence a small amount of money invested on awareness program can save $ 355,000 per person required for life time treatment of HIV.

Conclusion: Hispanics in US still experience health care discrepancies. Although, implementation of many wellness care programs and affordable medical insurance policies improves the conditions of Hispanics. ACA is one of the finest efforts of government of US to address the concern of medical care expenditure among various ethnic groups of US. ACA implementation reduces medical disparities among Hispanics and other ethnic groups. More efforts should be made to address clinical prevention and health promotion policies at federal, local and organizational level. Ethical issues of the Hispanics should also consider before making any program. Health promotion practitioners must understand ethical dilemma of people. Health promoters should encourage providing awareness with ethical and philosophical principles. The still existing disparity of healthcare in Hispanics can be reduced by addressing social, ethical, legal and economical principles of health care; this will definitely lead towards less number of deaths in Hispanics due to chronic diseases (Artiga, 2016)

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