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Global Health Learning in Nursing and Health Care Disparities

The health sector is very diverse regarding universal geographical boundaries. Numerous policies and guidelines associated with healthcare delivery vary from one nation to the other. However, according to the Global Network of WHO Collaborating Centers for Bioethics and World Health Organization, international bodies such as the World Health Organization (WHO) and the United Nations (UN) have joined efforts in formulating guidelines that serve as the standards regulating the world policies and practices in the health sector. Understanding the importance of global healthcare regulations on service delivery is key to improving nursing as a professional field and discipline. This is paramount in evaluating various aspects of infectious diseases from a global perspective. This paper analyzes the historical aspects of global health learning in nursing, discusses the significance of healthcare disparities, evaluates the Healthy People 2020 initiative and other regulatory guidelines, and considers some moral issues facing global healthcare activities concerning infectious diseases. Moreover, it reflects on global healthcare productivity, economic costs regarding infectious diseases, and the worldwide availability of healthcare providers.

Historical Perspectives on Concern for Global Health Learning in Nursing

Global health learning has been a subject of importance in the nursing profession. This is attributed to many advantages associated with the knowledge and understanding of the worldwide health status of diverse populations regarding various infectious diseases. Some include improvements in health standards, service delivery, and effective handling the infectious diseases through surveillance, detection, prevention, and eradication. In this regard, the historical perspectives on concern for global health learning in nursing are fundamental in appreciating the current evolution trends of dealing with infectious diseases and devising new ways of curbing future infections. Some historical aspects are discussed in the section below.

In the early 20th century, international travel and migration caused the spread of various infectious diseases, particularly typhoid. The case of Mary Mallon, an asymptomatic carrier of the typhoid bacterium, resulted in over fifty cases of new infections upon immigration into the US. At that time, there was no clear explanation of the infection mode of the disease from one person to another. As the infection spread to other parts of the world, it triggered the concern for global health learning in nursing to suppress its effects. Consequently, hygienic measures such as proper food preparation and hand-washing techniques were introduced to fight the spread of typhoid. As a result, global health learning facilitated the development of the typhoid cure.

The Ebola virus is an infectious disease that significantly impacted global health learning in the past millennium. According to Holtz, in 1976, two simultaneous outbreaks in the African countries of Sudan and the Democratic Republic of Congo were identified. These epidemics resulted in 151 and 280 cases of infections, respectively. The high infectious and mortality rates of the Ebola virus stimulated the need and concern for global health studies to curb its effects. Thus, health learning in nursing regarding the Ebola virus facilitated the comprehension of its symptoms and infectious patterns and control measures such as quarantine was devised to contain its spread. Consequently, the requisite for containing the disease enhanced concern for global health learning, particularly in nursing.

Moreover, the historical effects of smallpox invigorated the concern for global health learning in nursing. In this case, Holtz explains that Europe experienced an outbreak of smallpox during the 11th and 12th centuries, spreading greatly by the 15th century. She further maintains that explorers spread the disease to other parts of the world, such as America, making it a pandemic. Due to the need to eradicate the disease, the concern for global health learning grew, especially in nursing, to find feasible ways of subduing the prevalent disease. Therefore, developed countries generated the smallpox vaccine that was instrumental in controlling the virus. Moreover, global health learning in nursing also resulted in adopting other preventive measures, such as isolation and immunization, that are currently in place to avoid future outbreaks.

The Importance of Health Care Disparities

Healthcare disparities are significant in global health as they influence the category and quality of a patient’s services. A healthcare disparity can be defined as the discrepancies in various population groups along financial, racial, and ethnic aspects regarding health insurance limits, access to health care, and the value of care provided. The implication is that the minority in such disadvantaged groups are discriminated against regarding medical matters. These disparities are significant in some ways, as illustrated below.

Considering discrimination in the financial realm, those individuals with low income can access insurance coverage within a limited scope. Additionally, they receive low-quality health care in medical facilities. On the other hand, high-income people obtain access to insurance covers with higher capacities. According to Holtz, the rich are offered high-end quality health services since they have enough resources to spend. This aspect is significant because it implies that people experiencing poverty are disadvantaged in the health sector. Thus, they do not acquire similar healthcare services and care compared to those who can afford them. In the case of infectious diseases like HIV, the minority fails to access first-class medical attention, which is costly. Thus, the life expectancy of the indigent is relatively lower than that of the wealthy.

Racial discrimination is a contributing factor to healthcare disparity. In some communities, people of particular racial backgrounds are disadvantaged when accessing quality medical services. For instance, the level of healthcare service offered to an individual from a minority may differ from that provided to someone from another racial background, depending on the biasedness of a worker. Regarding infectious diseases, the disadvantaged minority may fail to access high-quality medication. This factor is fundamental because it enables nursing institutions and governing bodies to effectively address discrimination issues along racial boundaries.

Similarly, ethnic differences exacerbate healthcare disparities among different populations. Health workers from given ethnic communities often despise those from other ethnicities. Consequently, they must offer them standard medical services, especially for infectious diseases. Differences in ethnicities thus lower the quality of health care provision, and many lives are lost. Hence, addressing the issue of ethnic discrimination is essential in health care.

Healthy People 2020 and Other Regulatory Guidelines

To enhance Americans’ health status, the United States Department of Health and Human Services designed a strategy to guide disease prevention and promote national health by formulating Healthy People 2020. Haber describes Healthy People 2020 as a framework with a consolidated set of objectives to be achieved for 10 years with a focus on improving the lives of US citizens, particularly from the medical perspective. This initiative envisions having an environment whereby all individuals lead long and healthy lives. Its mission is to foster an enhanced quality of life through research, improved healthcare delivery, and strengthening policies that promote evidence-based practices. The implication is that the initiative aims to control global infectious diseases in greater capacities.

Healthy People 2020 strives to achieve its objectives through regulatory guidelines that govern its implementation. These foundation measures include the general health status, such as life expectancy, infectious disease prevalence, physical and psychological health situations, and international comparisons. Secondly, disparities and inequity amongst various populations also form the foundation measures. Assessments consider gender, geographical boundaries, social status, and ethnicity. Another basis relies on social health determinants. These factors range from the socioeconomic and physical environment to policies in force. Moreover, health-related quality of life and well-being are also foundation measures. These indicators focus on satisfaction, life quality in both physical and psychological aspects, and participation in physical activities.

Other regulatory guidelines include those articulated by the American Public Health Association in its Public Health Code of Ethics. Apart from preventing infectious diseases, the guidelines outlined in the Code aim to respect people’s rights, pay attention to disenfranchised people, and appreciate diverse populations’ values, beliefs, and cultures. Moreover, they emphasize engaging in public health activities that enhance social and physical environments. These guidelines are in place to foster coexistence and harmony amongst US citizens regardless of background differences.

Moral Issues in Global Healthcare

Despite efforts to promote global healthcare, some moral issues still arise. For instance, according to WHO, the major moral obstacles in world healthcare include corruption that leads to inadequate access to medical care. Many individuals cannot obtain proper health care though it is a vitally significant ethical principle. Low-resource nations often have poor health standards due to determinants such as poverty, malnutrition, low education levels, and poor living conditions. In as much as wealthier countries tend to offer aid in financial and food aspects to low-economy countries, corruption in both private and public sectors plays a significant role in the failure of the aid to reach people in need. Hence, this setback poses a moral issue in global health.

Brain drain is another factor that has exacerbated moral issues in universal healthcare. In this case, health professionals trained in low-income nations are often employed to work in high-income countries leading to a severe shortage of healthcare workers in their countries of origin. Palilonis et al. affirms that access to health care in these nations is limited due to inadequate staffing and the need for more professionals with the technical know-how to handle health problems. Consequently, this factor poses a moral issue in health care worldwide.

Cultural diversity also creates a moral problem for global health. Ethical standards may not be universal since the world comprises many communities with diverse cultural beliefs and practices. For instance, according to the Global Network of WHO Collaborating Centers for Bioethics and World Health Organization, some social groups conduct practices like female genital mutilation due to their religious or cultural beliefs. A moral issue manifests when the international community condemns such activities as human rights violations. Considering that exercise poses a risk factor to the health of women and children undergoing the ritual, ethical conflicts arise when the social groups strongly feel that part of their norms should not be interfered with.

Additionally, international research on biomedical, behavioral, and epidemiological activities contributes to concerns about global health ethics. According to the Global Network of WHO Collaborating Centers for Bioethics and the World Health Organization, human subjects are often used in these research studies. In particular, some researchers from developed countries conduct their research in impoverished nations where the participants are vulnerable due to language and cultural barriers that hinder informed consent. Palilonis et al. affirm that the subject of clinical trials and experiments on these individuals as part of investigative activities culminates into an ethical issue. In many cases, less care and benefits are provided to such participants at the end of the exercise. As a result, international research leads to moral concerns regarding global health.

Healthcare Productivity and Economic Costs

The relationship between the quality of infrastructure employed in health institutions and the services rendered determines the efficiency levels and, thus, the productivity of the health institutions. The essence of equipping healthcare systems is to foster healthy living and enhance disease control mechanisms apart from striving to cure them. Consequently, healthcare productivity is the cost-effective reduction of infectious diseases. Cimasi states that since high costs are incurred in purchasing hospital equipment, only some hospitals worldwide offer world-class services to their patients. As a result, only high-income nations have a larger share of these facilities. However, it does not necessarily imply that hospitals with high-end infrastructure are the ones with higher productivity. An efficient healthcare system offers high-quality health services despite little infrastructural input owing to the economic costs associated with the machinery.

Nevertheless, better-equipped hospitals have a better chance of ensuring high productivity due to the availability of tools that facilitate treatment capacities. Moreover, different institutions are specialized in providing care in diverse health situations. For instance, some hospitals provide high-quality oncology care; others offer specialized cardiology treatment and some efficiently handle various infectious diseases. Productivity levels thus differ from one facility to another. It is also imperative to note that no nation is excellent in managing all diseases and that those with the highest quality spend less on healthcare systems, according to Cimasi. Thus, there is diversity in the global healthcare systems.

The economic costs of infectious diseases are significant worldwide. Since many factors, such as the emergence of new diseases, increasing resistance of the existing ones and fluctuations in treatment costs impact the global economy; more resources are channeled toward the health sector. Additionally, numerous funds are involved in researching diseases such as HIV/AIDS that have no cure currently. Moreover, financial aid and other donations from wealthy nations are often provided to low-income countries to facilitate infectious disease control and management. As a result, infections have great effects on global economies. High productivity is thus crucial in addressing these economic effects. Successful countries often invest in early detection, prevention, and medication.

Availability of Healthcare Providers

Staffing is a major concern in many health institutions. The presence of professionals in healthcare facilities differs from one country to another worldwide. Based on income levels, high-income countries have hospitals with adequate staffing per the WHO standards. On the other hand, most low-income nations face a drastic shortage of medical personnel. The WHO recommends a minimum threshold of 23 health professionals per 1000 citizens in a country to facilitate the optimum delivery of essential health services. These professionals include medical doctors, nurses, and midwives.

Very few low-income economies have met the patient-staff ratios recommended by WHO, especially in the African and South East Asian continents. This shortage is attributed to the high costs of training health professionals. Moreover, the concept of brain drain has also significantly contributed to the shortage of skilled healthcare workers since they migrate to other wealthy countries to access higher education. Later, instead of returning to put the acquired skills into practice in their native land, they stay at work in high-income countries. As a result, developed countries benefit as opposed to developing nations.

Conclusion

Healthcare policy and delivery differ from one country to another. This paper has discussed this concept based on the international aspects focusing on world healthcare systems and the areas of concern in the health sector, such as infectious diseases. First, this research paper has evaluated the historical perspectives on health learning concerns, particularly in nursing. The historical events that facilitated the need for global health education and research are reviewed in this case. As discussed, understanding the effects of healthcare disparities is significant in providing equal healthcare opportunities to all individuals regardless of their religious affiliations or cultural and racial backgrounds. The paper has also reviewed the Health People 2020 in the US, considering the key areas it addresses and other regulatory guidelines relevant to this initiative’s objectives. Besides, there are various morals regarding healthcare delivery. Corruption, research ethics, and brain drain are some of the major ethical concerns discussed. The paper has also analyzed the global healthcare products and economic costs associated with healthcare delivery. In this case, the effect of medical services on productivity and the economy is evaluated. Finally, the paper has reflected on the global availability of healthcare providers focusing on the patient-staff ratios compared to the requirements of the WHO in various parts of the world.

📎 References

1. Cimasi, R. J. (2014). Healthcare Valuation. Hoboken, NJ: John Wiley & Sons, Inc.
2. Global Network of WHO Collaborating Centres for Bioethics & World Health Organization. (2015). Global health ethics key issues. Geneva: World Health Organization.
3. Haber, D. (2016). Health promotion and aging: Practical applications for health professionals (7th ed.). New York, NY: Springer Publishing Company.
4. Holtz, C. (2016). Global healthcare: Issues and policies (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
5. Palilonis, M. A., Iltis, A. S., Wake Forest University, & Wake Forest University. (2015). An introduction to global health and global health ethics: Seven topics for students. Winston-Salem, NC: Wake Forest University.
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