The U.S Healthcare Disparities

Despite the fact that the United States has grown significantly after World War II, health disparities in the country's population remain an Achilles' heel. There appears to be no just end, since the country is listed among nations with the highest income-based inequality in terms of population health. According to Khazan (2017), the poorest third of Americans make up one-third of the population, and up to 38% of those studied report to be in poor or fair health.which is somewhat worrying considering only about 12 percent of wealthy people reported being in such predicament. Such statistics have led many to believe that the nation has a longstanding issue regarding health care. More so, over the last two decades or so the United States has been praised for enacting what seemingly sound policies such as the Affordable Care Act are. This act is meant to help bridge the gap concerning access to health care services. Also, it includes efforts to lower care costs as well as expanded coverage all of which would suggest the nation is on the right track. The figures, however, indicate a different scenario altogether. Khazan (2017) adds that the country reveals considerable differences in various measures associated with health care outcomes making it unique among developed nations. As an example, data from recent findings illustrate that Americans are aware of the unfairness that characterize their health care system because wealthier individuals can afford better care (Khazan, 2017). It can be said the stakeholders have not managed to enact policies that can help to address the issue of increased health outcome disparity based on population result. To this end, research in this area is significant because it contributes to efforts to bridge the divide.
Overview
The touted American dream is undoubtedly built on the notion of equality regarding the economic opportunity. This concept means a person's prospects concerning upward social mobility does not necessarily depend on his family background. Indeed, the concerning rise in inequality associated with accessing the American dream has led policymakers from both sides of the political arena to become obsessed with bolstering economic opportunity. According to Venkataramani et al. (2016), American leaders over the years have realized that economic opportunity for all may carry significant implications for health. This is founded on the belief that credible prospects linked to upward social mobility are increasingly likely to incentivize citizens to raise investment in their health. It is beyond doubt that good health of significance in determining household earnings. It follows that income is vital to achieving the aim of health equity. The trend in the United States, however, is replete with damning statistics even as successive regimes attempt to enact policies meant to address poverty as well as income disparities. The aim is to bring everyone on board and thus improve the overall well-being of society. In particular, recent findings indicate a country that has somewhat regressed and lost gains made over the decades.
America is doing worse regarding the influence of household income on health. According to Burgard & King (2014), the American health expenditure has tripled since the 1960s, and the per capita figure in 2012 stood at $8,915 all of which meant the nation exceeds spending in other developed countries. Khazan (2017) notes that the issue of health disparity remains far-reaching and the country is outranked only by Chile and Portugal. Whereas the developed such as in Switzerland and Japan reveal citizens about equally healthy irrespective of their earnings, disadvantaged populations in the United States increasingly claim to be dissatisfied with health provision and often cite services to be poor. This fact also includes approximately two-thirds of citizens in America reporting relatively high rate of health care inaccessibility, which culminates in claims regarding a broken, unfair system. Bezruchka (2010) adds that such voices in America are founded because, overall, health disparities in the country have risen since the 1990s notwithstanding its position as the richest as well as the most powerful nation in global history. It can be said that increased expenditure, concerted efforts to take everyone on board and realize the American dream, as well as policy enactment, has left the poor population behind. Bezruchka (2010) observes that health inequalities in the United States indicate income as a key determinant of health status. In particular, comparisons between Canada and America reveal the poor populations in America are worse off, which can be understood to imply longstanding issues in society.
Analysis of the Issue
Socioeconomic factors play a crucial role in explaining the level of health disparity in the United States. Woolf et al. (2015) state that income, as well as wealth, represents part of a rather sophisticated web of social and economic characteristics affecting health. The conditions include employment, family structure, social policies, neighborhood features, health beliefs, culture, as well as education among others. The direction of society regarding health, in particular, is increasingly dependent on employment and earnings. This includes the fact the health of people in a community is tied to the socio-economic status of their households. Indeed, the social environment in people's childhood matters as far as shaping health and thus economic well-being throughout their, and their offspring are concerned. It must be noted that increased exposure to poverty means unfavorable living conditions as well as instability in one's life, which can contribute to profound negative influences on his economic future. The implication is that low-income families are caught up in a seemingly endless cycle placing them at increased disadvantage. In America, the issue of health disparity is exacerbated not just through relatively small income but also the rising level of economic unfairness. Woolf et al. (2015) point out that the income gap in the United States has risen in recent decades as evidenced in 2010 whereby the level of poverty peaked at about 15 percent, which is the highest figure since 1993. This has coincided with decreased socioeconomic mobility for poor populations in America.
It is evident there are several reasons why income level matters. Most importantly, it is troubling that poverty influences such primary outcomes as community health. Indeed, political, social, as well as administrative setting influences such dimensions as employment, education, and policy-making all of which affect poverty levels. It must be noted that political choices have a far-reaching effect on health. This happens because politics determine the manner in which the country apportions income as well as wealth, which makes it perhaps the most vital factor influencing the health of citizens today. Increased awareness has emerged regarding the role of further economic prosperity, which has been said not to be necessarily beneficial for well-being in the developed world including nations such as the United States. According to Bezruchka (2010), the observation is consistent with findings suggesting that in America and other rich countries population health seems to improve during economic recessions. The suggestion is that the wealth and money input into health expenditures in the developed world does not necessarily lead to improved outcomes including increased equity. Perhaps, the phenomenon explains why some groups in the United States have lagged behind regarding health care even as the country boasts the highest per capita expenditure on health. Burgard & King (2014) observe that rising costs in the country have contributed to an increasingly unequal distribution of health care. This is because health and health care landscape are pricing out most citizens especially those from low-income households. According to Woolf et al. (2015), the socio-political trend in America means that individuals will low earnings display health inequalities typified by increased failure to access quality medical care, more likely to be underinsured, as well as face increased financial barriers to health care expenses. On the other end of the spectrum, families that possess significant economic power can afford health care services all of which widens the health disparity gap.
Assessment of the Problem and Stakeholders
According to Bezruchka (2010), comparisons of American health inconsistencies with those of Canada reveal that income contributes to increasingly pernicious influences on the United States' health status. This fact is troubling because America not only neighbors Canada but also dwarfs its expenditure on health. The low-income groups in the United States do worse than Canadian ones. Bezruchka (2010) observes that access to care does not give away the discrepancies especially considering adverse personal behaviors linked to health are increasingly common among low socioeconomic status groups notwithstanding their geographical location. What is more, racial inequalities regarding health outcomes are relatively low in Canada. The suggestion is that the United States health care system is bedeviled by far-reaching factors conspiring to place the country at the bottom concerning income-based health disparity ranking of the world.
The main stakeholders involved in addressing the challenge include the government. In recognition of increasing disparities across the socioeconomic spectrum, the American federal regime has produced various policies meant to address the issue. This includes national goals such as USDHHS (U.S Department of Health and Human Services) aiming to eliminate socioeconomic differences that plague the nation. Others include the Affordable Care Act in which Act1 promises to reduce disparities in health via promoting access to equal care (Adepoju, Preston & Gonzales, 2015). The aim is to reduce costs associated with health care for the low-income groups and thus help to decrease or eradicate income-related health disparities. The other stakeholder includes the medical practitioners including professionals as well as students. These stakeholders have a vital role to play regarding the issue of health disparities based on income levels. More so, they possess inner knowledge that can help to pinpoint factors contributing to the undesired health outcomes in the United States even as the government and others work towards creating a health care system for all.
Proposed Policy and Implementation Consequences
Given that the issue has seemingly refused to disappear, it is proposed that a comprehensive approach to systemic and unjust distribution of opportunities become the primary drive. This approach could involve place-based policy as well as approach in which stakeholders are informed by the conditions where Americans live and work. A direct association is evident between the quality of these places and people's health outcomes. The policy should be designed with socioeconomic differences in mind. More so, new policies seeking to address health disparities in America including the Affordable Care Act have demonstrated a similar approach. Perhaps, the shortcomings associated with this enactment and its predecessors boils down to its failure to pursue the implementation of the individual mandate characteristic, which often characterizes their design. Nonetheless, focused policies would mean that social and economic features such as cultural beliefs, religion, employment and others are integrated into the approach and thus potentially leading to improved outcomes concerning health disparity in America. It must be noted that the systems that not only created but also expanded the country's divide in the major areas such as employment, education and wealth continues to feed the issue of health inequality. To this end, it is imperative that a socioeconomic equity lens is applied and an assessment of the likely impact is undertaken on various socio-determinants of health.
In sum, the United States faces a defining moment given the spiraling health inequalities even as policies are enacted to prevent the problem. Recent findings suggest the country has made relatively small gains, which underlines the need to adopt a paradigm shift whereby stakeholders seek to pinpoint the environments in which policies function. It can be said that the situation currently is disjointed as evidenced by grim figures. For this reason, it is proposed that place-based strategies are developed to help stakeholders focus on different socioeconomic characteristics throughout the nation. This fact would facilitate pinpointing causes of health disparities including income, and generate ideas on addressing such socioeconomic challenges.
References
Adepoju, O., Preston, M., & Gonzales, G. (2015). Health care disparities in the post-Affordable Care Act era. America Journal Public Health, 105(Suppl 5): S665-S667.
Bezruchka, S. (2010). Health equity in the USA. Social Alternatives, 29, 2, p. 50-56.
Burgard, S. & King, M. (2014). Health inequality. The Stanford Center on Poverty and Inequality. Retrieved from http://inequality.stanford.edu/sites/default/files/media/_media/pdf/pathways/special_sotu_2014/Pathways_SOTU_2014_Health_Inequality.pdf
Khazan, O. (2017). America's health-inequality problem. The Atlantic. Retrieved from https://www.theatlantic.com/health/archive/2017/06/america-has-the-third-worst-level-of-health-inequality-in-the-world/529158/
McGrail, K. et al. (2009). Income-related health inequalities in Canada and the United States. American Journal of Public Health, 99 (10), p. 1856-1862.
Venkataramani, A. (2016). Economic Opportunity, Health Behaviors, and Mortality in the United States. American Journal of Public Health, 106(3), p. 478-484. 
Woolf, S. et al. (2015). How are income and wealth linked to health and longevity? Center on Society and Health. Urban Institute.