In Search of Healthcare
A simple internet search indicates that Hawai'i is one of the most beautiful places on earth. There are six major islands and over 1.4 million people living in Hawai'i. Approximately 70% of the population live on the island of Oahu (US Census Bureau 2017) and it is the heart of government and business. In 2017, the State hosted visitors totaling more than six times the population (Hawai'i Tourism Authority 2017). These visitors are doubtlessly delighted to visit Hawai'i and take part in any number of activities while being completely unaware of the danger they face. The beaches of Hawai'i are famous, drawing millions to their shores. These same beaches are also the most deadly in the United States. The
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Rosenthal et al (2015) reported the Council on Graduate Medical Education (COGME), in 1988, identified geographic maldistribution as an area of concern stating that it is “one of the most persistent characteristics of the American health care system”.
Hawai'i has a significant shortage of physicians, which is exacerbated by geographic maldistribution. The center for health care in the State is on the island of Oahu. Wikipedia (2017) reports the State of Hawai'i has 24 hospitals with 13 located on Oahu and the remaining 11 hospitals disbursed among the remaining 7 islands, with not all islands having an acute care hospital to serve its residents. Even the island of Oahu, more than half of the islands' hospitals are located in the city of Honolulu. The University of Hawai'i (Annual Report 2017) reports significant physician workforce shortages. A review of the report tables 4 through 7 provide evidence that overall, physician shortages are greater on the outer islands. These shortages cause residents, on outer islands, to travel to Oahu, or the mainland, for health care.
Causes of Maldistribution
Doctors are distributed unequally all over the United States. This seems true for nearly all industrialized nations Ono, et. Al
Another threat is the current state of rural hospitals nationwide. According to the case study, about 25% of Americans live in rural areas and only about 10% of physicians actually practice in rural areas. There is a 15% gap in the ratio of rural citizens to available practicing physicians. This is a threat to ELH’s need to attract and hire more physicians. In relation to rural hospitals, citizens have longer drive times to their medical facilities. This causes them to delay routine visits which subsequently exacerbates
Research shows that healthcare is not equal among all demographics and it is evident that throughout time, various groups of people have been taken advantage of by the medical community.
When considering the American medical system, it is clear that the policy solutions for disparities occurring outside the clinical encounter
There are 2,157 Health Professional Shortage Areas (HPSA’s) in rural and frontier areas of all states and US territories compared to 910 in urban areas.**
There are two main measures of medical underservice in the U.S., health professional shortage areas and medically underserved areas and some special need populations. Both measures require communities to apply for designation. These designations allow the government to target resources to those determined to be most in need (Colwill and Cultice, 2003).
Amongst the other industrialized countries of the world, the United States has the worst healthcare system (Davis, Stremikis, Squires, & Schoen, 2014). This ranking does not come from a lack of funds, considering the United States spends more than twice as much per capita than the United Kingdom which is ranked at number one (Davis, Stremikis, Squires, & Schoen, 2014). A major problem is America is the health disparities that vary across the nation. Health disparities “refer to differences in access to or availability of facilities and services. Health status disparities refer to the variation in rates of disease occurrence and disabilities between socioeconomic and/or geographically defined population groups”("Health Care Disparities", 2009). Even though one RAND study suggests that virtually every demographic is at risk of not receiving needed care, there are definitely certain populations that are at higher risk of falling victim to these disparities ("National healthcare quality and disparities report 2014", 2015). A majority of Maine’s population falls into one of these riskier demographics, which is and will continue to affect the health and quality of life for Mainers if not addressed.
The relationship between the determinants of health and health outcomes had been thoroughly studied. In policies or programs to reduce and prevent health disparities, factors that contribute to the rise in trends are called the determinants of social health. It is equally important to recognize that childhood is an important time in which interventions can have a significant impact on health outcomes throughout life. (Dubiel et al, 2010)
The decline in hospital capacity was accompanied by a rise in staffing. Full-time equivalent personnel rose (Malagi & Kamath, 2016). Most of the additional personnel in hospitals are not focused on patient care but management or administration purposes. The American Hospital Association data shows that outpatient department visits have risen per 1,000 persons indicating that capacity for ambulatory services has risen overtime. Emergency departments have reduced with a larger percentage of closures being in rural areas. Compared to hospitals, physicians have continued to increase. Specialists have increased except for radiologists and general surgeons. There is, however, an uneven distribution of physicians between rural and urban areas. There is an estimated shortage of 3,000 physicians in nonmetropolitan areas. In addition to an increase in physicians, there are new forms of acute-care facilities. There are relatively new facilities that have been accredited. Ambulatory surgery centers have, for instance, risen (Best et al.,
As the population grows, the demand for family physicians, surgeons, and other health professionals grows along with it. Over the years, there has been an increase in the number of people from other countries working in the United States as physicians. The outcome of this is that the amount of Americans serving has decreased. But more specifically, the percentage of minority professionals has suffered. In my home city, Detroit, Michigan, most of the professionals work for the “Big Three,” Ford Motor Company, General Motors, and Chrysler.
New York’s population is almost four times as much as Alabama’s (United States Census Bureau); because of this, New York has a number more of healthcare facilities across New York. Unlike New York, Alabama is mostly made-up of rural areas that do not have healthcare facilities, meaning travel is commonly necessary to receive healthcare services. Rural areas have always had a greater need for physicians but continuously struggle to contain physicians. In most cases physician’s income is lower in rural areas causing doctors to move to areas with higher per capita income (Neumann, Sessions, Ali, Rigby, 2012).
There is some sort of reasons existing for the disparities in health care such as,
Unequal access to public services has contributed to an increase in obesity rates among Americans. A study by the National Recreation and Park Association found that populations in underserved communities, have higher obesity rates than populations in better served communities. The highest obesity rates were found among African Americans at 44.1 percent, followed by Hispanics at 37.9%, and the least among Caucasians at 32.6 percent (Parks & Recreation, n.d.). The study found a correlation between access to parks and green spaces with certain qualities that increased their use. The qualities equated to shorter walking distances to parks and recreations areas from dwellings, parks and recreation areas with higher acreage, parks and
Hawaii has been one of my childhood places i’ve always wanted to experience growing up. Many people around the globe have always said many positive comments about traveling to Hawaii. As growing up i’ve learned more and more about fun things to. For example, Hawaii’s active volcano is currently active to this day. Many citizens from parts of state have to evacuate from their area to move to a different location due to the volcano erupting. Hawaii has many rainforests,
Health is something that you can not buy so people needs to take care of it. Staying healthy should be a priority for everybody that want to live a long happy life without any sicknesses. Living a healthy lifestyle is not easy and requires a lot of work. These days people are working long hours and are extremely busy. They do not have time to eat properly and stay active. Employees spend about a quarter of their time at the office, in which they should consume at least two snacks and lunch. Since the beginning of the year, I am personally trying to live the healthy lifestyle so this topic is close to my heart. My employer offered to pay for my yoga classes which I am so grateful for. This has really changed my life, improved my health,
So, less doctor-distributed country may have longer waiting time to get service. The most distributed area is Washington DC in United States. However, the least distributed area is also United States. United States is huge country, so rural and urban areas have big differences. Germany is next highest distribution of doctors in the country.