Demographics and US Healthcare

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1. Imagine you are a student in healthcare administration who is doing an internship in a large primary care organization in an urban city in Florida. The organization has multiple locations and several types of services within a culturally diverse and underserved community. You are asked to prepare a brief about national issues related to eliminating healthcare disparities and improving wellness. Your brief will provide suggestions and initiatives that could improve patient outcomes in the organization and the community.

Include the following:

· A concise summary of the changes in patient population, patient demographics, and chronic disease within the United States (1 paragraph)

· An explanation of how health disparities, cultural competency, and health equality can impact health outcomes (1 paragraph)

· An explanation of how the National Standards on Cultural Linguistically Appropriate Services (CLAS) can influence effective communication between patient, primary care physician (PCP), and organization (1 paragraph)

· A concise summary of how the National Committee for Quality Assurance (NCQA) and the Joint Commission requirements on cultural competency impact the organization’s accreditation (1 paragraph)

Your Response

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Sample response from previous student for illustration purposes only

1.1: Summarize the changes in patient population, patient demographics, and chronic disease in the United States.

Cultural diversity and underserved communities are some of the factors that have been seen to impact healthcare in America. These two factors attribute to changes in population and demographics. According to the U.S. Census Bureau (2018), the U.S population is expected to increase though slowly as it ages and the country becomes more racially and ethnically varied. The population is expected to reach about 400 million by 2050 with every 1 in 5 Americans being older than 65 years. Internal migration will attribute to population growth more than natural increase as the population of individuals who have two or more races projected to be the fastest growing and the non-Hispanic Whites decreasing in number from 199 million to 179 million by 2060. Chronic diseases such as heart diseases, cancer, and diabetes which according to (Centers for Disease Control and Prevention, 2017) cause 70% of deaths in America affect population. For example, diabetes was number 7 cause of death with 1.5 million new cases diagnosed in 2015 and the non – Hispanic blacks having a higher incidence of diabetes while cancer was number 2 cause of death. Approximately half a million people died in the US from cancer (Centers for Disease Control and Prevention, 2017).   The noted demographic changes are expected to impact health care in America as an older population has increased health demands compared to the non-elderly population.

1.2: Explain how health disparities, cultural competency, and health equality impact health outcomes.

Health disparities or inequality as termed outside the U.S lead to poor health outcomes in America and need to be addressed to achieve health equality. (2018), describe health disparity as health differences associated with disadvantages due to social, economic and environmental factors.   These differences are noted for example among the people of color in America who have more barriers to access health care.  The Whites usually seek medical services earlier than other populations leading to better health outcomes (Orgera&Artiga, 2018). Orgera and Artiga also noted that some groups like the Blacks and American Indians are more likely to report diseases such as asthma, AIDS and diabetes more than Whites while low-income populations have poorer health outcomes compared to those with higher incomes. Cultural competency in health care organizations and among professionals can help address these disparities.  According to Sayre (2012), Healthcare organizations and professionals need to work effectively in cross-cultural situations to provide the best services to people of different ethnicities and languages. There is an association between health outcomes and effective communication between healthcare providers leading to patient satisfaction and adherence to treatment (Placeholder1). Betancourt et al also noted that not addressing sociocultural issues during a clinical encounter leads to poorer health outcomes. Therefore, lack of cultural competence leads to health disparities resulting in poor health outcomes. To bridge this gap, the Health Resources and Services Administration (HRSA) together with Institute for Healthcare Improvement (IHI) developed health disparity collaboratives to address racial, ethnic disparities at community health centers with a goal to improve delivery of healthcare.

1.3: Explain how the Cultural Linguistically Appropriate Services (CLAS) influences effective communication.

Communication in health is crucial as it affects access to service delivery. The National Standards on Cultural Linguistically Appropriate Services (CLAS) provide a platform that addresses this need through standards that enlighten, direct and enable effective practices in the delivery of care focusing on culture and language (Sayre, 2012). There needs to be communication for a patient and his primary care physician to understand each other. CLAS ensures that patients not proficient in English are offered language assistance at no cost (New Jersey Department of Health, n.d.). The organization, therefore, ensures that their staff is trained and aware of language assistance services, uses qualified interpreters and offers material that is easy to understand among the patient groups they serve. This initiative helps the patients get equitable health services and participate in their healthcare. An organization should provide training to their staff to appreciate different cultural practices and how these influence health-seeking behaviors to achieve the CLAS standards. These initiatives will not only improve the communication of all stakeholders but also improve health outcomes due to increased access to delivery.

1.4: Summarize how the National Committee for Quality Assurance (NCQA) and the Joint Commission (JC) requirements on cultural competency impact accreditation.

Healthcare organizations are mandated by specific requirements to address communication and cultural competence issues in their institutions. The National Committee for Quality Assurance (NCQA) and the Joint Commission have published standards which are to be followed by the organizations for them to be accredited and ensure compliance. The criteria by The Joint Commission (2014), address issues such as language and interpreters’ qualifications, data collection on patient race and ethnicity and non-discrimination care. The NCQA standards are related to data collection, language, and cultural responsiveness and accountability. Accreditation of healthcare organizations is therefore dependent on adherence to the rules provided by NCQA and the Joint Commission.





Sayre, N. K. (2012). Addressing Health Disparities: Cultural Proficiency. In S. B. Buchbinder, & N. H. Shanks, Introduction to Healthcare Management (2 ed., pp. 397-419). Burlington, MA: Jones and Bartlett Learning .

Betancourt, J. R., Green, A. R., Carrillo, J. E., & Park, E. R. (2005, Mrch/April). Cultural Competence And Health Care Disparities: Key Perspectives And Trends. Health Affairs, 24(2).

Centers for Disease Control and Prevention. (2017, June 27). Retrieved October 5, 2018, from CDC: (2018). Retrieved October 5, 2018, from

New Jersey Department of Health. (n.d.). Retrieved October 5, 2018, from New Jersey Department of Health:

Orgera, K., & Artiga , S. (2018). Disparities in Health and Health Care: Five Key Questions and Answers (Issue Brief). Kaiser Family Foundation. Retrieved October 5, 2018, from

The Joint Commission. (2014). Advancing effective communication, cultural competence, and patient- and-family-centered care: A roadmap for hospitals. The Joint Commission. Retrieved October 5, 2018, from The Joint Commission: /assets/1/6/ARoadmapforHospitalsfinalversion727

U.S. Census Bureau. (2018). Retrieved October 5, 2018, from U.S. Census Bureau:


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