Figure - available from: Journal of Clinical Medicine
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Conceptual diagram of the pathways model of health delivery which combines a medical pathway (left vertical) and a community pathway (right vertical), each of which involve both provider and patient characteristics. Cultural and social determinants strongly influence interactions between providers and patients in both pathways.
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Objective: Chronic diseases have become dominant in the global health landscape. Despite remarkable advances in basic science, pharmacology, surgery, and technology, progress in lifestyle improvements, now considered essential, has been disappointing. Patient adherence to medications and other instructions play the greatest role in individual outco...
Citations
... As a result of having a different language and cultural background than their health care providers, Vietnamese Americans are not able to communicate effectively with them which results in a lower quality of care and leads to a disparity in health compared to other ethnicities (Huang et al., 2020). In a study conducted by Rumana et al. (2019) on barriers to Vietnamese Women getting cervical cancer screenings, they found that most participants believed human papillomavirus (HPV) was rare and that it had a low chance of causing cervical cancer. Those who knew that Papanicolaou (PAP) tests could identify cervical cancer early had twice as many PAP tests as those who did not. ...
... conducted a similar study toRumana et al. (2019) but examined how demographic and acculturation characteristics, healthcare access barriers, and knowledge, attitudes, and beliefs about cervical cancer screening and HPVspecific knowledge influenced the number of Vietnamese Americans ever having had a human papillomavirus (HPV) PAP test. The lead researcher Grace X. Ma had a Ph.D., is the Associate Dean for Health Disparities and is the founding Director of the Center for Asian Health.Ma et al. (2020) gave a 20-30-minute baseline survey provided in Vietnamese and English to Vietnamese American participants that questioned them on their demographics and acculturation, health care access, health behavior, PAP test history, perceptions related to health belief model constructs, knowledge, attitudes, and beliefs of Vietnamese women about cervical cancer, and human papillomavirus (HPV). ...
Vietnamese Americans often face difficulties receiving quality care from the healthcare system due to acculturative barriers. These barriers can include misunderstanding of language, culture, and lack of social connections. These difficulties affect the health quality of Vietnamese Americans compared to other ethnicities in the U.S. Therefore, Vietnamese Americans were examined to see how the process of acculturation affected the Vietnamese community and its impact on access and quality of treatment from the healthcare system. Upon giving 26 Viet participants a survey many of them responded that they were satisfied with their care. However, cultural stigma played a huge role in dissuading them from accessing additional resources and participants cited language as a significant barrier. Overall, my project showed that Vietnamese Americans (ages 30-60) found their care satisfactory. Future work should investigate cultural stigma in order to get more Vietnamese Americans to access the medical care they need.
... It can facilitate different forms of international collaboration during the COVID-19 pandemic to reduce the disparate burdens among various regions without imposing significant burden on any particular contributor. The pathway approach allows international stakeholders in various social positionsincluding governments, civil society organizations, pharmaceutical/device companies, relevant industries, and academic/ research institutionsto respond to different components of the pathway based on their respective strengths and resources to help identify and fulfill essential needs, thereby breaking the cycle of global health inequity (Adler & Newman, 2002;Kones et al., 2019). Guided by the ethical principles of relational solidarity and pragmatic solidarity, we argue for a coordinated global division of labor. ...
While the effects of COVID-19 are being felt globally, the pandemic disproportionately affects lower- and middle-income countries (LMICs) by exacerbating existing global health disparities. In this article, we illustrate how intersecting upstream social determinants of global health form a disparity pathway that compromises LMICs’ ability to respond to the pandemic. We consider pre-existing disease burden and baseline susceptibility, limited disease prevention resources, and unequal access to basic and specialized health care, essential drugs, and clinical trials. Recognizing that ongoing and underlying disparity issues will require long-term correction efforts, this pathway approach is nonetheless helpful to inform ethical responses to this global pandemic. It can facilitate international cooperation during the pandemic to reduce the disparate burdens among different regions without imposing significant burden on any particular contributor. The pathway approach allows international stakeholders in various social positions to respond to different components of the pathway based on their respective strengths and resources to help break the cycle of global health inequity. Guided by the ethical principles of relational and pragmatic solidarity, we argue for a coordinated global division of labor such that different stakeholders can collaborate to foster equitable healthcare access during this pandemic.
