Socioeconomic Status and Public Health Financing

Health financing is the cornerstone of strategy development based on both in terms of raising resources and of ways to manage resources. It is critical to emphasize the need for greater evaluation of the distributional impact of policies and programs. Socioeconomic status could affect public health financing such as people with insurance or money, creating higher expenditures. On the other hand, medically underserved, uninsured and underinsured create greater expenses because they enter the health system at the advanced stages of diseases and in weakened conditions (Laureate Education, Inc., 2012). In addition to socioeconomic status, other social determinants that affects both average and distribution of health includes physical environment, lifestyle or behavior, working conditions, social network, family, demographics, political, legal, institutional and cultural factors. Since funding is considered as a scarce resource, it is paramount to allocate resources based on the identified gaps in care. The significance of socioeconomic data in US public health surveillance systems should be emphasized in order to monitor socio-economic gradients in health. Socioeconomic data is important in determining the allocation of resources for public health financing. Krieger et al. (2003) stated that the use of multilevel frameworks and area-based socioeconomic measures (ABSMs) for public health monitoring can potentially overcome the absence of socioeconomic data in most US public health surveillance systems. Moreover, political will is essential to bridging public health and action that will help in the development and implementation of public health policy based on scientific evidence and community participation. Epstein, Stern and Weissman (1990) found that hospitalized patients with lower socioeconomic status have longer stays and require more resources. It was suggested in this study that supplementary payments allocated to the poor merits further consideration. Strategies for more efficient provision of care for patients with low socioeconomic status can be developed at the managerial and clinical levels.

Inequality or disparity is defined as the difference in health status, inequalities in access to and quality of health care services. Additional disparities are attributed to factors such as discrimination in relation to health care system and the regulatory climate. The Institute of Medicine (IOM) found that disparities continue to dwell even when socio-demographic factors, insurance status, and clinical needs were controlled for racial and ethnic health care. Disparities dictate funding requirements for public health initiatives for the underserved populations. Furthering social justice and maximizing individual liberties will advance traditional public health goals. Socioeconomic status of communities drives the financing needs for public health initiatives; therefore, burdens of the program must be minimized and identified to reduce pre-existing social injustices. Social benefits, public health programs that stimulate dignified employment, and strengthening of communities are important benefits that should be given high consideration. Public health professionals and health department leaders may not have the capacity to implement all programs that could be beneficial to a target population or community, but advocacy is paramount to improving health. Sufficient data is critical to justify the necessity of the program. I believe that it is our duty as healthcare and public health leaders to remove from policy debates and decision-making any discriminatory procedures or unjustified limitations on personal liberties. Public policy should be based on an ethics perspective and multiple considerations.

References

Bleich, S. N., Jarlenski, M. P., Bell, C. N., & LaVeist, T. A. (2012). Health inequalities: trends, progress, and policy. Annual review of public health33, 7.

Carter-Pokras, O. & Baquet, C. (2002). What is a” health disparity”? Public health reports117(5), 426.

Epstein, A. M., Stern, R. S., & Weissman, J. S. (1990). Do the poor cost more? A multihospital study of patients’ socioeconomic status and use of hospital resources. New England Journal of Medicine322(16), 1122-1128.

Getzen, T. E. (2013). Health economics and financing (5th ed.). Hoboken, NJ: John Wiley and Sons.

Kass, N. E. (2001). An ethics framework for public health. American Journal of Public Health91(11), 1776-1782.

Krieger, N., Chen, J. T., Waterman, P. D., Rehkopf, D. H., & Subramanian, S. V. (2003). Race/ethnicity, gender, and monitoring socioeconomic gradients in health: a comparison of area-based socioeconomic measures-the public health disparities geocoding project. American journal of public health93(10), 1655-1671.

Laureate Education, Inc. (Executive Producer). (2012). Multi-media PowerPoint: Financing public health. Baltimore, MD: Author.

Palmer, N., Mueller, D. H., Gilson, L., Mills, A., & Haines, A. (2004). Health financing to promote access in low income settings—how much do we know? The Lancet364(9442), 1365-1370.

Patrick, D. L., & Erickson, P. (1993). Health status and health policy. Quality of life in health care evaluation and resource.

Shi, L., & Singh, D. A. (2011). The nation’s health (8th ed.). Sudbury, MA: Jones & Bartlett Learning.

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