How can healthcare education effectively prepare professionals to recognize, address, and mitigate health inequalities within diverse patient populations?
Education that prepares healthcare professionals (HCPs) to address health inequalities is imperative in today’s society. Maslow’s hierarchy of needs (1943) – a model depicting foundational needs such as safety and physiological well-being must first be met before higher-level goals can be achieved – provides a useful framework. Applying this theory to healthcare education allows HCPs to identify and mitigate disparities in access to essential resources, creating an equitable care environment for all.
Health inequalities, as defined by The King’s Fund, are avoidable, unfair and systematic differences in health between different groups of people (2024). These disparities have significant implications for patients. For example, patients with advanced cancer who face socioeconomic inequalities experience reduced healthcare access, sub-optimal outcomes and increased symptom severity (Salas et al., 2024). Ethnic minority patients in England report lower satisfaction levels with primary healthcare services, often associated with social deprivation, communication barriers and difficulties with access (Magadi and Magadi, 2022). Rural populations face similar challenges, where geographical isolation restricts access to specialist services (Mseke, Jessup and Barnett, 2024). These circumstances exacerbate the burden of disease and impede effective treatment.
Healthcare education faces several challenges in addressing health inequalities. Unconscious bias, for instance, may influence the way an individual processes information, and can lead to preconceived ideas about patients. This may affect clinical decision-making; tackling bias requires special attention and repetition in education programmes (Marcelin et al., 2019). Furthermore, systemic barriers like staff shortages and increased workloads limit work-based learning opportunities. Dedicated leadership, time and commitment to healthcare education should be integrated into work rotas to enable successful delivery of the content (Attenborough et al., 2019).
Chapter 2 of the NHS Long Term Plan details strategies to tackle health inequalities to provide accessible care for all patient populations. A crucial aspect of this is educating HCPs about the wider determinants of health, such as debt, housing and employment. This knowledge allows staff to recognise the root causes of disparities and adapt their care accordingly. Additionally, prevention-focused training – encouraging smoking cessation, obesity reduction and establishing Alcohol Care Teams (NHS England, 2019) – not only equips professionals with clinical knowledge of how these social factors impact patients, but also an understanding of public health strategies.
Patients have reported that when discussing social or economic needs that impact their care, HCPs should continue the conversation by asking how they can best support the patient. If direct resources are unavailable, the team should be trained to signpost patients to relevant resources or provide referrals (Henry et al., 2024). By promoting cultural competence and empathy, healthcare education can empower HCPs to confront systemic barriers and reduce existing disparities.
By acknowledging the implications of health inequalities, designing teaching programmes that address them and providing strategies for equitable care, healthcare education can motivate HCPs to cultivate a more inclusive healthcare system. Utilising frameworks such as Maslow’s hierarchy of needs and producing intentional learning materials are vital steps in achieving this.
References
Attenborough, J., Abbott, S., Brook, J. and Knight, R.-A. (2019) ‘Everywhere and nowhere: Work-based learning in healthcare education’, Nurse Education in Practice, 36, pp. 132-138. Available at: https://doi.org/10.1016/j.nepr.2019.03.004
Henry, T., Hayes, M., Eisele, C.D., Veldheer, S., Allen, S.I., Hoglen, B., Houser, K.R., Lengerich, E.J., Rodriguez-Colon, S.M., Jenkins, A.C. and Hobkirk, A.L. (2024) ‘Barriers to identifying and addressing health-related social needs in cancer care: Patient and patient navigator perspectives’, Journal of Cancer Policy, 42, article number 100508. Available at: https://doi.org/10.1016/j.jcpo.2024.100508
Magadi, J.P. and Magadi, M.A. (2022) ‘Ethnic inequalities in patient satisfaction with primary health care in England: Evidence from recent General Practitioner Patient Surveys (GPPS)’, PLoS ONE, 17(12), article number 0270775. Available at: https://doi.org/10.1371/journal.pone.0270775
Marcelin, J.R., Siraj, D.S., Victor, R., Kotadia, S. and Maldonado, Y.A. (2019) ‘The impact of unconscious bias in healthcare: how to recognise and mitigate it’, The Journal of Infectious Diseases, 220(2), pp. S62-S73. Available at: https://doi.org/10.1093/infdis/jiz214
Maslow, A.H. (1943) ‘A theory of human motivation’, Psychological Review, 50(4), pp. 370-396. Available at: https://psycnet.apa.org/doi/10.1037/h0054346
Mseke, E.P., Jessup, B. and Barnett, T. (2024) ‘Impact of distance and/or travel time on healthcare service access in rural and remote areas: A scoping review’, Journal of Transport & Health, 37, article number 101819. Available at: https://doi.org/10.1016/j.jth.2024.101819
NHS England (2019) The NHS Long Term Plan. Available at: https://www.england.nhs.uk/wp-content/uploads/2022/07/nhs-long-term-plan-version-1.2.pdf (Accessed: 16 December 2024).
Salas, A.S., LeGuerrier, B., Horvath, L., Bassah, N., Adewale, B., Bardales, O., Duggleby, W., Salami, B. and Watanabe, S.M. (2024) ‘The impact of socioeconomic inequality on access to health care for patients with advanced cancer: A qualitative study’, Asia-Pacific Journal of Oncology Nursing, 11(7), article number 100520. Available at: https://doi.org/10.1016/j.apjon.2024.100520
The King’s Fund (2024) Health inequalities in a nutshell. Available at: https://www.kingsfund.org.uk/insight-and-analysis/data-and-charts/health-inequalities-nutshell (Accessed: 20 December 2024).
