asthma while neglected homes without proper insulation, water leaks, and pest infestations can cause serious harm (High, 2017). Many areas with substandard housing also lack easy access to grocery stores and fresh produce while fast food is readily available.
Social Determinants of Health 14 My patient lives in a large, family-friendly neighborhood in Spring Hill, Tennessee with sidewalks, streetlights and plenty of open space. The air quality in the city of Spring Hill is not polluted. There is a large county-sponsored recreation center, Longview Recreation Center, located a short drive from her home. Her house is well maintained; it is clean, well-insulated, and provides plenty of room for her family. The grocery store within walking distance of her home is fully stocked with fresh produce and whole-grain options. Healthcare Received in Low-and-High Income Areas Similarities The Health Insurance Portability and Accountability Act (HIPPA) applies to all individuals regardless of income status. HIPPA protects patients’ medical records and other personal health information (PHI). Under this Act, patients also have the right to request a copy of their medical records and ask that corrections be made (U.S. Department of Health & Human Services & , 2015) Income status has no bearing on receiving emergency medical treatment. Since 1986, the Emergency Medical Treatment and Labor Act (EMTALA) requires that all patients, regardless of insurance or financial status, that present for emergency services be stabilized and treated. It is commonly referred to as the “anti-dumping law” because it prevents medical facilities from immediately transferring uninsured or patients with Medicaid to a public hospital without providing a medical screening to ensure they are stable for transfer (American College of Emergency Physicians, n.d.). Differences
Social Determinants of Health 15 Patients with low incomes may be forced to choose between paying for food and utilities or doctor visits. When they do not utilize preventative care services, they fail to establish a relationship with their healthcare providers. Their providers have few opportunities to address their health risks and address social factors that may be affecting their health (Cunningham, 2018). Because not all providers take public health insurance, choices may be limited and wait times longer to see a specialist. Access to physicians and hospitals is limited for individuals in low-income areas. A study that compared low-income and high-income communities nationwide found that residents in low-income communities have a lower supply of physicians and must drive further distances to access a specialty hospital (Nguyen, Chernew, PhD, Ostrer, & Beaulieu, PhD, 2019). Access to a vehicle or public transportation to receive medical care may also be limited.
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