Determinants of Health Care and Advancing Quality Health Care Seeking Practices In The U.S.

Contextualising people-centered needs, interests and preferences addresses evolving?paradigm shifts and plugs local issues into international aspirations such as universal health coverage, end to HIV epidemic, climate-change countermeasures which resolve loss of biodiversity, dwindling food produce and catalyzes engagement in life seeking practices. Health care is public health, it is deliberate and calls on one’s agency to engage in activities preventing diseases; prolonging life; and promoting health. Health care is about linking local issues to the power dynamics within national and international frameworks such as national plans to end Tuberculosis, promote Well Mother and Child goals and supporting countries to meet international aspirations. These aspirations, contribute to building resilient systems and structures to address pandemics, political crises, cataclysms and climate change disruptions. Health care is a discourse that highlights how states interact, communities thrive, sharing of resources and an opportunity for reflection and change for the better. To apply the learned lessons from the discourse there is need to characterise the enabling and responsive health care contexts. Otherwise, challenges will still remain deeply rooted because of unaddressed historical legacies, rigid exploitative policy and un-examined power dynamics. There is need to catalyze institutional and cultural shifts. Health care remains complex due to several factors that make it happen which require leveraging through health, political, physical, cultural, social, gender, biomedical, infrastructural, civil, economic, legal, and new thematic paradigms which drive demand, uptake and play a pivotal role in the quality of health care in any country. These same enabling and responsive contexts need to be rights-based and people-centered. Otherwise, they become complex bureaucracies, established hierarchies and decision-making processes which fail to address people’s needs, affect adaptability and make it harder to provide interventions in a timely manner.

Health aspirations call for attention to contextual issues, individual, community and country-wide responsibilities and roles to prevent diseases, prolong life, promote health and make the communities liveable and safe. This means that at all cost, contextualization is necessary because through it allows the dynamic, multifaced and evolving issues to be addressed. In addressing them practices and outcomes that are evidence-based, rights-based, distributive and aligned with the different health conditions are met (Bayliss et al, 2014).

Health care is an experience viewed differently by providers (producers) and seekers (consumers). To some it is a means of getting paid, to others it is about promoting better living conditions, a standard of living marker that has to be demanded but not expected and to others it is expected, a hall-mark of democracy and privilege. Health care is a means to distribute services, redistribute care to those who would otherwise be marginalized and rehabilitate those in need. It is a utility, a marketplace, a space where deliberate deterministic action to prevent diseases, prolong life and promote health take place. It is about the functioning of systems, structures and persons; addresses abilities or inabilities; is focussed on performance, capacities; and explores broader aspects such as body structures, climate, weather patterns, body functions, status, activity and participation, environmental and personal factors (van-Druten et al, 2022).

Political determinism links health care to the welfare duty of any government. However, it is also a reminder that in the event of nationalistic and liberal market dispensation that the call to protect, provide and preserve the life of people may face pressures due to electoral preferences and social pressures. This means that health care as a service is affected by political preferences (Terry, 2019).

Physical conditions in form of access, availability, affordability and acceptability, affect health care provision and demand. This physical experience of health care is interpreted at philosophical, individual, social and discretionary levels. It translates as a status issue, a privilege for the connected and wealthy due to their work, wellness and health status (Terry, 2019).

Cultural tendencies affect demand and uptake of health care services. People have tendencies and preferences they uphold such as only attending health care services during acute conditions and dismissing simple to do hygiene practices. For non-acute situations they prefer to use other alternatives ranging from self-prescriptions, neglect of pain cues in the name of denial or approach non-professional services that are more accessible to them (Leijen, 2021). ?

Social factors cause varied discourses reflecting preferences and status of consumers and producers that may change the way health care services are demanded and provided. These factors manifest as networks, referral mechanisms, partnerships, alliances and movement building which bring different voices of providers and consumers into focus. That way this becomes a negotiation or bargaining platform fostering improvement or a call for more affordable health care services (Litchfield et al, 2018).

Gender-lens, sensitivity and narratives led to approaches that promoted dignity, respect, privacy, interests of persons beyond their sex. This led to wide-ranging public-sector reforms whose aspirations included promoting gender equality, gender equity, humane treatment of people in the health care settings and ensuring denigrating medical assumptions continue to be? debunked. Health seekers can now expect to be provided services in safe work places where neglige??? nce and ill-treatment are called out and prosecuted (Percival et al, 2014).?

Improving evidence-based approaches address bio-medical experiences fostering optimal quality services. Health seekers provide anecdotal reports among peers about the reception they are provided depending on their condition at any given health care facility. These experiences reflect feelings, the attention they are given whenever they attend clinics, the level of tender loving care conferred by the providers and how they feel mentally, emotionally, socially and physically after attending health care services (Rogers et al, 2020). Settings where integrated and pluralistic approaches are provided ?making health care are popular destinations (Sundararajan et al, 2020).

Health care is more than palpitating, taking history, examination, post mortem or conducting triage. It adds to local economies. The infrastructural character of the service systems and structures involves a range of actors from governments, non-governmental organizations, privately founded for-profit hospitals, not-for-profit hospitals, long-term care facilities, Insurance institutions, occupational therapists, public administrators, business administrators, nurses and allied health workers. All these experience health care work through lived contexts which are further subject to epistemological, phenomenological, conceptual, ontological and paradigmatic lenses. Whereas the mission of the organization employing them could be to provide quality care services, ?this aspiration can be interpreted differently given their own station of duty (Harris et al, 2023). More actors contribute to the critical mass of health care services providing standard care in a country, more people are employed and eventually more people can afford the services (Jayaraman et al, 2023). This further translates into more people involved in the means of production and consumption of health and attendant services ranging from direct healthcare, transportation, real estate, research and development work which contribute to effectiveness, value, efficiency and best-practices standardizing local and international trends (Barbu, 2023).

Legal regimes and rule of law forces governments to invest in health care services. Citizens who cannot afford private health care end up missing treatment and develop illnesses whose end result is death. Public health and safety foster confidence of people in their governments, provides peace of mind, belief in leadership, promotes peaceful co-existence and attracts investments. Public health lawyers and health professionals build synergies championing for laws that ensure quality health and safety (Gostin et al, 2019).

Quality health care services reflect adapted and adopted trends of the times such as Sustainable Development Goals and One Health aspirations. These align with social justice aspirations of equity, inclusion, dignity affirmation, reaching out to people in conformity with the nature of diversity, provide the full benefits of altruism, address climate change effects, build resilient systems and structures against new drivers of diseases and align performance indicators along the SDGs to ensure optimal outcomes based on the people, planet and productivity balance. This ensures that health care providers embrace actionable standards catalysing a wholesome environmental, animal, plant and human health approach. This in turn promotes mental, social and physical health for all (Acharya et al, 2018; Habibzadeh et al, 2021; Mackenzie et al, 2019).

Quality health care is into clinical as well as social determinants of health. It promotes contextualization, is people-centered, addresses evolving?paradigm shifts and plugs local issues into international aspirations such as universal health coverage, end to HIV epidemic, climate-change countermeasures, is involved in biodiversity recovery and improves quality of life. Health care is public health, it is deliberate and calls on one’s agency to engage in activities preventing diseases; prolonging life; and promoting health.

?

?References:

Acharya, S., Lin, V., & Dhingra, N. 2018. The role of health in achieving the sustainable development goals.?Bulletin of the World Health Organization,?96(9), 591–591A Retrieved from? https://doi.org/10.2471/BLT.18.221432

Barbu, L. 2023. Global trends in the scientific research of the health economics: a bibliometric analysis from 1975 to 2022.?Health Econ Rev?13, 31. https://doi.org/10.1186/s13561-023-00446-7

Bayliss, E. A., Bonds, D. E., Boyd, C. M., Davis, M. M., Finke, B., Fox, M. H., Glasgow, R. E., Goodman, R. A., Heurtin-Roberts, S., Lachenmayr, S., Lind, C., Madigan, E. A., Meyers, D. S., Mintz, S., Nilsen, W. J., Okun, S., Ruiz, S., Salive, M. E., & Stange, K. C. 2014. Understanding the context of health for persons with multiple chronic conditions: moving from what is the matter to what matters.?Annals of family medicine,?12(3), 260–269. Retrieved from ?https://doi.org/10.1370/afm.1643

Chinchilla, M., Montiel, G. I., Jolles, M. P., Lomeli, M. C., Wong, C. F., Escaron, A. L., González-Figueroa, E., Garcia, J., Valencia, A. B., Kadono, M., Acosta, A., Martinez, C., Herrera, A. L., & Sonik, R. A. 2022. Linking health education, civic engagement, and research at a large Federally Qualified Health Center to address health disparities.?Health services research,?57 Suppl 1(Suppl 1), 105–110. https://doi.org/10.1111/1475-6773.13911

Gostin, L. O., Monahan, J. T., Kaldor, J., DeBartolo, M., Friedman, E. A., Gottschalk, K., Kim, S. C., Alwan, A., Binagwaho, A., Burci, G. L., Cabal, L., DeLand, K., Evans, T. G., Goosby, E., Hossain, S., Koh, H., Ooms, G., Roses Periago, M., Uprimny, R., & Yamin, A. E. 2019. The legal determinants of health: harnessing the power of law for global health and sustainable development.?Lancet (London, England),?393(10183), 1857–1910. https://doi.org/10.1016/S0140-6736(19)30233-8

Habibzadeh, H., Jasemi, M. & Hosseinzadegan, F. 2021. Social justice in health system; a neglected component of academic nursing education: a qualitative study.?BMC Nurs?20, 16. https://doi.org/10.1186/s12912-021-00534-1

Harris P & De Leeuw E. 2023.? Infrastructure and health: laying down the big connections for well-being. Oxford Open Infrastructure and Health, Volume 1, ouac002. Retrieved from https://doi.org/10.1093/ooih/ouac002

Jayaraman, A., & Fernandez, A. 2023. Role of civil society in health care: Mechanisms for realizing universal health coverage in vulnerable communities of India.?Frontiers in public health,?11, 1091533. Retrieved from https://doi.org/10.3389/fpubh.2023.1091533

Leijen, I., & van Herk, H. (2021). Health and Culture: The Association between Healthcare Preferences for Non-Acute Conditions, Human Values and Social Norms.?International journal of environmental research and public health,?18(23), 12808. Retrieved from ?https://doi.org/10.3390/ijerph182312808

Litchfield, I., Bentham, L., Hill, A., McManus R. L., Lilford R. & Greenfield S. 2018. ?The impact of status and social context on health service co-design: an example from a collaborative improvement initiative in UK primary care.?BMC Med Res Methodol?18, 136. Retrieved from ?https://doi.org/10.1186/s12874-018-0608-5

Mackenzie, J. S., & Jeggo, M. 2019. The One Health Approach-Why Is It So Important??Tropical medicine and infectious disease,?4(2), 88. Retrieved from https://doi.org/10.3390/tropicalmed4020088

Sundararajan, R., Mwanga-Amumpaire, J., King, R., & Ware, N. C. 2020. Conceptual model for pluralistic healthcare behaviour: results from a qualitative study in southwestern Uganda.?BMJ open,?10(4), e033410. Retrieved from? https://doi.org/10.1136/bmjopen-2019-033410

Rogers, L., De Brun, A. & McAuliffe, E. 2020. Defining and assessing context in healthcare implementation studies: a systematic review.?BMC Health Serv Res?20, 591.? Retrieved from https://doi.org/10.1186/s12913-020-05212-7

van Druten, V.P., Bartels, E.A., van de Mheen, D., E.D Vries, A.P.M. Kerckhoffs & L.M.W Nahar-van Venrooij.?2022. Concepts of health in different contexts: a scoping review.?BMC Health Serv Res?22, 389. https://doi.org/10.1186/s12913-022-07702-2

Percival, V., Richards, E., MacLean, T., & Theobold S. 2014. Health systems and gender in post-conflict contexts: building back better? Confl Health?8, 19. Retrieved from https://doi.org/10.1186/1752-1505-8-19

Terry P.E. 2019. Neighborhoods, Work, and Health: Forging New Paths Between Social Determinism and Well-Being.?American Journal of Health Promotion; 33(5):646-651. doi:10.1177/0890117119847584