Table of Contents
Introduction
To begin with, Washington D.C city is situated on the north bank of the Potomac River. At the same time, to the southwest it borders Virginia and on the other sides Maryland. From a broader perspective, it can be termed as the greater Washington D.C metropolitan area. As it has always been for any metropolitan area Culture is an element that cannot be easily defined in such an area. This is for the reason that in a metropolitan area different people from different cultures are found. Thus in such an area, it cannot be a pure culture. The Virginia side of Washington, D.C is termed as northern Virginia and is densely populated. The reason for this is that it is near the Washington D.C cosmopolitan area. The northern Virginia area is considered to be more cosmopolitan than all the other areas of Virginia due to the fact that it is in the vicinity of the Washington D.C. As a matter of fact, the greater Washington D.C cosmopolitan is assumed to have a population of more than 5.3 million people living in it. During the week days, the District has more people due to the reason of work. In line with this, the northern Virginia in addition has more people migrating to the area as it is more of a cosmopolitan and in actual fact people come to live in the area. Again and again, this increases the population of the area during the week days (Sperling & Sander, 2007).
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On the other hand, due to its proximity to the Washington D.C cosmopolitan area, Maryland has more people preferring to live in the area that borders Washington D.C making the area to be the most populous area of Maryland. In short, the most populous city of Maryland State is Baltimore which borders Washington D.C. Generally, Maryland is a state that is marked by a great population that is of median income households. So to speak, with the overview of what the Maryland, Virginia Washington DC metropolitan area is like in terms of its population or rather its community, one can be better placed to determine the subculture of this community together with their practices.
Since it is a metropolitan area, the cultures have been mixed up and there is no specific culture that can be cited. However, the communities who live in this area involve the blacks or rather the African Americans making the larger percentage of the population. The second largest community of people are the white, then followed by the Asian and the American Indian. In addition, there are other people from other races who make a greater percentage that is more that that of the Asian. Also, there are Hispanics who make even a greater percentage of the District’s population that is again greater than that of Asians. In accordance to this distribution of communities, the foreign immigrants are also part of the population that is found in this Metro area of the United States of America.
From this point of view, it is evident that the metro area is a place of mixture of cultures. In this sense, it may prove to be so hard for anyone to define the culture of the communities living in this area. Therefore, values, beliefs and practices held in this area may vary so much since each group has its own beliefs and values. In connection to this, diversity in health care organizations in Maryland, Virginia Washington DC metropolitan area will be brought into view. Accordingly, the effects of culture on health care services provision will be discussed in detail. In addition, the accessibility of the health care by the population will be discussed. These points and others as it will be highlighted will be discussed.
Methodology
In order to come up with the report or the whole picture of the diversity in health care organizations in Maryland, Virginia Washington DC metropolitan area, several sources of information will be made use of. In this case, the secondary sources of information used will be mainly books which will provide information on this broad topic. They will cover things like the greater Washington D.C metropolitan area and the population living in the area. There will also be the culture of the population and how the people live. The distribution of health care services and the effects of culture on it will be covered in addition. The books used will be provided at the end of this works as references.
Literature Review
From the past research findings, it has been pointed out that the diversity in heath care in Maryland, Virginia, Washington D.C Metropolitan area is great. For instance, it has been noted that the part of the metropolitan area that is Maryland, has the National Institutes of Health and in particular it is rich in biotechnology as Maryland’s Washington Suburbs are the major centre of biotechnology. In the same line of thought, there has been the Prince George’s Hospital Centre which specializes with teaching about acute care in Maryland. Equally, the Virginia side of the metro area has been noted to have had the Northern Virginia Hospital which is a 164-bed hospital. It has been in service of the community in the Past over 30 years. In the Washington D.C Metropolitan area, there has been a network of good hospitals, doctors, ambulatory services and a good network of health care services and centers available for the diverse population that dwells in the area.
Findings and Discussions
In spite of good and extensive or rather diversified health care organizations, there have been some limiting factors to the distribution and access along with the utilization of the health care services and the faculties available. In regard to this point, the main limitation of health care services distribution is culture. On one side, there are good hospitals and health care centers as well as clinics but cultural beliefs, values and practices may hinder some people to utilize access and use the health care provisions.
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At the same time, some people may be having the desire to use this health care provision but in one way or the other, they may be limited especially financially. One cannot conclude that the people found in this area are generally rich, however, of essence is to note the fact that the population in this metro area is diverse. In their diversity, taking the example of northern Virginia, there are quiet a good number of people who so much hold to the Appalachian culture and living in the mountains. The people in this area love the mountains so much and in their beliefs, they hold their belief to God whom they hold that he created the mountains.
Sometimes due to their beliefs they prefer not to utilize the health care services based on their belief in the part of religion. Some may not be able to access the health services due to their lack of access as their area is mountaineos. On the other hand, Maryland has been pointed out as a residential area of median income households. In such a case, for a median income household, access to some health care services as well as the utilization of the same may prove tasking. This is for the reason that the socio-economic class of the people or the population does not provide for enough income to access and utilize the best health care services. In the Washington metro area, there are those individuals who are uninsured and of low income (Wolper, 2004).
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In order to provide for their health wellness, there has been for Maryland MMC-Free Health Clinic and Maryland Department of Health and Mental Hygiene (DHMH) which is in Baltimore. Moreover, in Virginia there is the Arlington Free Clinic and Walk-In Medical care. In Washington D.C there is the Washington DC Free Clinic and the Washington DC Department of Health. In other words, there has been a provision for the uninsured and the low income population in the area.
Since Washington DC metropolitan area is an area with many African Americans and whites, the Hispanics, Asians, American Indian and other races may be disadvantaged as racial disparity and ethnicity may affects the distribution, access and utilization of medical health care. There is therefore a great need to note that when it comes to matters of culture, language is quiet important. Of course in the case of this metro area, the language used by the population is not the same language and since African Americans and Whites are the majority, then English may be the only unifying language of communication (Helms, 1993).
When it comes to care provision, language is a very important component that cannot be underrated. So to speak, a patient may be sick but since he or she is unable to communicate the sickness to the care provider, the care provider may not be able to help the patient. In a metropolitan area like Washington DC, only those that are familiar with English can be greatly helped since that is the only language that can be used. Hispanics, especially if not educated, may not access the health care services. Accordingly, the other races together with the immigrants may face hardship in accessibility and utilization of the health care. Due to communication barrier, non-English speaking population may not access the health care.
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Healthcare therefore, should be armed with enough tools in order to necessitate good health care service provision. Since this aspect cannot be easily achieved without a translator, a good health care system without translation and interpretation services may not work. A translator is required in areas like when prescription of drugs is required and the patient cannot understand the language of the care provider. Overcoming the language barrier by providing access to language services of interpretation, translation and signals among others, would translate to quality health care access to the Limited English Proficient patients.
This then calls for involvement of the community through programs that would make the community come to the knowledge of the available health care services. There are many individuals sick and hurting for the reason that they are not aware of the available health care services. Awareness can make even the ones who are not exposed to make use of the available care services especially if this is made possible by the community. In relation to diversity in health care organizations in Maryland, Virginia Washington DC metropolitan area, it is a clear indication that culture is an important component in determining a good health care system. Taking a situation whereby people live in one area with a common language, values and beliefs, as such, it can be so easy to determine the best health care system fit for them (Helms, 1993).
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Nevertheless, diversity in health care organizations in Maryland, Virginia Washington DC metropolitan area is evidence of what a cultureless or rather a mixed culture population can affect health care system. Taking the example of Medicare for those aged above 65 years of age, there is the Maryland Primary Care Program for the ones 19 years old and able. The program involves those that have low income. Another program in Maryland is the Maryland Health insurance Plan managed by the state in order to provide residents who are uninsured with insurance. Additionally, there is a Maryland Children Health Care Program which insures children up to age 19 and women of any age who are pregnant at their cost. This is to mean that the women have to pay for their health care in this program.
Following this point, it seems that there has been a diverse health care organization in ensuring the health of this population. Nonetheless, cultural values, beliefs and practices remain to be a barrier to care access, utilization and distribution as well. In connection to this, limited English Proficiency patients may not be able to access the care due to the fact that they may not be aware of its existence, unable to utilize it according to the prescription and not being aware of the diverse care programs that can be of great benefit to them (Thomas et al., 2003).In a culture that exalts men than women, only men who happen to work and as a result a woman may be underprivileged when it comes to access and utilization of the care. Even when long term care is required for a patient who may happen to be a woman, she may be limited as culture dictates that she takes care of the children. In this sense, culture becomes a great obstacle in establishing a good health care system.
Having pointed out that Maryland, Virginia Washington DC metropolitan area has diverse health care organizations, an ideal health care system that can effectively serve the population is the one that which is not based on any culture. As it was highlighted in the introduction, Maryland, Virginia Washington DC metropolitan area has a mixed culture and it is therefore not possible to define the culture in this case. An ideal system that can work for it is the one that is not based on any culture. Of great importance to note is the issue of treating each and every individual as equal to each other and putting it that no culture that is superlative to another. The Metro area happens to have had a good network of hospitals, doctors and medical technology and the only limitation would be the language aspect of culture (Ford, 2004). Education in this case related to health would work the trick of language barrier. Most important, It would be profitable for health literacy conducted by the few who understand the English language and who in reality can translate, interpret and initiate programs that can help the others to understand, read and interpret medical literature for their benefits.
More hospitals should be established and health centers and doctors should be educated and trained from the many different communities that live In Maryland, Virginia Washington DC metropolitan area. By so doing, those that are Limited English proficiency can be able to get help from the doctors and nurses or rather care providers who understand their language. Other factors of culture may be overcome with time, but language is a cultural aspect that needs to be considered. In a mixed culture, eating habits may be amended and if any unhealthy feeding habit was realized in a certain community, can easily be nullified. Thus hospitals and health care services should adapt a standard way of health feeding since in such an environment it can work out. Health related programs should be established with the sole aim of educating the population of the available health services and how to access them (Thomas et al., 2003). Since doctors from different communities as well as professionals from different cultures meet, an ideal care system would be preferably hybrid. Such a system would be the universal health care system which can best be termed as integrated health care system.
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An integrated health care system is the one in which a comprehensive health care services are provided through a universal care system. Such a system ensures equal distribution of health care services, faculties and distribution of health care centers. It brings the care services to the consumers by ensuring that they are readily available through a fair distribution of the health care facilities, ensuring the accessibility through affordability and utilization through education. This would be the ideal system for Maryland, Virginia Washington DC metropolitan area since it is a highly populated area being the ninth largest in the United States of America. An integrated system would ensure that the residents have their medical needs met since the health facilities will be well distributed, accessible and affordable as well as well understood through educative programs to ensure excellent utilization of the services (Brown, 1996).
Integrated Health care system ideal for the residents of Maryland, Virginia Washington DC metropolitan area is the one that is coordinated in a way that there is appropriate delivery of care services. It should involve a numerous participation of care coordination. Equally, the participants in this coordinated kind of care are dependent of each other in carrying out the activities in a patient care. Therefore, a great level of knowledge is required for each of the participants to understand his or her role as well as understanding the role of each other. This system also deals with medical services, general health services and the general wellness of its population. The system is directed or rather focused on the convenience of the patient or client together with the ease of providing the care through a multi-level care system (Jonas & Knickman, 2005). Typically, the system may take a large central hospital that has different offices and services connected to it. So to speak, these offices may include other clinics scattered throughout the area, in Maryland, northern Virginia and Washington D.C. The smaller centers and hospitals work from the larger hospital. With this kind of system, a patient is able to visit a doctor in the available medical care and get served well. In this combination, the patient is able to get or in simple terms can be able to trace his or her records with much ease.
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Conclusion and Recommendation
The integrated heath care system would mean that, there is a great interdisciplinary health care team of different members. The members may include the physicians, psychologists, social workers, occupational and physical therapists among others (Brown, 1996). However, the members depend on the needs of the patient. Following this network of professionals in an integrated health care system, benefits are many and cannot be underrated.
The benefits range from the ones directed to the patients, caregivers, providers and in the larger perspective the whole health care systems. It has also been noted that such a system is effective in reducing depressive symptoms. This is the case due to the fact that psychologists and other mental health care providers are made available in the primary care ( Kongstvedt 2003). As a result, the system enhances access to services, improved quality of care and in the larger perspective health care expenditures are reduced thus able to reach the disadvantaged in terms of finances in the metro area.
On the other hand, there are some of the limitations that may face an integrated health care system as a result of the costs involved. It may be so costly to establish a health care system with the connections mentioned as more medical centers, health centers, clinics and hospitals may be needed. Such facilities and the care providers required may prove tasking for an unstable economy. From this point, an ideal health care system for the Maryland, Virginia Washington DC metropolitan area should be a cost effective system owing to the area being not the best in terms of economy. As earlier on highlighted, though it has a good network of health care centers, nursing homes, programs for the children and elderly, it should not be forgotten that the area has many different people who come from different parts of the world. Some are poor while others are rich. Especially for the non English speakers inclusive of the immigrants, the need for translation, interpretation and health related education is prerequisite for effectiveness. It is one thing to have the system in place and it is another thing to overcome the barrier of language caused by culture and reach the Limited English Proficient patient. Therefore, factoring in the points discussed, an integrated health care system would be the best for Maryland, Virginia Washington DC metropolitan area.