The role of public health in addressing health disparities

Chanel Matney, PhD

Health disparities occur when there is a significant difference in the burden of illness, injury, disability or mortality between demographic groups. A combination of educational, economic and environmental factors – known as social determinants – impact the health outcomes of individuals, often to the detriment of minority groups in the U.S. Contaminated housing, shortage of food stores with healthy choices, and lack of public recreational areas for exercise all contribute to higher rates of – and mortality from – heart disease, cancer and diabetes among non-Hispanic blacks, Hispanics, American Indians, Asians, Native Hawaiians, and Pacific Islanders, according to the Centers for Disease Control and Prevention (CDC).

Low-income families, who are disproportionately minorities, have limited access to affordable health care and often receive lower quality medical services, leading to lack of preventative care and increased disease severity and mortality. In one urban U.S. city, for example, epidemiologists found a 19-year gap in life expectancy between the wealthiest and the poorest neighborhoods, with some areas experiencing life expectancies lower than that of North Korea.

Public health researchers, clinicians and community organizers are key to eliminating health disparities. They work together to better understand the unique concerns that contribute to gaps in health care and health quality for minority groups. Among their findings is that lack of ethnic and racial diversity among clinical trial participants limits researchers’ ability to understand important differences in how people respond to drug therapies. In addition, lack of information, not lack of willingness, contributes to low enrollment of minority groups in clinical trials, according to a survey commissioned by Research!America. It’s important to increase educational outreach efforts surrounding clinical trials.

Public-private partnerships are also crucial. For 15 years, the CDC’s Racial and Ethnic Approaches to Community Health (REACH) program has partnered with local organizations to design evidence-based and culturally-tailored behavioral health intervention programs for minority groups. In 2011, the U.S. Department of Health and Human Services (HHS) launched the HHS Disparities Action Plan, which lays out guidelines to transform health care; strengthen the infrastructure and workforce of health and human services nationwide; advance the health, safety and well-being of Americans; advance scientific knowledge and innovation; and increase the efficiency, transparency and accountability of HHS programs.

Every citizen deserves the opportunity to enjoy a healthy life, free of disease and disability, but health disparities persist as a result of unequal socioeconomic factors. Americans agree that it is important to conduct research to eliminate these health disparities, according to a survey commissioned by Research!America. In addition, the disproportionately high burden of illness and morbidity experienced by minority groups loses the economy billions of dollars each year in decreased productivity, absenteeism, and lost wages. Eliminating health disparities for minorities from 2003–2006 would have reduced direct medical expenditures by approximately $229 billion and reduced indirect costs associated with illness and premature death by approximately $1 trillion, according to a 2009 study. Eliminating health disparities is essential to strengthening the nation’s health and economic prosperity.

Chanel Matney, PhD, is a communications intern at Research!America.

This blog post is part of a series focusing on different aspects of public health in recognition of Public Health Thank You Day, held each year on the Monday before Thanksgiving. Visit www.publichealththankyouday.org for more information, and join us on social media using the hashtag #PHTYD

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Luck shouldn't play a role in why I'm alive.
Laurie MacCaskill, a seven-year pancreatic cancer survivor