Discussing Health Disparities with Dr. Cicily Hampton
This blog post is part of a weekly series focusing on different aspects of public health leading up to Public Health Thank You Day on Monday, November 21, 2016. Join the conversation on social media with the hashtag #PHTYD and visit www.publichealththankyouday.org for more information.
Dr. Cicily Hampton currently serves as the Senior Director of Health Science & Policy at the Society for Public Health Education. As senior director, She leads SOPHE’s legislative and regulatory advocacy efforts to bring attention to public health, health disparities, and health education. Dr. Hampton received her Ph.D. in public policy from UNC Charlotte.
In your opinion, what do you think are the most concerning health disparities currently observed in the U.S.?
I think we should be concerned about all health disparities. There should not be health disparities that are more concerning or less concerning or most concerning because for the most part many of these health conditions have the same root causes that must be addressed. Additionally, the chronic disease burden associated with health disparities are most often visited on those who can least afford them. That being said, obesity is a good place to start because so many chronic conditions and risk factors for premature death such as high blood pressure, stroke, diabetes and heart disease are associated with obesity.
Hypertension is more common in White Americans than African-Americans, however, diabetes is more common in African-Americans than White Americans. What role does research play in uncovering the social determinants that factor into these differences?
First, and probably most importantly, we need a national research agenda focused on health disparities that is committed to uncovering the social determinants of health. For too long the agenda has been dominated by documenting disparities where they exist (white v. black, urban v. rural, etc.) rather than working to first uncover and then combat the physical, social, environmental, and economic factors present in communities that create or exacerbate health disparities. Many of these factors may be found across populations and we would be better able to target our programs.
How does individual behavior, such as binge drinking and cigarette smoking, impact health disparities? How can public health efforts work to combat these on a community- and population-wide level?
People need to understand how their individual behaviors will affect them, both in the present but also in the long run. We also have to make the healthy choice the easy choice, and in the case of cigarette smoking and binge drinking for instance, we have to give people adequate opportunity and strategies to deal with the chronic stressors in their life that lead to these behaviors. Behavioral risk factors are important, of course, but they aren’t the answer to achieving health equity. Binge drinking and cigarette smoking have to be addressed obviously, but more urgent individual behaviors that lead to a host of chronic conditions and significantly lead to decreased quality of life, such as inability to purchase and eat healthy foods due to living in a food desert, inadequate transportation options or food insecurity due to poverty or lack of an active lifestyle due to neighborhood characteristics are much better targets. One strategy to combat behavioral risk factors is health education.
How can public health research be deployed to understand and combat health disparities?
We have adequate methods to research and understand health disparities better but we’re not using them. First we need to compile large datasets with adequate information to determine the underlying causes of disease across populations and use correctly specified models to find significant causal variables. Lastly, as a public health community, we need to be willing to tackle these causes of health disparities when we do find them even if they are outside of the traditional health care and public health system.
Do you think a world without health disparities is possible? If so, what would it take for us to get there? If not, what insurmountable barrier is standing in the way?
I do think a world without health disparities is possible but a reframing of our thinking is necessary to achieve a world without health disparities. We need to look beyond the health care system to societal level factors that influence health to achieve health equity though.
Dylan Simon is the Science Policy Intern at Research!America.