Global Health Blogs with Professor Swahn

What is Health Disparity? If you asked me this question two years back, my answer would be-  “differences in health.” Do you want to answer the question? I am quite sure that we will get several different answers. Many of you might understand the term health disparity or people who are in health care profession, public health, nutrition etc. might be able to describe the term. However, we as individuals have failed to understand the term “Health Disparity” in its entirety.

HEALTH DISPARITY

A dictionary defines health disparity as merely a difference, variation, or an inequality but fail to provide any further explanation. However, as the terms “health disparity” and “health equity” have gain some momentum and popularity in the public health field, it becomes essential to understand the true meanings of each term.

Health People 2020 defines Health Disparity as –

“a particular type of health difference that is closely linked with economic, social, or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater social or economic obstacles to health based on their racial or ethnic group, religion, socioeconomic -status, gender, age, or mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.”

In the definition, economic disadvantage refers to lack of material resources and opportunities—such as, low income or lack of wealth, and the consequent inability to purchase goods, and services. Social disadvantage which is a broader concept and includes economic disadvantage, also refers more generally to someone’s relative position in a social pecking order—an order in which individuals or groups can be stratified by their economic resources, as well as by race, ethnicity, religion, gender, sexual orientation, and disability. These characteristics possess the ability to influence how an individual is treated in a society. In the Healthy People definition, environmental disadvantage refers to built environment such as residing in a neighborhood where there is concentrated poverty and/or the social disadvantages that often accompany it.

Health equity on the other hand is a principle that is focused on a commitment to reduce and thereby eliminate disparities in health and in its determinants including social determinants of health. Achieving health equity means to pursue and strive for the highest possible standard of health for all people and giving special attention to the needs of those at greatest risk of poor health, based on their social conditions. Many disciplines including ethics, human rights, social science etc. identify health as an important and most needed aspect for smooth functioning in every sphere of life. Thus, health equity refers to as an equal and tailored distribution of resources which not only includes medical care but also health promoting living and working conditions as per individual needs.

HEALTH DISPARITY AND COVID-19

The year 2020 has been like a promoter for the terms “Health Disparity” and “Health Equity.” The pandemic (Covid-19) has highlighted the underlying issues related to health disparities in all the countries worldwide. It was not only the developing economies that faced hardships in tackling the spread of covid-19 infections but astonishingly, a developed nation like the United States, performed worst in managing the spread of this infectious disease (SARs Cov-2). Along with this poor performance, the United States could not hide the poorly managed health care systems and the arising health disparities in the country.

 

HEALTH DISPARITY AND “BLACK LIVES MATTER (BLM)”

A recent movement in the United States along with the pandemic has gained equal attention. The “Black Lives Matter” protests began after the death of an African American named George Floyd. On June 6^th around half million individuals in 550 different places were out on the streets participating in protests and demonstrations to address the inequalities, disparities, and inequity in the country. This movement was another point to highlight the health disparities and health inequities instilled within the system in the United States.

United States has unfortunately experienced and is still experiencing Systemic Racism. “The continuing inequalities in education, housing, employment, wealth, and representation in leadership positions are rooted in our country’s shameful history of slavery and systemic racism” – as stated by the U.S. Conference of Catholic Bishops. The United States has made progress in eliminating some of the institutional, legalized racial discrimination however, data on social and economic welfare show disparities between many persons of color and their white counterparts.

This systemic racism has made the minority population a soft target to influence and indulge in poor lifestyle behaviors. Social determinants of health along with commercial determinants of health have a direct and adverse effect on the health of these minority groups. The social and health inequities pull these individuals to reach their full potential. These inequities also push the individuals towards poor lifestyle and health behaviors further pushing them into the vicious cycle of non-communicable diseases.

HEALTH DISPARITY AND NON-COMMUNICABLE DISEASES

The most disadvantaged group are at the highest risk of experiencing non-communicable diseases. The idea that chronic diseases are associated with affluent life is merely a myth. According to World Health Organization – “Poorer people are disproportionately affected by non-communicable diseases and mental health conditions.” According to a research analysis at Yale University and University of Pittsburgh-

“black people are more than 3.5 times more likely to die of COVID-19 than white people, and Latino people are nearly twice as likely to die of the virus as white people”

Similarly, according to a statement released by the American Heart Association,

“The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites”

Thus, health disparity is intertwined with systemic racism. Social and health inequity also has an important part to play in addressing the health disparity in the country. In day-to-day life we might ignore and walk right past the racism, inequities and disparities but it is during unprecedented times like the present (covid-19 pandemic) when we realize the dire need to manage these gaps in the society.