Disparities in health often mean earlier death and increased morbidity for one group of people versus another. Groups can be defined by race, ethnicity, age, sex, disability status, geography (urban vs. rural), or socioeconomic status. In the case of health disparities defined by race and ethnicity, non-Hispanic Whites tend to experience better health than African Americans, Native Americans, Hispanics and specific segments of the Asian population. Differences can also be found within groups and by health indicator. For example, the rate of low birth weight infants for the Hispanic population as a whole is lower than that of non-Hispanic Whites, while the same rate for Puerto Ricans, a subgroup of the total Hispanic population, is 50% higher.
Regardless of the health indicator being examined – whether it is heart disease and stroke, diabetes, low birth weight, HIV/AIDS, or obesity – disparities in health usually point to inequalities in income and education. So, it is no wonder that marginalized groups in the U.S. carry a higher burden of disease and disability.
Even our individual health behaviors – for example, whether we exercise regularly or eat healthily – are influenced by such underlying factors as income and education, which in turn predict our access to quality goods and services. To illustrate, low-income neighborhoods are less likely to have access to fresh fruits and vegetables, sidewalks, walking trails and bike lanes. And even in those low-income areas where such resources are available, residents might not take advantage of them due to neighborhood crime and the relatively high price of fresh foods.
Various groups are working to eliminate the problem – the American Medical Association, in an effort to ensure quality health care for all, is encouraging physicians to examine their own practices; the American Public Health Association is pushing for comprehensive federal legislation to address the underlying causes of disparities in health status and health care access; and Healthy People 2020, the latest set of 10-year national health objectives put forth by the U.S. Department of Health and Human Services, will integrate “social determinants of health” – a term which describes those socioeconomic factors that increase or decrease our risk for disease – across all objectives.
The North Carolina Council of Churches, a statewide ecumenical organization that promotes social justice and Christian unity, regards the issue of health disparities as a moral one. The Bible instructs us to “learn to do good; seek justice, rescue the oppressed, defend the orphan, plead for the widow” (Isaiah 1:17, NSRV). When certain groups are treated unfairly, it insults our Maker. It honors God when we plead their cause (Proverbs 14:31).
To learn more about the elimination of health disparities, please visit the NC Office of Minority Health and Health Disparities’ website at http://www.ncminorityhealth.org/omhhd/.
Willona Stallings, Project Director, Partners in Health and Wholeness