Infectious disease is of great concern worldwide. In the United States, there are federal agencies tasked with the goal of reducing health disparities. Currently, there are 10 of these centers in the United States. Findings also showed a main interaction effect between ethnicity and racial identity conformity attitudes and mental health outcomes with high conformity linked to increased perceived stress for Latino Caribbeans and Black Caribbeans compared to African Americans. The authors drew several important conclusions from their review. A meta-analysis of 155 studies that looked at the prevalence of dental caries found that lower socioeconomic status, as indicated by levels of education, occupation, or income, was associated with higher risk of having lesions or experience with dental caries; the relationship appeared to be stronger in more developed countries (Schwendicke et al., 2015). Immigrant paradox. Oxford Research Encyclopedia of Communication, College of Communication and Information, University of Kentucky, U.S. Department of Health and Human Services, CDC: Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, National Institute on Minority Health and Health Disparities, Office of Minority Health & Health Equity, Rockefeller Foundation and the Swedish International Development Cooperation Agency, U. S. Department of Health and Human Services, Gender (Gay, Lesbian, Bisexual and Transgender Studies), Incidence and Prevalence of Morbidity and Mortality, Health Literacy and Health Information Seeking, https://doi.org/10.1093/acrefore/9780190228613.013.222, http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=ceth20, http://digitalscholarship.unlv.edu/jhdrp/, http://www.springer.com/medicine/journal/40615, http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review, http://www.euro.who.int/__data/assets/pdf_file/0004/109759/EHFA5-E.pdf, http://www.ahrq.gov/professionals/education/curriculum-tools/population-health/adler.html, Health disparities and health equity: Concepts and measurement, Specifying race-ethnic differences in risk for psychiatric disorders in a US national sample, A systematic review and meta-analysis of the effectiveness of behavioural smoking cessation interventions in selected disadvantaged groups, Racial and ethnic approaches to community health: Reducing health disparities by addressing social determinants of health, http://www.cdc.gov/nccdphp/dch/programs/reach/pdf/final_reach_fact-sheet-092012_tag508.pdf, Cancer coverage in general-audience and Black newspapers, The promise of prevention: The effects of four preventable risk factors on national life expectancy and life expectancy disparities by race and county in the United States, Migration, social mobility and common mental disorders: Critical review of the literature and meta-analysis, Racial/ethnic disparities in HIV infection among people who inject drugs: An international systematic review and meta-analysis, Conceptual approaches to the study of health disparities, Race and ethnicity in public health research: Models to explain health disparities, Do interventions designed to support shared decision-making reduce health inequalities? The inverse relationship between deprivation and health outcomes though well established as shown above (Table 2 and recently in Newton JN et al 2015) is also slightly more complex as shown below. In low-income countries, the average life expectancy is 62 years, while in high-income countries, it is 81 years. The likelihood of meeting the Sustainable Development Goal 3 on good health and well-being is closely linked to the targets of goal 11 on sustainable cities and communities. In doing so, communication researchers must keep communication theory in mind and focus on those etiological factors that would respond to a communication intervention. Printed from Oxford Research Encyclopedias, Communication. There are multiple definitions of health disparities available. have different levels of health, yet not all of these differences are always categorized or defined as health disparities. There may be unmet need for services among Pakistani and Bangladeshi children. In terms of policy, requiring seatbelt use, restricting smoking areas, and increasing tax on alcoholic beverages all can have a positive impact on health. He found differences between the groups on the whole and between U.S. Hispanics and foreign-born Hispanics. Below is a sample of meta-analytic studies of interventions designed to reduce a variety of health disparities. For example, Piedmont … Findings were not very revealing and seemed to be limited by individual study-level methodological issues, such as choice of health literacy measure and inadequately described health disparity outcome. Examples include reductions in cardiovascular disease and cancer in disadvantaged groups in England and reductions in maternal and child deaths in Ecuador. As described in this chapter, there are also differences in outcomes relating to socioeconomic status, ethnicity, geographical region and other social factors. Around 95% of TB deaths are in the developing world. Developing countries account for 99% of annual maternal deaths in the world. On the whole, results showed that Whites had the lowest blood pressure and Southern rural Blacks had the highest blood pressure. Better instead to delineate explicitly persisting and changing structural and political determinants of these persisting—and changing—inequalities, including who deliberately or inadvertently benefits from these inequalities, so as to inform efforts to secure social equity in health. First, though, it is important to ask whether such efforts have any chance at improving health disparities. Moving toward greater equity is achieved by selectively improving the health of those who are economically/socially disadvantaged, not by a worsening of the health of those in advantaged groups. Social determinants vary widely, ranging from one’s social network and the associated norms and attitudes to socioeconomic conditions, including income and transportation. This landmark report, commissioned in 1984 by Margaret M. Heckler, the Secretary of the U.S. Department of Health and Human Services, documents the factors that influence health disparities among Blacks, Hispanics, Asian/Pacific Islanders, and Native Americans, and it offers recommendations to reduce them through (a) health information and education, (b) health services, (c) health professions development, (d) cooperative efforts, (e) data development, and (f) a minority health-focused research agenda. There are numerous theoretical models in the literature that explain the etiology of health disparities. The important point is that socially advantaged and disadvantaged groups have different levels of access and exposure to and experience with these determinants of health, and that is what leads to health disparities. Maternal mortality is a health indicator that shows the wide gaps between rich and poor, both between and within countries. This fact file looks at what health inequities are, provides examples and shows their cost to society. The European Parliament has estimated that losses linked to health inequities cost around 1.4% of gross domestic product (GDP) within the European Union – a figure almost as high as the EU's defense spending (1.6% of GDP). A meta-analysis of 21 studies that looked at mental health among cancer patients found that U.S. Hispanics experienced worse distress, depression, social health-related quality of life, and overall health-related quality of life than non-Hispanic Whites (Luckett et al., 2011). As might be expected, there are health disparities in both cases. In considering various definitions of health disparities, Carter-Pokras and Baquet (2002) observed three approaches: “(1) comparison with the non-minority or majority population … (2) comparison with the general population … and (3) differences among segments of the population” (p. 492). One is the basis on which groups are being compared. It is of interest to note that the term “health disparities” is most commonly used in the United States, whereas other countries tend to use the terms “health inequities” or “health inequalities” (Carter-Pokras & Baquet, 2002). Under the terms of the licence agreement, an individual user may print out a single article for personal use (for details see Privacy Policy and Legal Notice). (2010) studied the impact of four preventable risk factors (smoking, high blood pressure, high blood sugar, and body fat) on life expectancy across eight subgroups in the United States known as the “eight Americas” (Asians, below-median-income Whites living in the Northland, middle America, poor Whites living in Appalachia and the Mississippi Valley, Native Americans living on reservations in the West, Black middle-America, poor Blacks living in the rural South, and Blacks living in high-risk urban environments). In shifting to aspects of mental health, a meta-analysis of 12 studies that considered migration, social mobility, and mental health found that migrants who experienced “downward social mobility” were more likely to experience mental disorders than those who either had no change in their socioeconomic status or experienced an increase in socioeconomic status (Das-Munshi, Leavey, Stansfeld, & Prince, 2012). In its latest comprehensive report on health disparities, the CDC considered a wide spectrum of health behaviors and outcomes ranging from environmental hazards and behavioral risk factors to various markers of morbidity and mortality. Using the 2005 HINTS data, Zhao (2010) explored differences in cancer information seeking between U.S. and foreign-born populations. Examples will be reviewed below. Third, there are several different strategies for communicating about health disparities (comparing different social groups, emphasizing specific groups, framing the causes of disparities, using narratives) and each has, not surprisingly, different outcomes. Causal inference is a key challenge in public health policy research intended to assess past policies and help decide future priorities. The analysis compared health news stories from 23 weekly Black newspapers to stories from a sample of 12 daily general audience newspapers and considered the extent to which there were differences in cancer coverage, reporting of types of cancer, reporting of disparities, inclusion of local information, and inclusion of “personally mobilizing” information. The U.S. Department of Health and Human Services (USDHHS, 2008), in its Healthy People 2020 initiative, provides a more comprehensive definition: A health disparity is a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. With this promise in place, this section provides a brief review of some of the government and foundation level efforts, as well as research-driven interventions, designed to ameliorate health disparities. First, American audiences have very little awareness of health disparities, do not think the issue is very important, and tend to put responsibility for health at the individual level rather than the social level (as in social determinants of health). Foster transdisciplinary collaborations that integrate evidence from basic biomedical science with social, behavioral, and population science methodologies in intervention design and outcomes assessment. Health inequities are avoidable inequalities in health between groups of people within countries and between countries. The studies briefly reviewed next provide examples of the extent to which different groups have different experiences with the variety of determinants of health. Danaei et al. Design and evaluate rigorous multilevel interventions to change both individual behavior and the social, policy, and built environments; assess multidirectional influences of interventions. The journal also covers issues of culture, religion, gender, class, migration, lifestyle and racism, in so far as they relate to health and its anthropological and social aspects.” (http://www.tandfonline.com/action/journalInformation?show=aimsScope&journalCode=ceth20), Journal of Health Disparities Research and Practice: “The Journal of Health Disparities Research and Practice is a refereed online journal that explores the dimensions of health disparities globally. Moving beyond an exclusive focus on the United States, Fleischer, Diez Roux, and Hubbard (2012) considered body mass index and smoking behavior across 70 countries using data from the 2002–2003 World Health Surveys, looking for instances of disparities by urbanicity and education. Both gender differences and gender inequalities can lead to disparities in health outcomes and access to health care. A definition from Braveman (2006) highlights the role of policy and social advantage in potentially ameliorating health disparities: A health disparity/inequality is a particular type of difference in health or in the most important influences on health that could potentially be shaped by policies; it is a difference in which disadvantaged social groups (such as the poor, racial/ethnic minorities, women, or other groups that have persistently experienced social disadvantage or discrimination) systematically experience worse health or greater health risks than more advantaged groups. This report investigates health disparities in the United Kingdom related to socioeconomic status, ethnic status, and sex; it also makes recommendations to address the social determinants of health underlying the disparities. Improve communication skills and cultural competency of health professionals, researchers, interventionists, and community stakeholders. the process of individual change and adaptation as a result of continuous contact with a new, distinct culture. Explain what challenges disparate populations face in your state. Coronavirus disease outbreak (COVID-2019), Coronavirus disease outbreak (COVID-19) ». Outcomes reported by proxy may be systematically different from those obtained from patients directly. The following books and special journal issues address the topic of health disparities: The following reports should be of interest to anyone interested in health disparities: Report of the Secretary’s Task Force on Black & Minority Health (The Heckler Report). Health inequalities arise because of the conditions in which we are born, grow, live, work and age. Health services involve access to and affordability of preventive services and medical treatment, which can be significant barriers for the disadvantaged. The following sections address each of these fronts. immigrants do unexpectedly better than non-immigrants in regards to health; further … The authors emphasized the importance of partnerships with governments, businesses, and organizations to help disseminate research-based interventions. This should include differences and health outcomes between groups. Taking a broader view, this essay briefly discusses trends in scholarship on health disparities, noting the precipitous increase in academic journal article publications on the topic, including the publication of journals specifically focused on publishing health disparities scholarship. Krieger argued, however, that such relationships had been revealed long ago, citing studies by Louis René Villérmé in 1826 and Friedrich Engels in 1844 that linked mortality to poverty. In a comprehensive review article, Niederdeppe, Bigman, Gonzales, and Gollust (2013) pursued four objectives: “(a) identify key outcomes and audiences for communication about health disparities; (b) describe what is known about public awareness of health disparities; (c) review selected research on the content of communication about health disparities in the mass media, the effects of that communication, and opportunities for use of mass media technology in communication about health disparities; and (d) identify priorities for future research to understand how communication about health disparities can shape concern and action to reduce health disparities” (pp. When da… Reducing inequalities shoul… The lower an individual’s socio-economic position, the higher their risk of poor health. We applied the sampling weights to all models to account for the CLHLS study design. This report issued by the Institute of Medicine documents the extent of U.S. health disparities and the factors that contribute to them; it also recommends strategies to reduce health disparities. Nursing and Health Science. The Journal invites submission of original manuscripts from researchers, public health, behavioral health, clinical and social science experts and practitioner that seek to continue the discussion of health disparities in order to eradicate them.” (http://digitalscholarship.unlv.edu/jhdrp/), Journal of Immigrant and Minority Health: “The Journal of Immigrant and Minority Health is an international forum for the publication of peer-reviewed original research pertaining to immigrant health. Individual behavioral risk factors are numerous, involving such things as alcohol, tobacco, and other drug use and risky sexual behavior resulting in sexually transmitted infections and unplanned/early pregnancy. Health equity means social justice in health (i.e., no one is denied the possibility to be healthy for belonging to a group that has historically been economically/socially disadvantaged). differences in health outcomes by groups, for instance, between males and females, people of different ethnicities, and people of lower and higher socioeconomic status. Acculturation. RWJF focus areas are child and family well-being, health coverage, health leadership and workforce, health system improvement, healthy weight, and health communities. Asians consistently had the lowest body fat (as measured by body mass index), blood sugar levels, and smoking rates. Its mission statement is simply put: “to improve the health and health care of all Americans” (RWJF, n.d.). Another is the point of comparison or the reference group used in a study. ‘Health inequalities’ refers to differences in health outcomes between groups, for example a higher rate of lung cancer incidence in more deprived areas compared with less deprived areas. Although individuals from different environmental, continental, socioeconomic, and racial groups etc. But scientific research and sound policy analysis demand information about causal relationships. In all countries – whether low-, middle- or high-income – there are wide disparities in the health status of different social groups. The term ‘health inequities’ relates to perceived unfair differences in health outcomes between groups that are potentially avoidable. (2009) determined that such interventions were effective. Every year the National Cancer Institute collects and publishes data based on patient demographics. Prioritize community engagement and equitably shared community and researcher power to maximize intervention success and sustainability. ... or ‘Asian’ may mask considerable within-group differences and emphasise between-group differences. These health inequalities, avoidable and unfair differences in health status between groups of people or communities1, reflect historic and present-day social inequalities in our population. A literature search of five major databases (MEDLINE, PsycINFO, CINAHL, Psychology and Behavioral Sciences Collection, Academic Search Complete) using “health disparities” as a subject term revealed 19 academic journal articles published between 1965 and 2000, 214 published between 2001 and 2005, 5,828 between 2006 and 2010, and 13,800 between 2010 and 2015. According to its vision statement, “NIMHD envisions an America in which all populations will have an equal opportunity to live long, healthy and productive lives,” and its mission is “to lead scientific research to improve minority health and reduce health disparities” (NIMDH, n.d.). For example, the United Kingdom tends to use occupation whereas the United States tends to use race/ethnicity. The Principal Investigators of the CPHHDs wrote an editorial for the American Journal of Public Health in which they presented their “bold new vision” for health disparities intervention research. A meta-analysis of 20 studies of pediatric food allergy prevalence in the United States found that although prevalence of food allergy has increased overall, increases were greater among non-Hispanic Black children (Keet et al., 2014). Additional examples of health disparities between groups by socioeconomic status, race/ethnicity, sex, and other factors will become apparent in the section on morbidity and mortality that follows. Harrington (2013) also highlighted the importance of the work of communication scholars in these efforts: Communication scholars have a clear role to play in many of the efforts to reduce health disparities. Another meta-analysis of 39 studies of non-small cell lung cancer found greater survival rates among women than men (Nakamura et al., 2011). Pre-reform differences in outcomes are perhaps due to unobserved differences across states that contaminated the previous, naive estimate. Health inequities are systematic differences in the health status of different population groups. Income was the biggest predictor of differences in health outcomes, according to Zimmerman. The contributors are expert in diverse fields including public health, epidemiology, medicine and nursing, anthropology, sociology, population research, immigration law, and ethics. The U.S. Centers for Disease Control and Prevention (CDC, 2011) presents a concise definition: “Health disparities are differences in health outcomes between groups that reflect social inequalities” (p. 1). In a meta-analysis of 29 studies looking at HPV vaccine uptake among young adolescent women, results showed that young Black women were less likely than young White women to be vaccinated and that young women in the United States who did not have health insurance were less likely to be vaccinated than young women with health insurance (Fisher, Trotter, Audrey, MacDonald-Wallis, & Hickman, 2013). Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion. This report reviews the “Health for All” policy adopted by member states of the World Health Organization’s European Region at the 51st World Health Assembly in May 1998. due to age, while … This supplement is the second CDC Health Disparities and Inequalities Report (CHDIR). The Robert Wood Johnson Foundation (RWJF), a philanthropy established in 1972, is the largest such organization in the United States whose work is focused entirely on health. This essay provides a brief review of the voluminous literature on health disparities, with a focus on several major threads including populations of interest, incidence and prevalence of morbidity and mortality, determinants of health, health literacy and health information seeking, media influences on health disparities, and efforts to reduce disparities. Different outcomes in mental and physical health exist between all census-recognized racial groups, but these differences stem from different historical and current factors, including genetics, socioeconomic factors, and racism. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. 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