Last week in this column we defined health disparities. Merriam-Webster defines disparity as “the state of being different.”
The term “health disparities” refers to several conditions. It almost always refers to differences in groups relating to socioeconomic status, race and/or gender. It can mean differences in the presence of certain diseases within groups. It can mean the outcomes of diseases treated in these groups. It can mean the quality of health care and access to healthcare services that exist within these groups.
Disparities can also be caused by a lack of efficiency within the healthcare system. As a result of the lack of efficiency, some studies have speculated (Joint Center for Political and Economic studies) that approximately $50 billion are spent wastefully every year in the U.S. By reducing or eliminating health disparities, there could be a significant savings to the healthcare system accompanied by an overall increased quality of health care.
Several factors contribute to health disparities amongst socioeconomic, racial, gender, and ethnic groups. These factors include poor access to care, low quality of care, community markers (such as poverty and violence), and social habits.
Health disparities are often observed in association with underserved ethnic minority groups, individuals who have experienced economic challenges, those with physical challenges, and those living in areas with little or no medical services available. Health disparities can be observed in both rural and urban settings.
The next step is deciding whether we are serious about reducing healthcare disparities. If we are, nothing short of an organized national effort will do.
We know one cannot ignore the strong correlation between access to quality health care and disparities in socio-economic status and differences in educational, employment, housing, and nutritional opportunities. But first let’s focus on health disparities and consider a national effort to reduce healthcare disparities as part of an overall “increase everyone’s state of health program.”
No single entity or factor will resolve the challenge. Success will require commitment and effort from individuals, families, schools, elected officials, physicians and clinics, medical schools, community programs, religious institutions, insurance plans, pharmaceutical companies — you get the picture.
Individual and family commitments
Let’s start with the individual. I recently heard a colleague discussing the state of health care, and he suggested that no matter what access we provide to the public, there will be those who do not get off the couch to get care when they need it, resulting in eventual catastrophic care.
I first thought this was a rather pessimistic view, but then considered that he may have a point. We must instill in all of us that personal health and family health are a priority. We must de-stigmatize the need for responsible health maintenance, whether it is a social stigma or a concern over cost.
The evidence is overwhelming that when we all do our part — meeting with our doctor, developing a personal health plan, addressing issues early — we save ourselves and the healthcare community tremendous resources and improve our quality of life.
To stay on top of our individual health, each person should develop a plan of scheduled health visits that include appropriate screening based on gender and age: mammograms, prostate testing, colonoscopy, eye exams, hearing tests, and regular health exams. This basic, commonsense commitment is magnified dramatically when we include meeting with a nutritionist or dietitian and fitness adviser, where appropriate.
The point is for each of us to commit to our health through a specific customized personal health plan (PHP) developed with a physician and executed and updated on a yearly basis. The entire family should share their PHPs and support each other to make sure they are followed.
Next week: How pharmaceutical companies, insurance companies, elected officials and the media can help reduce health disparities.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.