Defining health disparities

Dr. Crutchfield, what do people mean when they use the term “health disparity”?

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 their socioeconomic status, race and/or gender.

It can also mean differences in the presence of certain diseases within groups. It can mean the outcomes of disease treatment 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 (Joint Center for Political and Economic Studies) have speculated 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 increase in the 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.

Despite continuing efforts to reduce health disparities in the United States, they persist. When comparing ethnic and racial groups and their White counterparts, some of the markers to follow include, but are not limited to: infant mortality rates, life expectancy rates, healthcare coverage rates, certain cancer rates, and rates of chronic disease presence in groups. Chronic diseases include hypertension, chronic obesity, diabetes, cardiovascular disease and several others.

Some examples of health disparities include:

• Infants born to Black women are 1.5 to three times more likely to die than those born to women of other races and ethnicities.
• American Indian and Alaska Native infants die from SIDS at nearly 2.5 times the rate of White infants.
• African American men are more than twice as likely to die from prostate cancer as Whites.
• Hispanic women are more than 1.5 times as likely to be diagnosed with cervical cancer as Whites.
• African Americans, American Indians and Alaska Natives are twice as likely to have diabetes as White individuals.
• Diabetes rates among Hispanics are 1.5 times higher than those for Whites.

Health disparities are getting the attention of politicians and physicians across the United States. Legislators, physicians and other members of the healthcare system are considering how to reduce or even eliminate these disparities.

Questions being asked include: What role does the government have in reducing health disparities? What role do physicians have in reducing health disparities? What role do people have in reducing health disparities in their communities? How are other states and countries addressing health disparities? What strategies can be employed to reduce health disparities in a cost-efficient manner?

This week my goal is to better define just what is meant by the term “health disparity.” Next week I will talk about strategies to 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.