It’s easy for many people to assume that everyone has the same access to health care in the US (it is 2020, after all). But unfortunately, that's an incorrect and dangerous assumption.
The truth: Health disparities—that is, preventable, poor health outcomes experienced by socially disadvantaged populations—aren’t a new concept, but COVID-19 has shown they’re still very much a problem in the US, with black Americans bearing the brunt of severe outcomes of the disease.
In a recent analysis conducted by the non-partisan research group APM Research Lab, statisticians found that black Americans are dying from the virus at 2.4 times the rate of their white counterparts. But their analysis didn't stop there: the research lab broke down ethnicity in COVID-19 deaths across 40 states, where information was available. Here’s what they found:
- 1 in 1,850 black Americans has died
- 1 in 4,000 Latino Americans has died
- 1 in 4,200 Asian Americans has died
- 1 in 4,400 white Americans has died
The researchers also present this eye-opening data: If all minority groups died at the same rate as white Americans, about 13,000 black Americans, 1,300 Latino Americans and 300 Asian Americans would still be alive.
The Brookings Institution, an American research group, had similar conclusions from their data analysis and found that, in some areas across the country, black people represent about 80 percent of coronavirus cases. And preliminary data released by New York City Department of Health and Mental Hygiene in April also found that black and Latino people in New York City are dying at twice the rate of Caucasians and Asian people.
Health disparities don’t just exist for minorities, though, and they’re not limited to COVID-19—they have a broader reach than most people think. Here’s what you need to know, generally-speaking, about health disparities and how they can affect people, plus what some organizations are doing to combat them.
What are health disparities?
Health disparities are preventable differences in the burden of disease, injury, violence, or opportunities to reach your best health that are experienced by socially disadvantaged populations, according to the Centers for Disease Control and Population (CDC). Health disparities are often directly related to historical and current unequal distribution of social, political, economic, and environmental resources, the CDC says.
The word “disparity” is usually used to describe a difference in racial or ethnic outcomes, but it extends further than that. If there is a difference in health outcomes between groups of people, there is a health disparity, says the Office of Disease Prevention and Health Promotion (ODPHP). That means people can experience disparities due to race, ethnicity, gender, sexual identity, age, disability, socioeconomic status, and even geographic location.
Health disparities can surface due to several factors, according to the CDC:
- Environmental threats
- Inadequate access to health care
- Individual and behavioral factors
- Educational inequalities
The point: Although not everyone is aware that health disparities exist, they’re extremely common. “It is important that people are aware of health disparities because they reflect the injustices that exist in our society,” Devin English, PhD, an assistant professor at the Rutgers School of Public Health, tells Health.
How can health disparities impact people?
It depends. Health disparities technically affect everyone—it’s just the impact that varies. “White, cisgender, and straight people have the longest lifespans in the U.S.,” English says. “This is not because of any biological reason, but rather because they benefit from systems of white supremacy and anti-LGBTQ+ hate. So, what we see is that the impact is positive for privileged groups and destructive for groups that face marginalization.”
But the negative consequences of health disparities are wide-reaching, Zul Surani, MPH, Director of Community Outreach and Engagement & Operations at the Research Center for Health Equity at Cedars-Sinai, tells Health. “In the cancer field, for example, delayed diagnosis of cancers that could be treatable is an issue of health disparity,” he says. “If cancer is diagnosed early and people have access to the right medications, that can lead to a better quality of life for people.”
The American Cancer Society (ACS) specifically calls out the problem of health disparities in cancer online, noting that racial health disparities exist across many forms of cancer. For example, African-Americans are more than twice as likely as white Americans to die prostate cancer and nearly twice as likely to die of stomach cancer. Hispanic and American Indian/Alaska Native women have higher rates of cervical cancer than women of other racial and ethnic groups, and African-American women have the highest rates of death from the disease.
Here are just a few more health disparities to be aware of—though of course not a full list—per the American Psychological Association (APA):
- HIV: African-Americans make up 45% of HIV diagnoses, but make up about 12% of the U.S. population
- Suicide: Reported rates of suicide attempts are up to seven times higher in LGBT youth than those who identify as heterosexual
- Diabetes: Native Americans have a greater chance of having diabetes than any other U.S. population
- Smoking: Rural Americans are more likely to be exposed to second-hand smoke, and have less access to smoking cessation programs
What you can do to help combat health disparities in the US:
People of privilege are the ones who should fight the hardest for health equity, or the opportunity for every person to attain their highest level of health. “Fighting for health equity means pushing your elected officials to present concrete plans to reduce police violence, mass incarceration, and housing and education inequality,” English says. “It means supporting the community organizations that are fighting for health equity by fighting for social equity and civil rights. It means identifying the ways in which you benefit from injustice in our society and using that privilege to promote equity and opportunity in your neighborhood, workplace, and nation.”
And if you are a member of a population that often experiences health disparities, Surani recommends trying to find the right health care provider for you, who gets your personal needs and risk factors. “If you’re LGBTQI, for example, ask for an LGBTQI provider who you feel that you can be honest and authentic with,” he says.
Health disparities are a huge, wide-reaching problem and, of course, no one person can tackle them alone. That’s why there are several organizations that are working hard to combat health disparities in the US. Supporting the below list of organizations—groups doing both scientific research on health disparities and pushing for policy changes for underserved communities—can help:
- Adventist HealthCare Center for Health Equity and Wellness: As part of Adventist HealthCare, a faith-based not-for-profit organization, the Center for Health Equity and Wellness helps develop "culturally-tailored health programming" to promote health equity in their Maryland community.
- American Hospital Association: The group of five national organizations—the American College of Healthcare Executives, American Hospital Association, Catholic Health Association of the United States, America's Essential Hospitals, and Association of American Medical Colleges—collaborates on the national improvement efforts of health equity.
- Center for Health Equity Research & Promotion Collaborations: Part of the US Department of Veterans Affairs, the CHERP works to advance equitable health care for vulnerable populations.
- FamiliesUSA: A "leading national, non-partisan voice" to aid health care consumers in finding high-quality, affordable health care for all.
- Henry J. Kaiser Family Foundation: The endowed, non-profit organization helps fill the need for trusted, independent information on national health issues.
- National Center for Cultural Competence: Part of Georgetown University, the NCCC aims to increase the capacity of health care and mental health care programs to address and promote health and mental health equity.
- National Quality Forum: The NQF aims to help the nation achieve better, affordable health care to improve the health of Americans.
- New York Academy of Medicine: The NYAM works to tackle barriers—like affordable housing, food, and health care—that prevent all individuals from leading a healthy life.
- Prevention Institute: The institute helps policymakers, decision-makers, professionals, and the general public to understand the importance of high-quality prevention measures.
- RAND Corporation: A research organization that helps develop solutions to public policy challenges to help make global communities safer and healthier.
- Robert Wood Johnson Foundation: Through grant programs and research, the Robert Wood Johnson Foundation helps to provide everyone in America a fair opportunity for health and well-being.
- The Commonwealth Fund: The Fund promotes a health care system for better access, improved quality, and greater efficiency for society’s most vulnerable populations.
- The Cross Cultural Health Care Program: A program that works to serve as a bridge between communities and health care institutions to provide access to quality health care that is culturally and linguistically appropriate.
- The Dartmouth Atlas of Health Care: A research project that documents variations in how medical resource are distributed and used across the US.
- The Urban Institute: A non-profit research organization that helps to diagnose challenges in health care and identify opportunities for change.
- The Joint Center for Political and Economic Studies: A non-profit organization that creates ideas to improve the socioeconomic status and civic engagement of African Americans.
Government organizations like the CDC, the US Department of Health & Human Services, the National Cancer Institute, the National Institute of Mental Health, and the Office of Minority Health are also working to help fight health disparities.
Again, health disparities are such a massive issue that it’s nearly impossible for one person to tackle them alone. But that doesn’t mean you can’t help fix the problem, Surani says. “Being aware that health disparities exist and demanding equality is important,” he says.
Understanding just how serious health disparities are matters, too. “Health disparities are a matter of life and death,” English says. “If we as a society are not working towards health equity, then we are saying that some people deserve to live more than others. We are accepting inequities in death across race, immigration status, sexual and gender identity, and so much more.”
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