Question

How are health disparities identified?

Give 3 examples of a health disparity and discuss the role of the Community Health Nurse in identifying ad addressing these disparities.

What are the community resources available in NYC to address health disparity concerns?

What public health policies exist to address health disparities?

Answer 1

Disparities can be measured relative to the rate for the total population represented by the domain of groups. The rate for the total population is a weighted average of the group rates in a domain (the group rates are weighted by the proportion of persons in each group.

Health disparities are health differences between different groups of people. These health differences may include

• How many people get certain diseases
• How severe the diseases are
• How many people have complications because of the diseases
• How many people die from a disease
• Whether people can get health care
• How many people get screened for a disease

These groups of people may be based on

• Race
• Ethnicity
• Immigrant status
• Disability
• Sex or gender
• Sexual orientation
• Geography
• Income
• Level of education

ADDRESSING HEALTH CARE DISPARITIES

• Raising public and provider awareness of racial/ethnic disparities in care;
• Expanding health insurance coverage;
• Improving the capacity and number of providers in underserved communities; and.
• Increasing the knowledge base on causes and interventions to reduce disparities.

A major national enterprise has grown up since the Institute of Medicine (IOM) report devoted to documenting health disparities; understanding their clinical, service, and social determinants; and mounting specific projects that address particular combinations of health status and racial and ethnic populations. This work has given extraordinary visibility to the existence of significant and stubborn disparities and mobilized an impressive number of university centers, provider groups, and community partners. Significant federal and private foundation funding has mapped onto this agenda. A great deal of innovation and adaptation has been spawned in this field, most notably the establishment and federal support for a broad body of community-based participatory research. Important state policy initiatives, such as the recently enacted Massachusetts Health Reform, have specific governance and accountability for disparities reductions.

Despite the number and variety of health disparities initiatives, there is growing restlessness that this enterprise is not yielding effective and scalable approaches and, most importantly, evidence of significant outcomes.

Health and health care disparities are commonly viewed through the lens of race and ethnicity, but they occur across a broad range of dimensions. For example, disparities occur across socioeconomic status, age, geography, language, gender, disability status, citizenship status, and sexual identity and orientation