8.2: Health Disparities and Inequities
Health disparities refer to differences in health outcomes (morbidity and mortality) between populations that are not based in genetics or individual biology. Health inequities are defined as an increased risk of poorer health correlated with race/ethnicity, gender, sexual orientation, socioeconomic status, health insurance status, rural/urban residence or (geographical location), and housing status (U.S. DHHS, HRSA, Office of Health Equity., 2020). Although the terms “disparities” and “inequities” are often used interchangeably (even in this text), it is the inequities in health opportunities that often lead to the disparities we see in health outcomes of different groups. In other words, we are recognizing that there are differences in how long we live and what diseases affect us (and how seriously sick we become) that have more to do with social, economic, political, and environmental factors than any genetic or biological influence. Why do people in one zip code live longer than those in another? Why is income or education level such a strong predictor of health? We should recall back to the philosophies of Virchow and Winslow (chapter 3) in recognizing that these social determinants of health are perhaps the strongest predictors of overall population health. “Health inequities refer to inequalities that are unfair, unjust, avoidable or unnecessary, and that can be reduced or remedied through policy action”(U.S. DHHS, HRSA, Office of Health Equity., 2020). Pursuing health equity - providing opportunities for all to attain their highest level of health - is a paramount role for public health (Healthy People 2030, n.d.).