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Health Disparities and Health Inequities: Impact and Advocacy

April 9, 2024

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Health Disparities and Health Inequities: Impact and Advocacy

Despite spending more money on health care than any other developed country in the world, the U.S. healthcare system vastly underperforms on important health metrics. For example, among high-income countries, the United States had the lowest life expectancy at birth, highest death rates for treatable conditions, and the highest maternal and infant mortality rates in 2022.

The United States is known for its wealth and technological advancements, but it is also known for its persistent health disparities. People interested in public health should understand how public health leaders understand health disparities and health inequities and how adverse health outcomes relate to health equity broadly.

Health disparities (also called health inequities) are differences in health outcomes between different populations, and they are a major public health concern. These disparities are often driven by social, economic, and environmental factors that are beyond the control of individuals, such as poverty, discrimination, and inadequate access to health care.

At the same time, health equity, which means ensuring that everyone has the opportunity to achieve optimal health regardless of their background, remains an elusive goal for the U.S.. Explore the complex issue of health disparities and health equity in the U.S., the factors that contribute to them, and potential solutions to address these disparities and promote a more equitable society.

Health Disparities Defined

The word “disparity” means a difference or variation, but the concept of a health disparity is more complex.

Health disparities, also called health inequities, are differences in health between groups that arise from broader social inequities. The term has been widely used to refer to differences in health outcomes based on a variety of factors, including race, ethnicity, socioeconomic status, geographic location, gender, and sexual orientation.

Not All Differences Are Disparities

Importantly, not all differences in health outcomes are health disparities. Professional basketball players are more likely to incur ankle sprains than the general public — but this difference in injury outcomes is not a health disparity because it is not related to a person’s identity or relative social standing in society, nor a lack of opportunities or resources.

Similarly, poor health outcomes, on average, among older adults ages 70 and up compared to young adults ages 18 to 25 are the result of natural aging processes, not social disadvantage. However, older adults may also experience ageism when seeking health care or may face financial barriers to high-quality care, which may represent health disparities.

The guiding principle to distinguish a health difference from a health disparity is this: health disparities adversely affect members of groups that face social or economic barriers to health on the basis of their group membership (whether that group is racial, religious, gendered, geographic, or related to socioeconomic status, sexual orientation, disability, veteran status, or a combination of these).

Health Disparity Examples

Here are five examples of health disparities in the United States:

Racial and ethnic disparities: People of color, including Black, Latino, and Native American populations, are more likely to experience a range of health disparities, including higher rates of chronic disease, infant mortality, and maternal mortality.

Socioeconomic disparities: People who live in poverty or have lower incomes may have less access to quality health care, healthy food options, safe neighborhoods, and other resources that contribute to good health.

Geographic disparities: Rural communities may have fewer healthcare facilities and providers, leading to disparities in access to care and health outcomes.

Sex disparities: Women may experience health disparities, including higher rates of certain conditions such as autoimmune diseases, depression, and worse cancer prognoses as the result of inadequate screening for breast and cervical cancer.

Gender disparities: Transgender and gender nonconforming individuals face unique challenges and disparities in accessing health care and experiencing discrimination in healthcare settings.

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Health Equity Defined

Health equity is the concept that everyone should have the opportunity to achieve optimal health regardless of their race, ethnicity, gender, socioeconomic status, geographic location, or any other factor that might put them at a disadvantage. In essence, health equity means that everyone has a fair and just opportunity to achieve their potential for health and well-being.

Understand Health Equity

Health equity aims to ensure that everyone has access to the conditions and resources they need to achieve good health, including:

Quality health care, including dental, vision, and advanced care for injuries and chronic conditions
Affordable housing
Safe and secure dwellings and neighborhoods
Consistent access to healthy food
Social support

By the same token, pursuing health equity involves addressing the social, economic, and environmental factors that contribute to poor health outcomes — expanding access, removing barriers, and creating health systems through policy change and implementation that benefit everyone by addressing the needs of society’s most disadvantaged groups.

How Are Health Disparities Related to Health Equity?

Health equity means that no one is denied the possibility for health due to their membership in a group that experiences economic or social disadvantage.

Health disparities are the metrics that public health leaders use to measure how close or far a population is to health equity. Reducing health disparities signals movement toward greater health equity in a given community — something that everyone should strive for. Increasing health disparities can signal that specific health policies are inadequate or even harmful to specific groups — indicating that immediate change is needed.

Why Experts Study Health Disparities and Health Inequities

Addressing health disparities is essential for improving the overall health of our society and promoting social justice.

Public health experts study health disparities because they are a major public health concern that can have significant negative impacts on individuals and communities. These disparities include increased rates of morbidity and mortality, decreased quality of life, and reduced productivity. Health disparities can also lead to increased healthcare costs, reduced economic growth, and greater social inequality.

By studying health disparities, public health experts can identify the factors that contribute to them, the populations that are most affected, and the best potential solutions to address them. This information can be used to develop interventions and policies aimed at reducing health disparities and promoting health equity, which means ensuring that everyone has the opportunity to achieve optimal health regardless of their background or social identity.

Health Inequity Examples: How Public Health Leaders Take Action

Federal efforts to reduce health disparities and health inequities focus on specific priority populations in the United States. These groups include people who are low-income, people of color, women, children and teens, older adults, individuals with special healthcare needs, or people living in rural areas where healthcare resources are more sparse.

Discover how public health leaders take action against health inequities. Consider four examples of health inequity and advocacy by public health leaders.

Low Income Individuals and Families

People with lower incomes and less education tend to have worse health outcomes than those with higher incomes and more education. For example, low-income people living in the U.S. have higher rates of heart disease, stroke, diabetes, and other chronic conditions compared to those with higher incomes.

For the 6.8 million children living in poverty, there are negative consequences across the lifespan related to inadequate nutrition, exposure to environmental pollutants, difficulties with developing language skills, and higher rates of chronic illness compared to children who grow up in a higher socioeconomic class.

Public health leaders are addressing poverty in a variety of ways, recognizing that poverty is a major determinant of health disparities. Some of these advocacy activities include:

Research. Public health leaders are conducting research to better understand the impact of poverty on health outcomes and to identify effective interventions. This includes studying the relationship between poverty and chronic diseases, mental health, and other health issues.

Education. Public health leaders educate the public about the link between poverty and health outcomes. This includes providing information on how poverty affects access to health care, healthy food, safe housing, and other essential resources.

Collaborations. Public health leaders are collaborating with community organizations and other stakeholders to address the root causes of poverty. This includes partnering with organizations that provide job training, financial literacy education, and other support services to low-income individuals.

Policy development. Public health leaders are working with policymakers to develop policies that address poverty and improve health outcomes. This includes advocating for policies that increase access to affordable health care, increase the minimum wage, improve access to health insurance, and expand social safety net programs.

Mental Health Care

There are significant health disparities and health inequities in mental health care, such as access to and quality of mental health care for different populations, including racial and ethnic minorities, individuals with disabilities, and people living in rural areas.

For example, around 21 percent of adults experienced a mental illness in 2022, according to Mental Health America. The percentage of all adults who reported serious thoughts of suicide was 4.8 percent, but the percentage of adults who identified with two or more races who reported serious thoughts of suicide was much higher at 11 percent.

Mental Health America also found that in 2022, over 5.5 million adults with mental illness were uninsured — leading many to forego the mental health treatment they needed.

Public health experts are addressing the mental health crisis by advocating for increased funding for mental health services, expanding telehealth options, and increasing awareness about the importance of mental health and destigmatizing seeking mental health care.

Public health experts also work at dedicated organizations with the mission to support people experiencing mental illness.

The National Alliance on Mental Illness (NAMI) is a grassroots organization that focuses on advocacy, education, and support for people living with mental illness and their families. NAMI offers resources and programs for improving mental health outcomes, including support groups, education and training programs, and public awareness campaigns.

NAMI also advocates for policies that improve access to mental health care, such as expanding Medicaid coverage for mental health services and increasing funding for mental health research. Additionally, NAMI works to address the stigma and discrimination that people with mental illness often face by promoting education and awareness about mental health issues and advocating for greater acceptance and understanding.

Black Maternal Health

Black mothers are more likely to experience complications during pregnancy and childbirth and are more likely to die from pregnancy-related complications compared to white mothers.

Public health experts are addressing this issue by advocating for increased access to prenatal care, improving provider training on implicit bias, and implementing policies that address the social determinants of health that disproportionately impact Black women, such as poverty and racism:

Expanding access to quality prenatal care. Prenatal care is crucial for ensuring healthy pregnancies and reducing maternal complications. Public health experts are working to increase access to prenatal care for all individuals, particularly those from racial and ethnic minority groups who may face barriers to care.

Addressing implicit bias and racism in health care. Implicit biases and racism can impact the quality of care that individuals receive during pregnancy and childbirth. Public health experts are advocating for implicit bias training for healthcare providers and addressing systemic racism within the healthcare system.

Promoting community-based interventions. Public health experts are working to increase community-based interventions that address the social determinants of health, such as poverty and inadequate housing, that contribute to maternal health disparities.

Advocating for policy changes: Public health experts are advocating for policy changes, such as expanding Medicaid coverage, increasing access to contraception and family planning services, and implementing paid family leave policies, that can help reduce maternal health disparities.

Engaging and empowering communities. Public health experts are working to engage and empower communities that are most affected by maternal health disparities. This includes working with community organizations and leaders to raise awareness about the issue, promote advocacy efforts, and provide resources and support.

Rural Health Care

Rural communities often face significant challenges when it comes to accessing health care compared to people who live in cities. Limited healthcare resources (including healthcare providers, equipment, and specialized care centers) can make seeking health care harder in rural areas compared to urban ones. Many rural communities face significant transportation barriers such as long travel distances and a lack of public transportation options when seeking care from rural areas.

Public health leaders are working to improve rural health by addressing these challenges in a number of ways. Some strategies include:

Telehealth: Telehealth services can improve access to health care for rural residents by allowing them to receive medical consultations and other services remotely, without the need to travel long distances.

Workforce development: Public health leaders are working to increase the number of healthcare providers in rural areas by providing training and education opportunities for healthcare professionals who are interested in working in rural communities.

Community health workers: Community health workers can help to bridge the gap between healthcare providers and rural residents by providing education and support for healthcare needs.

Policy development: Public health leaders are advocating for policies that improve access to health care for rural residents, including increased funding for rural healthcare facilities and providers, as well as policies that support telehealth and other innovative approaches to healthcare delivery.

By working to improve access to healthcare services, increase the number of healthcare providers in rural areas, and develop innovative approaches to healthcare delivery, public health leaders can help to improve the health and well-being of rural residents.

Promote Health Equity With a Degree in Public Health

Learning about health disparities vs. health inequities and how public health leaders are addressing health outcomes due to social disadvantage can provide a solid foundation for a career in public health.

Public health jobs are increasingly needed. The U.S. Bureau of Labor Statistics predicts that health care will create nearly 4 million jobs by 2026 — about a third of all new jobs. Prepare to serve in a variety of settings and roles, including program development and management, health education, and research.

Aspiring public health professionals seeking to address health disparities and improve health equity should consider an advanced education, such as Tulane University’s Online Master of Public Health (MPH) programs. Pursuing an MPH program can help potential and existing leaders gain the expertise and hands-on training they will need to pursue a career path that promotes public health and equity.