Bill Oxford @bill_oxford

The COVID-19 pandemic shed light on what wasn’t a new problem but was one that became more understood in a crisis, which is how disparities affect health care and health outcomes.

Practitioners and health care organizations are going to have to make this a key priority in coming years through collaborative care management and other strategies.

Before specific steps are taken, there has to be an understanding of what health care disparities are and what the impacts can be.

What Are Disparities in Health Care?

The American Medical Association encourages doctors to look at their practices to make sure they are providing equality in care.

Studies have shown that minorities, for example, tend to experience lower-quality health care. They’re also less likely to receive routine care, and they have higher mortality and morbidity rates than non-minorities.

There was a recent assessment conducted by the Institute of Medicine (IOM) that found the following:

  • Health care disparities occur within larger inequality.
  • Disparities exist and are associated with worse outcomes in terms of health.
  • There are many sources contributing to disparities.
  • Clinical uncertainty, stereotyping, and bias are contributors.
  • There are also studies that show minority patients are more likely to refuse treatment.

The AMA has outlined its policy to help reduce disparities. Their policies aim to increase awareness about disparities among the general public and strengthen the relationships between patients and providers in health care plans that are publicly funded.

The AMA is also working to apply managed care protections that apply to private HMO participants to publicly funded HMO participants.

Defining Disparities

According to Healthy People 2020, a disparity in health is a difference closely associated with economic, social or environmental disadvantage, so this expands the definition beyond being exclusive to racial or ethnic minorities.

Health disparities, according to Health People 2020, adversely affect people who have had systematic obstacles to health.

According to the Centers for Disease Control and Prevention (CDC), health disparities are defined as a preventable difference in disease or injury burdens or opportunities to reach optimal health experienced by socially disadvantaged populations.

The terms inequity and health inequality are sometimes used in this context as well.

According to Healthy People 2020, health equity is all people attaining the highest level of health possible. For this to happen, all patients have to be valued equally and there should be ongoing efforts to avoid inequalities and disparities.

The CDC says health equity is achieved when everyone is able to attain his or her own health potential, and they aren’t prevented from doing so because of social circumstances.

Cyclical Impacts

Research has shown that health disparities don’t just affect people on the individual level. They impact communities and society as a whole and are often self-perpetuating.

For example, if there’s a sick parent in a family and they can’t work, then they might become low-income. Someone low-income or unemployed has less access to health care coverage. That could make them sicker, which could further impact their ability to find employment, and it continues from there.

Health disparities can have generational effects too.

Pregnancy is an example.

The health of a mother when she’s pregnant and the care she receives affects her baby. Chronic stress, for example, can impact a pregnancy. It could lead to a baby being born too early, and preterm babies are at a higher risk of having health complications later in their lives.

On a societal level, reducing health disparities nationally could have saved the U.S hundreds of billions of dollars between 2003 and 2006.

Examples

While there are many, the following are some specific examples of the effects of health disparities:

  • Black women and Mexican-American men have higher obesity rates than other races or ethnic groups.
  • People with lower education levels and incomes are more likely to get cancer and die from it, and that gap is growing.
  • Babies born to black women in the U.S. die at over double the rate of babies born to white women.
  • Black people have twice the likelihood as white people to develop Alzheimer’s in the U.S.
  • Native American people have higher rates of smoking, and the same is true of people who are unemployed and living below the federal poverty level.

There’s no one root cause of health disparities. It’s complex and there are often many factors, including income inequality, systematic discrimination, and environmental factors.

Health care disparities and outcomes are something that’s going to broadly impact the medical industry in the coming years as it works to identify potential solutions.