Magazine article Clinical Psychiatry News

Get to Root of Disparities, CDC Official Says

Magazine article Clinical Psychiatry News

Get to Root of Disparities, CDC Official Says

Article excerpt

WASHINGTON -- The definition of "health disparities" should be broadened to include the conditions that caused the affected groups to have poor health in the first place, according to Dr. Camara Jones of the Centers for Disease Control and Prevention.

The usual definition of health disparities refers to differences in the quality of care patients receive within the health care system, as well as differences in access to care, including preventive and curative services, Dr. Jones said at a meeting of the federal Advisory Committee on Minority Health.

However, "differences in life opportunities, exposures, and stresses that result in differences in underlying health status" also must be taken into account. So although health is partly determined by medical care and public health conditions, "it clearly extends beyond these [factors]," she said.

Dr. Jones said the social determinants of health include individual behaviors, such as what people choose to eat; individual resources, such as education, occupation, income, and wealth; neighborhood resources, such as housing, available grocery and dining choices, public safety, transportation, parks and recreation, and political clout; hazards and toxic exposures; and opportunity structures.

Therefore, reducing health disparities requires intervention in societal structures and attention to systems of power, said Dr. Jones, who is the CDC's research director on social determinants of health and equity. "We must address the social determinants of health, including poverty but also social determinants of equity, [such as] racism, in order to achieve social justice and eliminate health disparities," she said.

Progress in eliminating health disparities has been slow because the country has been "pruning [the problem] instead of getting to the root," she said. For example, it could be hypothesized that racism is a fundamental cause of disparities in health. (See box.)

Dr. Jones cited a U.N. …

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