Minority Enduring Status:
Health Disparities
S o c io lo g y 1 0 8
P r o fe s s o r C a th e r i n e l e e
W eek 12
Health disparities
P o p u l a ti o n - o r g r o u p - s p e c i fi c
d i ffe r e n c e s i n p r e s e n c e o f d i s e a s e ,
h e a l th o u tc o m e s , o r a c c e s s to h e a l th
c a re .
W h y s h o u ld w e c a re a b o u t
health disparities?
M i n o r i ty s ta tu s : i n d i c a ti v e o r c a u s e
Is s u e s a b o u t e q u a l i ty , fa i r n e s s , j u s ti c e
H u g e e x p e n d i tu r e s i n h e a l th c a r e - 1 5 %
o f G D P - o n a v g t w i c e o f o th e r
a d v a n c e d i n d u s tr i a l n a ti o n s c o s ts B U T n o t tw i c e a s g o o d ( i n te r m s o f
o u tc o m e s )
What are health disparities
G a p s i n q u a l i ty o f h e a l th
G a p s i n q u a l i ty o f h e a l th c a r e
Examples of gaps in quality of
health
In fa n t M o r ta l i ty R a te ( IM R )
D i s e a s e i n c i d e n c e , m o r ta l i ty
Exampls of gaps in quality of
health care
L a c k o f h e a l th i n s u r a n c e
L a c k o f re g u la r p h y s ic ia n
L a c k o f a c c e s s to h i g h - q u a l i ty ,
a g g re s s iv e c a re
--> U n e q u a l c a re
Some reasons for health
disparities
G e n e ti c s
P o v e r ty
L a n g u a g e b a rrie rs
E d u c a ti o n a n d h e a l th l i te r a c y
C u l tu r a l d i ffe r e n c e s /a tti tu d e s
S o c ia l b e h a v io rs
U n e q u a l h e a l th c a r e
P e r c e n t o f A d u l ts W h o H a v e N o
R e g u l a r D o c to r
Percent of Adults who have Problems
Communicating with their Doctor.
Older African Americans Receive Lower Rate of
Surgery And Have Lower Resulting Survival Rate
Some definitions of race in
b io m e d ic a l r e s e a rc h
ASA: social concept that changes over time
AAA: an ideology distorts that our ideas about
human differences and group behavior
A human population that differs from others in the
relative frequency of genes.
A class of individuals having common inheritable
physical characteristics
Definition of Ethnicity
A g r o u p w i th p u ta ti v e c o m m o n a n c e s tr y
th a t s h a r e s c u l tu r a l s y m b o l s a n d p r a c ti c e s
s u c h a s l a n g u a g e , d i e t, r e l i g i o n , n o r m s ,
a n d v a lu e s
Human variation: proof of
b i o l o g i c a l r a c e ?
A r e th e r e p h y s i c a l d i ffe r e n c e s ?
Is th e r e g e n e ti c v a r i a ti o n ?
D o e s th e e x i s te n c e o f d i s e a s e s s u c h a s
T a y S a c h s o r s ic k le c e ll a n e m ia p ro v e
th e e x i s te n c e o f r a c e ?
D o e s a n c e s tr a l c o n ti n e n ta l o r i g i n e q u a l
ra c e ?
Blood pressure response to ACE inhibitors
(Sehgal, 2004, Hypertension 43: 566-72)
4.6 mm Hg
SD=14 mm Hg
SD=12 mm Hg
Geneticist Lynn Jordes Conclusions
H u m a n s a r e g e n e ti c a l l y s i m i l a r , r e fl e c ti n g a
r e c e n t, c o m m o n o r i g i n
G e n e ti c v a r i a ti o n i s c o r r e l a te d w i th
g e o g r a p h y a n d te n d s to b e d i s tr i b u te d
c o n ti n u o u s l y a c r o s s g e o g r a p h i c s p a c e
Race is not biologically meaningless, but it
is b io lo g ic a lly im p re c is e
P e r s o n a l i z e d m e d i c i n e , w h e n fe a s i b l e , w i l l b e
m e d i c a l l y m o r e u s e fu l th a n e th n i c i ty o r r a c e
Race/Ethnicity, Health, and
Disparities
H o w s h o u l d w e i n v e s ti g a te th e
r e l a ti o n s h i p ?
P i tfa l l s to i n v e s ti g a ti n g b i o l o g i c a l &
g e n e ti c d i ffe r e n c e s i n r a c e & h e a l th ?
Biologize race
Ignore social inequalities