Challenging Inequities in Health


Book Description

This text provides a unique view of global inequities in health status and health sytems. Emphasizing socioeconomic conditions, it combines chapters on conceptual and measurement issues with case studies from around the world.




Communities in Action


Book Description

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.




The Health Gap


Book Description

'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.




Health Disparities in the United States


Book Description

Challenging students to think critically about the complex web of social forces that leads to health disparities in the United States. The health care system in the United States has been called the best in the world. Yet wide disparities persist between social groups, and many Americans suffer from poorer health than people in other developed countries. In this revised edition of Health Disparities in the United States, Donald A. Barr provides extensive new data about the ways low socioeconomic status, race, and ethnicity interact to create and perpetuate these health disparities. Examining the significance of this gulf for the medical community and society at large, Barr offers potential policy- and physician-based solutions for reducing health inequity in the long term. This thoroughly updated edition focuses on a new challenge the United States last experienced more than half a century ago: successive years of declining life expectancy. Barr addresses the causes of this decline, including what are commonly referred to as "deaths of despair"—from opiate overdose or suicide. Exploring the growing role geography plays in health disparities, Barr asks why people living in rural areas suffer the greatest increases in these deaths. He also analyzes recent changes under the Affordable Care Act and considers the literature on how race and ethnicity affect the way health care providers evaluate and treat patients. As both a physician and a sociologist, Barr is uniquely positioned to offer rigorous medical explanations alongside sociological analysis. An essential text for courses in public health, health policy, and sociology, this compelling book is a vital teaching tool and a comprehensive reference for social science and medical professionals.




Challenges and Successes in Reducing Health Disparities


Book Description

In early 2007, the Institute of Medicine convened the Roundtable on Health Disparities to increase the visibility of racial and ethnic health disparities as a national problem, to further the development of programs and strategies to reduce disparities, to foster the emergence of leadership on this issue, and to track promising activities and developments in health care that could lead to dramatically reducing or eliminating disparities. The Roundtable's first workshop, Challenges and Successes in Reducing Health Disparities, was held in St. Louis, Missouri, on July 31, 2007, and examined (1) the importance of differences in life expectancy within the United States, (2) the reasons for those differences, and (3) the implications of this information for programs and policy makers.




Working for a healthier tomorrow


Book Description

Around 175 million working days were lost to illness in 2006. Some 7 per cent of the working population is workless and receiving benefits because of long-term health conditions or disabilities. This represents a significant cost to the economy - in cost of benefits, healthcare, forgone taxes, lost production, sickness absence, informal care - estimated at between £103 and £129 billion. The review's vision for health and work in Britain is based on three principal objectives: prevention of illness and promotion of health and well-being; early intervention for those who develop a health condition; an improvement in the health of those out of work. The review establishes the first baseline for the health of the working population. It then examines the role of the workplace in health and well-being. Work is good for both physical and mental health (Waddell & Burton, 2006, "Is work good for your health and well-being?" TSO, ISBN 9780117036949). Employers, trade unions, employees, safety and health practitioners should all promote the benefits of investment in health and well-being. The review calls of a fundamental shift in the perception of fitness for work, to move away from it being inappropriate to be at work if not 100 per cent fit. Early intervention can prevent short-tem sickness becoming more serious, and pilot trials of a new Fit for Work service are proposed. More health support for workless people on incapacity benefits is recommended. Professional expertise for working age health is needed, and occupational health should be in the mainstream of healthcare provision. To safeguard the future health of the working population, young people should understand the benefits of a life in work. The review closes with proposals for taking the agenda forward.




Unequal Treatment


Book Description

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.




Why Are Health Disparities Everyone's Problem?


Book Description

How can we all work together to eliminate the avoidable injustices that plague our health care system and society? Health is determined by far more than a person's choices and behaviors. Social and political conditions, economic forces, physical environments, institutional policies, health care system features, social relationships, risk behaviors, and genetic predispositions all contribute to physical and mental well-being. In America and around the world, many of these factors are derived from a lingering history of unequal opportunities and unjust treatment for people of color and other vulnerable communities. But they aren't the only ones who suffer because of these disparities—everyone is impacted by the factors that degrade health for the least advantaged among us. In Why Are Health Disparities Everyone's Problem? Dr. Lisa Cooper shows how we can work together to eliminate the injustices that plague our health care system and society. The book follows Cooper's journey from her childhood in Liberia, West Africa, to her thirty-year career working first as a clinician and then as a health equity researcher at Johns Hopkins University. Drawing on her experiences, it explores how differences in communication and the quality of relationships affect health outcomes. Through her work as the founder and director of the Johns Hopkins Center for Health Equity, it details the actions and policies needed to reduce and eliminate the conditions that are harming us all. Cooper reveals with compelling detail how health disparities are crippling our health care system and society, driving up health care costs, leading to adverse health outcomes and ultimately an enormous burden of human suffering. Why Are Health Disparities Everyone's Problem? demonstrates the ways in which everyone's health is interconnected, both within communities and across the globe. Cooper calls for a new kind of herd immunity, when a sufficiently high proportion of people, across race and social class, become immune to harmful social conditions through "vaccination" with solidarity among groups and opportunities created by institutional and societal practices and policies. By acknowledging and acting upon that interconnectedness, she believes everyone can help to create a healthier world. Features • Raises readers' health care inequities literacy through an approachable narrative with specific examples • Introduces the concept of "herd immunity" as it applies to building communal awareness of systemic injustices • Features sections that underscore key takeaways • Includes contributions from the world's leading minds through their research findings and quotations • Guides readers on what can be done at an individual level as a patient, public health professional, and community member • Includes inspiring stories of effective health equity studies and practices around the world, from Ghana's ADHINCRA Project addressing hypertension control to Baltimore's BRIDGE Study for depression in African Americans and the Maryland and Pennsylvania–based RICH LIFE Project for hypertension, diabetes, and other medical conditions Johns Hopkins Wavelengths In classrooms, field stations, and laboratories in Baltimore and around the world, the Bloomberg Distinguished Professors of Johns Hopkins University are opening the boundaries of our understanding of many of the world's most complex challenges. The Johns Hopkins Wavelengths book series brings readers inside their stories, illustrating how their pioneering discoveries benefit people in their neighborhoods and across the globe in artificial intelligence, cancer research, food systems' environmental impacts, health equity, science diplomacy, and other critical arenas of study. Through these compelling narratives, their insights will spark conversations from dorm rooms to dining rooms to boardrooms.




Health Disparities


Book Description

This uniquely accessible volume challenges professionals to understand—and help correct—health disparities, both at the patient level and in their larger social contexts. Dedicated to eradicating this ongoing injustice, contributors focus on marginalized populations, the role of healthcare systems in perpetuating inequities, the need for deeper engagement and listening by professionals, and the need for advocacy within professional education and the political/policy arena. The compelling case narratives at the core of the book illustrate the interrelated biopsychosocial components of patients’ health problems and the gradations of learning needed for practitioners to address them effectively. The book’s tools for developing a health disparities curriculum include a selection of workshop exercises, facilitator resources, and a brief guide to writing effective case narratives. A sampling of the narratives: “Finding the Person in Patient-Centered Health Care” (race/ethnicity/culture). “The Annual Big Girl / Big Boy Exchange” (gender). “Just Give Me Narcan and Let Me Go” (poverty/addiction). “Everyone Called Him Crazy” (immigration). “Adrift in the System” (disability). “Aging out of Pediatrics” (mental illness and stigma). “Time to Leave” (LGBT) A work of profound compassion, Health Disparities will be of considerable interest to researchers and practitioners interested in public health, population health, health disparities, and related fields such as sociology, social work, and narrative medicine. Its wealth of educational features also makes it a quality training text. "I was impressed when I read Health Disparities: Weaving a New Understanding through Case Narratives. As a patient who has experienced unpleasant situations in health care, I was moved to see that it was emotional and personal for the writers. The book confirms for me that the time is now for change to take place in our health care systems. I see this book as a light that can shine bright in the darkest places of health care. The editors have assembled a powerful book that provides all health professionals with specific steps they can take towards addressing and then eventually eliminating health disparities. A few steps that I really connected with were improving critical awareness, delivering quality care, listening and empathizing with patients and families, and advocating for changes. I recommend that anyone interested in working to improve health care obtain a copy of this book—it’s filled with useful information that every medical professional should know. The book reminds me of a quote by Wayne Dyer, 'When you change the way you look at things, the things you look at change.'" -Delores Collins, Founder and Executive Director, A Vision of Change Incorporated, Certified Community Health Worker. Founder of The Greater Cleveland Community Health Workers Association.




Tackling Health Inequities Through Public Health Practice


Book Description

Social justice has always been a core value driving public health. Today, much of the etiology of avoidable disease is rooted in inequitable social conditions brought on by disparities in wealth and power and reproduced through ongoing forms of oppression, exploitation, and marginalization. Tackling Health Inequities raises questions and provides a starting point for health practitioners ready to reorient public health practice to address the fundamental causes of health inequities. This reorientation involves restructuring the organization, culture and daily work of public health. Tackling Health Inequities is meant to inspire readers to imagine or envision public health practice and their role in ways that question contemporary thinking and assumptions, as emerging trends, social conditions, and policies generate increasing inequities in health.