Health Equity and Disparity

What is Health Equity?

Health equity refers to the study of differences in health and healthcare quality across different populations. Health equity is different from health equality, as it relates only to the absence of disparities in controllable or remediable aspects of health. It is not possible to work towards complete equality in health, as there are some factors of health that are beyond human influence. Inequity implies some kind of social injustice. Thus, if one population dies younger than another because of genetic differences, a non-remediable/controllable factor, we tend to say that there is health inequality. On the other hand, if a population has a lower life expectancy due to a lack of medication access, the situation would be classified as a health inequity. These inequities may include differences in the “presence of disease, health outcomes, or access to health care” between populations with different races, ethnicity, sexual orientation, or socioeconomic status.

  • Health equity falls into two major categories: horizontal equity, the equal treatment of individuals or groups in the same circumstances; and vertical equity, the principle that individuals who are unequal should be treated differently according to their level of need. Disparities in the quality of health across populations are well‐documented globally in both developed and developing nations. The importance of equitable access to healthcare has been cited as crucial to achieving many of the Millennium Development Goals.

What Are Health Disparities?

In 2000, United States Public Law 106‐525, also known as the “Minority Health and Health Disparities Research and Education Act,” which authorized the National Center for Minority Health and Health Disparities, provided a legal definition of health disparities:

“Health disparities are gaps in the quality of health and health care that mirror differences in socioeconomic status, racial and ethnic background, and education level. These disparities may stem from many factors, including increased risk of disease from underlying genetic, ethnic, or familial factors, increased risk of disease from occupational exposure, and accessibility of health care.”

Health disparities are differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States.” – National Institutes of Health

“A population is a health disparity population if there is a significant disparity in the overall rate of disease incidence, prevalence, morbidity, mortality or survival rates in the population as compared to the health status of the general population.”

The following are examples of health disparities related to infectious diseases and diseases of the immune system:

HIV/AIDS

  • African Americans, more than any other racial/ethnic group, bear the greatest burden of HIV in the United States. In 2010, the overall HIV infection rate among African Americans was almost eight times higher than that of Caucasians.
  • Hispanics are also disproportionately affected by HIV. In 2010, the HIV infection rate among Hispanics was three times that of Caucasians in the United States.

Asthma

  • Approximately 2 million Hispanics/Latinos in the United States have asthma, and Puerto Rican Americans have almost three times the asthma rate of the overall Hispanic population.
  • African Americans are diagnosed with asthma at a 28 percent higher rate than Caucasians.

Organ Transplantation

  • African Americans are at greater risk than Caucasians for diabetes, chronic kidney disease, and cardiovascular disease, all of which can lead to end‐stage organ failure. Although minorities donate organs in proportion to their share of the U.S. population, their need for transplants is much greater, leading to a shortage of available organs for this group.
  • In comparison to other racial and ethnic groups, African Americans experience higher rates of organ rejection and lower survival rates after transplantation.