Health Disparities vs Health Equity:
The Outcomes Matter, Not the Words.
Since release of the Institute of Medicine signature report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, Institute of Medicine”, in 2002, the term “Health Disparities” has been widely used in the health field. However, the outcomes to date, to the extent known, don’t match the talk. Therefore, Health Power has the following concerns:
1. There has been Inadequate analysis, summarization, and reporting of individual and overall health disparities outcomes as a result of various efforts to decrease racial and ethnic health disparities since 2002.
2. The basis in recent years for movement to the term, “health equity” rather than “health disparities” by many in the health field needs to be revisited and if appropriate, put in a broader context. What I’ve heard is that the term “health disparities” has a more negative meaning than the term “health equity”. Hopefully, that’s not the main reason for change because health disparities are a reality, and a negative reflection on society and the health field. This reality cannot be erased by changing terminology.
Further, the term “health equity” means different things to different people. While some assume that the term has a more positive meaning than the term “health disparities”, others define “health equity” as referring to those differences in population health status that can be traced to unequal economic and social conditions that are systematic and avoidable, and thus unfair. While Health Power agrees that social and economic factors are unfair, and have a significant negative effort on health behavior, health status, and health care outcomes, to the extent they are emphasized as causes for health disparities, they might inappropriately be used by some as an excuse for not eliminating health disparities.
Clearly, there needs to be a general consensus about the meaning of “health equity” as it relates to racial and ethnic populations, since the latter term is being increasingly used rather than the term “health disparities”.
3. If “health equity” is going to become the favored term instead of health disparities, in my view it needs to be seen as the following goal: going “From health disparities to health equity” – with “health equity” meaning equal health status, AND receipt of equal health care. Further, progress needs to be documented by comparing baseline and progress outcome measurements.
As I mentioned in the Opening Page of our “Racial and Ethnic Health Channel” in discussing preferred terms for different racial and ethnic populations, we can go on and on about ‘best terms’ to use. However, we cannot afford the luxury of spending a lot of time focusing on which terms are more politically correct while too many minorities/people of color/multicultural populations are:
– Ailing too much
– Sicker than others, and
– Dying too soon
Note: “What It Means”: Our Glossary, which can be found in the upper left corner of every page of the website, contains definitions for “Health Disparities and Health Equity.