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The Imperative of Reducing Health Disparities through Prevention: Challenges, Implications, and Opportunities

Reprinted with permission from the Prevention Institute

The following is the introduction to the first in a series of articles focusing on the importance of prevention in reducing health disparities.

“Despite steady improvement in the overall health of the U.S. population, racial and ethnic minorities, with few exceptions, experience higher rates of morbidity and mortality than non-minorities.” – Institute of Medicine

What are Health Disparities?
Our nation spends nearly one trillion dollars a year on diagnosing and treating disease. Nevertheless, each year hundreds of thousands of deaths due to preventable causes occur—including nearly 400,000 deaths due to poor diet and inactivity; 85,000 deaths as a result of alcohol misuse; 55,000 attributable to toxic agents; and 29,000 attributable to firearms.13 These deaths and other associated health problems occur disproportionately among poor and minority populations.

The National Institutes of Health defines health disparities as “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.”14 Racial and ethnic health disparities are “large, persistent, and even increasing in the United States.”15 When elements of racism, poverty, and problematic community environments converge, greater overall threats to health and safety develop. When efforts are designed to address this convergence, disparities can be reduced.

The Imperative of Reducing Health Disparities
According to the Institute of Medicine, “All members of a community are affected by the poor health status of its least healthy members.”16 Therefore, poor health is not only a burden to those affected but also to others. Conversely, by reducing disparities, the health care system would be enhanced for all.

An excess of people with poor health overburdens the health care infrastructure, increases the spread of infectious diseases, and uses up public health and health care resources. Good health for all is precious; it enables us to be productive, learn, and build on opportunities. Poor health jeopardizes our independence, responsibility, dignity, and self-determination. The success of our communities, society, and economy also depends on good health. Healthy workers and a healthy emerging workforce are critical for social and economic progress. As a nation we are spending one out of every seven dollars of our Gross Domestic Product on health care, and it is anticipated that the proportion will soon rise to one out of every six dollars.17,18 Our health expenditures double those of any other nation.19 The strain is also taking a toll on government resources and consequently on taxpayers. When public money is used for medical care, less money is available for other vital services that enable us to thrive, such as education and transportation. But by spending primarily on the medical end—after people get injured or sick—we are not using our money wisely.

The prevalence of disparities may increase in the U.S. as the population becomes even more diverse. In coming years, achieving a healthy and productive nation will increasingly rely on our ability to keep all Americans healthy and reduce racial and ethnic disparities by improving the health of communities of color. A significant health gap exists in the U.S. We know the strategies that will be effective in closing it; many of them are described in this report.

We have a social and moral responsibility to act.

For the full article, please visit the Prevention Institute online at: http://www.preventioninstitute.org/documents/ DRA_ReducingHDthruPrx.pdf


13. Mokdad,A.H., Marks, J.S., Stroup,D.F., Gerberding, J.L., Actual causes of death in the United States, 2000. JAMA 2004: 291:1238 – 1245.
14. National Institutes of Health, Addressing Health Disparities:The NIH Program of Action.What are health disparities.Available at: http://healthdisparities.
nih.gov/whatare.html. Accessed January 14, 2002.
15. House, J.S.,Williams,D.R. Understanding and reducing socioeconomic and racial/ethnic disparities in health. In: Smedley, B.D. Syme, S.L.
Eds. Promoting Health: Intervention Strategies from Social and Behavioral Research.Washington,D.C.: National Academy Press; 2000: 81.
16. Smedley, B., Stith, A., Nelson,A. Eds., Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.Washington,D.C.:The
National Academies Press; 2003: 37.
17. California HealthCare Foundation., Health Care Costs 101. 2005.Available at http://www.chcf.org. Accessed February 2006.
18. California HealthCare Foundation., Health Care Costs 101: California Addendum. 2005.Available at http://www.chcf.org. Accessed February
19. Farley, 2005:XI


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