The Science of Health Disparities Research. Группа авторов

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Название The Science of Health Disparities Research
Автор произведения Группа авторов
Жанр Биология
Серия
Издательство Биология
Год выпуска 0
isbn 9781119374848



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or ethnic group; ethnic identity and acculturation; socioeconomic position; sex; religion; age; sexual orientation or gender identity; immigration/generation status; geographic location; mental health; health literacy; cultural understanding; use of cultural‐traditional health services; and cognitive, sensory, or physical disability [9]. These populations shoulder illness and poorer health outcomes disproportionately [9, 10].

      Let's begin with the basic measure of mortality, whose causes, including heart disease and diabetes, as well as statistics on other diseases, demonstrate the differences. All‐cause death rates in 2014 were highest for African Americans (males, 1034.0/100 000; females, 713.3/100 000) than for any other racial or ethnic group, and all‐cause death rates in infants (younger than a year old) were more than twice as high for African Americans than for Whites in both boys (1125.4 vs. 551.3) and girls (956.3 vs. 457.6; all rates per 100 000) [11]. African Americans outpaced their counterparts in rates of heart disease and hypertension [11]. Though Latinos are less likely than Whites to die from most of the top 10 causes of death of Whites, the death rate associated with diabetes is about 50% higher in Latinos than in Whites [12]. Unlike other major racial and ethnic groups, Latinos are more likely to die of cancer than heart disease [13]. Childhood obesity, which is found disproportionately in communities with high poverty rates and in communities of color (especially among Latino children), flourishes where there are few safe places to be physically active and access to healthy foods and beverages is limited [14]. Many Latino families suffer a lack of access to and knowledge about proper nutrition and active spaces for physical activity. They also lack economic support, educational opportunities, and access to healthcare and health insurance. One‐third of US Latino families lives in poverty, while nearly 27% report not having access to a regular healthcare provider. Lack of access to early childhood education has led to gaps in cognitive development in Latino children [15]. All of these circumstances impact Latinos later in life.

      Efforts to reduce health disparities have expanded, most active within the scope of specific diseases or the domain of health services research. Fueling the expansion has been the recognition of the interrelationships between health and biology, genetics, and behavior, as well as the influences of socioeconomic position, literacy, the physical environment, mental health, health services, and racism and discrimination. These factors affect the health not only of individuals but also of populations. Over a lifespan, behavioral determinants can affect outcomes, so the earlier a disparity occurs, the greater the opportunity to compound its negative effects. Conversely, consider the child who escapes lung cancer by not adopting her parents' smoking habit, the adolescent who avoids being overweight and the risks of diabetes by substituting physical activity for screen time, and the adult or elder who sits less and walks more to avoid chronic disease. Physical activity in adults can decrease the risk of disease and early death, reduce symptoms of psychological distress (e.g., depression, stress), improve control of body weight, help control blood pressure and blood glucose, enhance one's quality of sleep, and promote independent living [16].

Schematic illustration of the behavioral determinants for noncommunicable disease mortality in low- and middle-income countries, identified by the World Health Organization, four risk factors are linked to 85-percent of the noncommunicable disease mortality.

      Source: World Health Organization [17].

      Health disparities can grow in minority, rural, and other communities where education, supportive institutions, employment, health engagement, and care access and utilization are in short supply. Organizations, communities, states, or nations—any individuals who band together—in contrast, may have options for structural change through evidence‐based advocacy and legislation.