Addressing inequities in medical care

A comprehensive examination of global health disparities

https://doi.org/10.53730/ijhs.v8nS1.15091

Authors

  • Eman Smair Alenizi KSA, National Guard Health Affairs
  • Mudi Naif Alharbi KSA, National Guard Health Affairs
  • Huda Fawaz Alanazi KSA, National Guard Health Affairs
  • Bandar Khulaif Aldhahawi KSA, National Guard Health Affairs
  • Rawaf Hussain Alsuwaydaa KSA, National Guard Health Affairs
  • Homoud Awade Al Shammari KSA, National Guard Health Affairs
  • Saleh Abdullah Alnais KSA, National Guard Health Affairs

Keywords:

Health Disparities, Health Inequity, Social Determinants of Health, Medical Education, Global Health Inequities, Structural Racism, Systemic Bias

Abstract

Background: Health disparities and inequities persist globally, significantly affecting marginalized racial and ethnic groups. Medical institutions and educators must address these issues to foster a more equitable healthcare system. Aim: This chapter aims to explore the definitions and implications of health disparities and inequities, emphasizing the need for a comprehensive understanding in medical education to address these challenges effectively. Methods: The chapter reviews definitions from leading health organizations and examines case studies from various countries to highlight the impact of historical, structural, and social determinants of health (SDOH) on health outcomes. Methodologies for measuring these disparities, including quantitative and qualitative approaches, are discussed. Results: Health disparities often arise from systemic and institutional biases, with historical injustices like colonialism and slavery continuing to influence modern health outcomes. Case studies from the United States, Brazil, the United Kingdom, and the Netherlands illustrate ongoing inequities in maternal mortality and other health outcomes. Conclusion: Addressing health disparities requires an understanding of historical contexts, structural factors, and SDOH. Medical education must evolve to incorporate these elements to equip future healthcare professionals with the skills to combat these disparities effectively.

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References

Amutah C, Greenidge K, Mante A, et al. Misrepresenting race–the role of medical schools in propagating physician bias. N Engl J Med. 2021;384(9):872–8. https://doi.org/10.1056/nejmms2025768 DOI: https://doi.org/10.1056/NEJMms2025768

McCartney G, Popham F, McMaster R, Cumbers A. Defining health and health inequalities. Public Health. 2019;172:22–30. https://doi.org/10.1016/j.puhe.2019.03.023. DOI: https://doi.org/10.1016/j.puhe.2019.03.023

Nichter M. Global health: why cultural perceptions, social representations, and biopolitics matter. University of Arizona Press; 2008.

Friedman EA, Gostin LO. From local adaptation to activism and global solidarity: framing a research and innovation agenda towards true health equity. Int J Equity Health. 2017;16(1):18 https://doi.org/10.1186/s12939-016-0492-8. DOI: https://doi.org/10.1186/s12939-016-0492-8

Voelker R. Decades of work to reduce disparities in health care produce limited success. JAMA. 2008;299(12):1411–3. https://doi.org/10.1001/JAMA.299.12.1411. DOI: https://doi.org/10.1001/jama.299.12.1411

Pearcy JN, Keppel KG. A summary measure of health disparity. Public Health Reports. 2002;117(3):273-80. https://doi.org/10.1093/phr/117.3.273. DOI: https://doi.org/10.1016/S0033-3549(04)50161-9

Braveman PA, Kumanyika S, Fielding J, et al. Health disparities and health equity: the issue is justice. Am J Public Health. 2011;101(Suppl 1):S149–55. https://doi.org/10.2105/AJPH.2010.300062. DOI: https://doi.org/10.2105/AJPH.2010.300062

Disparities | Healthy People 2020. Accessed 4 Feb 2022. https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities

Centers for Disease Control and Prevention. Health Disparities. https://www.cdc.gov/healthyyouth/disparities/index.htm.

Carter-Pokras O, Baquet C. What is a “health disparity”? Public Health Rep. 2002;117(5):426–34. https://doi.org/10.1093/PHR/117.5.426. DOI: https://doi.org/10.1093/phr/117.5.426

Marmot M. Social determinants of health inequalities. Lancet. 2005;365(9464):1099–104. https://doi.org/10.1016/S0140-6736(05)71146-6. DOI: https://doi.org/10.1016/S0140-6736(05)71146-6

World Health Organization. Health inequities and their causes. Accessed 4 Feb 2022. https://www.who.int/news-room/facts-in-pictures/detail/health-inequities-and-their-causes

Arcaya MC, Arcaya AL, Subramanian SV. Inequalities in health: definitions, concepts, and theories. Glob Health Action. 2015;8(1):27106. https://doi.org/10.3402/GHA.V8.27106. DOI: https://doi.org/10.3402/gha.v8.27106

Health Equity: Why It Matters, and How To Take Action – RWJF. Accessed 4 Feb 2022. https://www.rwjf.org/en/library/features/achieving-health-equity.html

Krieger N, Van Wye G, Huynh M, et al. Structural racism, historical redlining, and risk of preterm birth in new York City, 2013–2017. Am J Public Health. 2020;110:1046–53. https://doi.org/10.2105/AJPH.2020.305656. DOI: https://doi.org/10.2105/AJPH.2020.305656

Lynch EE, Malcoe LH, Laurent SE, Richardson J, Mitchell BC, Meier HCS. The legacy of structural racism: associations between historic redlining, current mortgage lending, and health. SSM – Popul Health. 2021;14:100793. https://doi.org/10.1016/J.SSMPH.2021.100793. DOI: https://doi.org/10.1016/j.ssmph.2021.100793

Uddin J, Acharya S, Valles J, Baker EH, Keith VM. Caste differences in hypertension among women in India: diminishing health returns to socioeconomic status for lower caste groups. J Racial Ethn Health Disparities. 2020;7(5):987–95. https://doi.org/10.1007/S40615-020-00723-9. DOI: https://doi.org/10.1007/s40615-020-00723-9

Bawaskar HS, Bawaskar PH, Bawaskar PH. Health and the Indian caste system. Lancet. 2015;385(9966):416. https://doi.org/10.1016/S0140-6736(15)60149-0. DOI: https://doi.org/10.1016/S0140-6736(15)60149-0

Braveman P, Krieger N, Lynch J. Health inequalities and social inequalities in health. Bull World Health Organization. 2000;78(2):232-4. https://pubmed.ncbi.nlm.nih.gov/10743295/

Reidpath DD, Allotey P. Measuring global health inequity. Int J Equity Health. 2007;6:16. https://doi.org/10.1186/1475-9276-6-16. DOI: https://doi.org/10.1186/1475-9276-6-16

Brandt JE, Priori R, Valesini G, Fairweather D. Sex differences in Sjögren’s syndrome: a comprehensive review of immune mechanisms. Biol Sex Differ. 2015;6:19. https://doi.org/10.1186/s13293-015-0037-7. DOI: https://doi.org/10.1186/s13293-015-0037-7

Mackenbach JP, Meerding WJ, Kunst AE. Economic costs of health inequalities in the European Union. J Epidemiol Community Health. 2011;65(5):412–9. https://doi.org/10.1136/JECH.2010.112680. DOI: https://doi.org/10.1136/jech.2010.112680

Nelson A. Unequal treatment: confronting racial and ethnic disparities in health care. J Natl Med Assoc. 2002;94(8):666–8.

White K, Lawrence JA, Tchangalova N, Huang SJ, Cummings JL. Socially-assigned race and health: a scoping review with global implications for population health equity. Int J Equity Health. 2020;19(1):25. https://doi.org/10.1186/s12939-020-1137-5. DOI: https://doi.org/10.1186/s12939-020-1137-5

Ramírez M, Ford ME, Stewart AL, Teresi JA. Measurement issues in health disparities research. Health Serv Res. 2005;40(5 Pt 2):1640–57. https://doi.org/10.1111/J.1475-6773.2005.00450.X. DOI: https://doi.org/10.1111/j.1475-6773.2005.00450.x

Pearcy JN, Keppele KG. A summary measure of health disparity. Public Health Reports. 2002;117(3):273–80. https://doi.org/10.1093/phr/117.3.273. DOI: https://doi.org/10.1093/phr/117.3.273

Rojas F. Poverty determinants of acute respiratory infections among Mapuche indigenous peoples in Chile’s ninth region of Araucania, using GIS and spatial statistics to identify health disparities. Int J Health Geogr. 2007;6(1):26. https://doi.org/10.1186/1476-072x-6-26. DOI: https://doi.org/10.1186/1476-072X-6-26

Harper S, Lynch J, Meersman SC, Breen N, Davis WW. An overview of methods for monitoring social disparities in cancer with an example using trends in lung cancer incidence by area-socioeconomic position and race-ethnicity, 1992–2004. Am J Epidem. 2008;167(8):889–99. https://doi.org/10.1093/aje/kwn016. DOI: https://doi.org/10.1093/aje/kwn016

Wen CP, Tsai SP, Chung W-SI. A 10-year experience with universal health insurance in Taiwan: measuring changes in health and health disparity. Ann Intern Med. 2008;148(4):258–67. https://doi.org/10.7326/0003-4819-148-4-200802190-00004. DOI: https://doi.org/10.7326/0003-4819-148-4-200802190-00004

Habib RR, Hojeij S, Elzein K, Chaaban J, Seyfert K. Associations between life conditions and multi-morbidity in marginalized populations: the case of Palestinian refugees. Eur J Public Health. 2014;24(5):727–33. https://doi.org/10.1093/EURPUB/CKU089. DOI: https://doi.org/10.1093/eurpub/cku089

Small MJ, Allen TK, Brown HL. Global disparities in maternal morbidity and mortality. Semin Perinatol. 2017;41(5):318–22. https://doi.org/10.1053/J.SEMPERI.2017.04.009. DOI: https://doi.org/10.1053/j.semperi.2017.04.009

Jung, S.D., Aragon, K., Anderson, Y.K. (2023). What Are Health Disparities?. In: Powell, J.M., Linger, R.M. (eds) Best Practices for Acknowledging and Addressing Racial and Ethnic Health Disparities in Medical Education. IAMSE Manuals. Springer, Cham. https://doi.org/10.1007/978-3-031-31743-9_2 DOI: https://doi.org/10.1007/978-3-031-31743-9_2

Published

15-01-2024

How to Cite

Alenizi, E. S., Alharbi, M. N., Alanazi, H. F., Aldhahawi, B. K., Alsuwaydaa, R. H., Al Shammari, H. A., & Alnais, S. A. (2024). Addressing inequities in medical care: A comprehensive examination of global health disparities. International Journal of Health Sciences, 8(S1), 1080–1092. https://doi.org/10.53730/ijhs.v8nS1.15091

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