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Assessing and Addressing Health Inequities

This week we will be examining aspects of health disparities in our communities. Despite being the richest nation in the world some segments of our population continue to have health outcomes and conditions that are similar to developing nations. For example infant mortality rates in African-Americans in many communities in the U.S. are two or three times higher than White rates. Similarly they may have heart disease or breast cancer mortality rates many times higher than their White neighbors in the same community.

Healthy People 2010 focused heavily on eliminating disparities, especially racial and ethnic disparities in health. While some progress was made, in large part disparities in health still remain. In the past much of the focus of addressing these disparities among public health professionals was on individual behavior change – getting people to make better choices. While this is an important approach to improving health, increasingly public health professionals recognize that the most effective way (and biggest obstacle) to assist individuals and communities to eliminate health disparities is by addressing the detrimental conditions that contribute to poor health – the social determinants of health. These community level factors may seem out of the scope of public health, but as we saw in the APHA video _-This is Public Health (Select link or open the link in the browser to view video)  – community conditions including safety, transportation, housing, social isolation, formal education play a role in health and public health.

This is the basis of the social-ecological model of health and health improvement – poor health is the result of poor individual choices, but also community and societal factors that limit or impede these choices. Reversing these factors also take a multi-tiered approach aimed not only at the individual.

Address the following discussion question then is:

What are the sources of health inequities in our communities and nation?
How can we best address these effectively?
How can we move beyond a clinical — doctor/practitioner/educator and patient/client model of prevention to focus on a population based primary prevention model?
What are the opportunities and barriers in trying to address social determinants in order to reduce health inequities?


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