Despite improvements in healthcare and disease prevention, there are cases of health disparity, which pose significant moral and ethical dilemmas for the US healthcare system. Reducing and eliminating health disparities is, first of all, a moral imperative, but they also have a substantial economic impact. Disparities in healthcare not only affect the groups of people facing them but also limit gains in quality of care and health for the broader population and lead to unnecessary costs. Addressing this issue, researchers take into account the conditions in which people live, learn, and work as they can have a strong impact on health and produce disparities.
According to the experts, “social determinants that negatively impact health and wellbeing include poverty; lack of access to quality education or employment; unhealthy housing; unfavorable work and neighborhood conditions; exposure to neighborhood violence” (Thornton et al., 2016, p. 1416). Enhancing access to high-quality education is a crucial determinant of health as less educated people have higher rates of illness, disability, and shorter life expectancies. Early childhood education and parental support programs can help to strengthen families, improve economic outcomes, enhance educational achievement, and, therefore, have positive health impacts both on children and on their parents. Early childhood interventions can also produce a significant return on investment. The research showed that “people receiving the intervention had higher rates of safety belt use and engaged in fewer risky health behaviors, such as smoking and illicit substance use in adulthood” (Thornton et al., 2016, p. 1417). They had post-secondary education, health insurance coverage, and lower rates of crime.
Another important factor that can help to reduce health disparities is a healthy community environment. Urban planning and community development may enhance nutrition, physical activity, and safety within communities. For instance, to increase awareness of a healthy diet among residents, researchers developed skill-building programs that teach food shopping behaviors and nutritional knowledge to consumers. The other interventions that may change behavior are stocking policies at stores, along with taxes on unhealthy foods and subside for healthy foods. There is evidence that “interventions addressing distribution of alcohol outlets in low-income communities can impact substance abuse related morbidity, crime, and neighborhood safety” (Thornton et al., 2016, p. 1418). Since this fact has implications for lowering health disparities, urban planning policy reforms should be aimed at restraining the overconcentration of alcohol outlets in low-income areas.
To build healthy communities, all people need to have access to safe, affordable, and stable housing. It has a direct effect on people’s ability to access quality education and on other social determinants of health. Particularly, “housing segregation has a direct connection with student poverty rates and inadequate school resources, among other indicators of poor academic outcomes” (“Achieving health equity in the United States,” 2018, para. 14). Housing mobility programs, such as the Yonkers Scattered-Site Public Housing Program, demonstrated that low-income families who got access to economic opportunities and safer neighborhoods could improve their health (Thornton et al., 2016). When low-income residents, who participated in the Yonkers Scattered-Site Public Housing Program, moved to middle-income neighborhoods, the researchers noticed certain positive changes, for instance, reduced substance use, increased rates of employment, and decreased exposure to neighborhood violence.
Nowadays, there is not a coordinated strategy for the nation to achieve health equity. Meanwhile, some science- and evidence-based national initiatives have demonstrated positive results in reducing and eliminating healthcare disparities at the local level when they have efficiently addressed social determinants of health. In conclusion, to succeed in reducing health disparity, it is necessary to build safe, healthy communities; help all children graduate from high school; decrease income inequalities; provide affordable, nutritious foods and quality healthcare for everyone; strengthen public healthcare infrastructure.
References
Achieving health equity in the United States. (2018). Web.
Thornton, R. L. J., Glover, C. M., Cene, C. W., Glik, D. C., Henderson, J. A., & Williams, D. R. (2016). Evaluating strategies for reducing health disparities by addressing the social determinants of health. Health Affairs, 35(8), 1416-1423.