Health Disparities

EARLY DEATH IS A GREATER RISK FOR BLACK PEOPLE (than white individuals) in the United States. New research points to social disparities as the primary culprits. Today we look at social determinants — eight keys for extending lives and closing health disparities in America.

Lengthening Black (and other) American lives requires addressing various social, economic, and healthcare disparities affecting certain communities disproportionately. My goal today is to get us thinking about health outcome disparities (and some ways we can begin to close them).

Is Race a Sociocultural Construct?

Over a century ago, the renowned American Sociologist W.E.B. Du Bois expressed concern that people used race as a biological explanation for what he believed to be sociocultural differences between different populations. 

Du Bois opposed the concepts of “white” and “black” as discrete groups, offering that such divisions ignored human diversity’s scope. More recently, Columbia University Professor Barbara Fields penned an essay while a guest scholar at the Woodrow Wilson International Center for Scholars, Smithsonian Institution.

First, the scholar acknowledges that racism has been America’s tragic flaw and that we continue to live with its ugly and explosive consequences. 

Professor Fields observes, “It would be absurd and frivolously provocative to deny this, and it is not my intention to do so. I intend to suggest that Americans, including many historians, tend to accord race a transhistorical, almost metaphysical, a status that removes it from all possibilities of analysis and understanding. Ideologies, including those of race, can be properly analyzed only at a safe distance from their terrain.”

Race – A Social Construct?

To Fields, people assume race is an observable physical fact (rather than a profoundly ideological notion). She offers a practical example: A newspaper article about the changing composition of the population of Washington, D.C., included the following statement: 

“The Washington area’s population of races other than white or black, meaning mainly Asians, tripled between 1970 and 1977. Recent statistics equivalent to those for racial groups are not available for Hispanics, who are an ethnic group rather than a separate racial category.” What makes Hispanics an ethnic group, while blacks, whites, and Asians are racial?

Presumably, the fact that, while they share a language (no one, surely, would suppose that Hispanics all share a single culture), they do not comprise a single physical type, and they originate from different countries. But, on that reasoning, black and white Americans constitute an ethnic group: they are originally from different countries and certainly do not all look alike but share a language. 

What about Asians? They are not of a single physical type, and they, too, come from different countries. It is hard to see how they are a single race or ethnic group: they do not all share a language or a culture.

Then what about blacks? They do not look alike; they came from different countries, spoke different languages, and had different cultures. In the heyday of the Atlantic slave trade, both traders and their customers understood that the cargo of the slave ships included Africans of different national, cultural, and linguistic backgrounds. 

Slave-buying planters talked in voluble, if no doubt misguided, detail about the varied characteristics of Coromantees, Mandingoes, Foulahs, Congoes, Angolas, Eboes, Whydahs, Nagoes, Pawpaws, and Gaboons. Experienced buyers and sellers could distinguish them by sight and speech, and prices would vary accordingly. Black people, in other words, were initially no more a racial group than Hispanics.”

Modern science favors Du Bois and his modern counterpart, Dr. Fields; race is a social construct without biological meaning. With these thought-provoking observations, I will leap and present eight keys for extending lives and closing disparities in America.

Race, Social Determinants, and Health

Writing in Science, four scholars offer that racial categories are weak proxies for genetic diversity and need to be phased out. 

Tulane University (USA) researchers used the U.S. National Health and Nutrition Examination Survey to analyze disease prevalence and risks for their study. They then modeled the impact of these eight factors on an individual’s life expectancy. Here are their findings:

The [racial] disparity in deaths was at zero when accounting for all social determinants.

Even having one unfavorable social determinant of health doubles an individual’s chances of early death.

The researchers noted no differences in premature mortality when comparing Blacks and whites. With this observation in mind, let’s turn to eight keys to improving health- and lifespans for all Americans, focusing on addressing disparities in healthcare in America.

8 Keys for Extending Lives and Closing Disparities

Here are eight key areas that can contribute to improving health outcomes and extending lifespans for all Americans, with a specific focus on addressing disparities faced by Black individuals:

1. Accessible and Affordable Healthcare. 
2. Ensuring universal access to quality healthcare is essential. This focus includes expanding Medicaid, improving healthcare infrastructure in underserved areas, and implementing policies that reduce healthcare costs for low-income individuals and families.
3. Health Education and Literacy. Promoting health education and literacy can empower individuals to make informed decisions about their health. This approach includes targeted outreach and education initiatives addressing specific health concerns in marginalized communities.
4. Eliminating Racial Disparities. Acknowledging and actively working to eliminate racial disparities in healthcare is crucial. This work involves addressing implicit biases among healthcare providers, diversifying the workforce, and implementing policies prioritizing equity in healthcare delivery.
5. Social Determinants of Health. Addressing social determinants of health, such as poverty, education, housing, and employment, is vital. Implementing policies that alleviate economic disparities, improve educational opportunities, and create affordable housing can significantly impact overall health outcomes.

Five more Tips

1. Nutrition and Food Security. Promoting access to healthy and affordable food options is essential. Supporting community-based initiatives like farmers’ markets, promoting nutrition education, and implementing policies that increase food security can help combat diet-related health issues.
2. Mental Health Support. Recognizing the importance of mental health and providing accessible mental health services is crucial. Investing in mental health infrastructure, reducing stigma, and promoting culturally competent care can improve mental well-being and overall health.
3. Violence Prevention. Addressing violence and promoting community safety is vital for improving health outcomes. This intervention involves implementing evidence-based strategies to prevent gun violence, supporting community-based organizations that address systemic violence, and investing in trauma-informed care.
4. Empowering Communities. Empowering communities to advocate for their health and well-being is key. Supporting community-led initiatives, fostering community engagement, and promoting policies that amplify community voices can lead to sustainable improvements in health outcomes.

It is important to recognize that these eight keys are incomplete, and additional factors and complexities are involved in achieving health equity. Continued research, policy reform, and community engagement are crucial to making meaningful progress toward lengthening and improving the lives of all Americans.

Key points — Extending Lives and Closing Health Disparities in America

Questions. What are the eight social determinants critical for health and well-being? How do social disparities affect certain communities disproportionately? Is race a biological or sociocultural construct?

Findings. Eight key areas can contribute to improving health outcomes and extending lifespans for all Americans. 

Meaning. Early death is a greater risk for Black people than White people in the U.S.; new research suggests social disparities as the primary culprits. As a society, we must do better at addressing the social determinants of health. We all would benefit, especially from optimizing education, employment, and income. These are the biggest contributants to the mortality gap.

Another takeaway lesson is that I need to be more specific with language. Terms such as population or ancestry better represent the relationship between humans and their genes. Of course, as the current study reminds us, for now, race as a construct has some utility in scientific research, including as a sociopolitical (rather than biological) variable.

One more thing:

Genetics by the Numbers: 10 Tantalizing Tales
www.livescience.com

The information I provided in this blog is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider for medical advice, diagnoses, or treatment. I am not liable for risks or issues associated with using or acting upon the information in this blog.

Thank you for reading “8 Keys for Extending Lives and Closing Health Disparities in America.”