The health of people with low incomes historically has been a driver of public health advances in the United States. For example, in New York City, cholera deaths during outbreaks in and concentrated among the poor helped push forward the Metropolitan Health Law, which allowed for regulation of sanitary conditions in the city.

The law was an exemplar for other municipalities across the United States, saving countless lives during subsequent cholera epidemics as well as from typhus, dysentery, and smallpox. Health inequality persists today, though our public health response—our modern Metropolitan Health Laws—must address more insidious causes and conditions of illness. There is a robust literature linking income inequality to health disparities —and thus widening income inequality is cause for concern.

US Census data show a steady increase in summary measures of income inequality over the past 50 years. To put this into perspective, the year life expectancy difference for women is equal to the decrement in longevity from a lifetime of smoking.

To improve health, interventions may need to account for starkly different lived experiences across different geographic contexts. Educational attainment, sex, and race interact with and complicate the income-health relationship. Two additional dimensions add complexity: thinking beyond income to wealth and thinking beyond mortality to morbidity. Wealth refers to the total value of assets and debts possessed by an individual, not just the flow of money defined as income.

This matters because it is one way that inequities persist over time —through, for instance, legacy effects of Jim Crow laws or discriminatory housing policy that affect family wealth and health over generations.

peer reviewed articles on health disparities

Studies on inequality and mortality may garner the most attention, but disparities in morbidity and quality of life are also evident. Low-income adults are more than 3 times as likely to have limitations with routine activities like eating, bathing, and dressing due to chronic illness, compared with more affluent individuals. Children living in poverty are more likely to have risk factors such as obesity and elevated blood lead levels, affecting their future health prospects.

Is it the role of physicians and other health professionals to address poverty? Our answers to these questions determine whether wealth gradients lead only to health inequality—or whether they contribute to health inequitywhich is inequality that is avoidable and unfair. Two arguments favor paying attention to income and wealth distributions as part of advancing health equity. First, health care spending—the realm of medical professionals—can worsen income inequality, at both individual and systemic levels.

Individually, poor people have to spend a much greater proportion of their income on health care than richer people do. Inmedical outlays lowered the median income for the poorest decile of US individuals by Systemically, medical spending can crowd out other government spending on social servicesdrawing resources away from education and environmental improvement, for example.

Clinicians who care about the social determinants of health must also pay heed to the cost and opportunity cost of health care. Second, we are in a period when declines in key public health indicators may be wrought by policies that ostensibly have little to do with health—such as tax policy.The Journal of Health Disparities Research and Practice is a refereed online journal that explores the dimensions of health disparities globally.

Issues of the Journal are published quarterly. The Journal invites submission of original articles from researchers, public health, behavioral health, clinical,and social science experts and practitioner that seek to continue the promotion of health equtiy and the discussion of health disparities in order to eradicate them. The Journal of Health Disparities Research and Practice is an Open Access publication; all articles are freely available online immediately upon issue publication.

All articles are rigorously peer-reviewed, and brough to publication as rapidly as possible. See the Aims and Scope for a complete coverage of the journal. Pacheco, Charley Lewis, Christina M. Pacheco, Jason W. Hale, Jessica A. Williams, Sean M. Daley, Christine M. Daley, and Won S. Parvanta, Clement K. Gwede, Cathy D. Meade, and Dinorah Martinez Tyson.

Francoise Knox-Kazimierczuk. Crowther, Sandra G. Suther, Jullet A. Weaver, Clement K. Advanced Search. Privacy Copyright. All items in Digital Scholarship UNLV are protected by original copyright, with all rights reserved, unless otherwise indicated.

Skip to main content University of Nevada, Las Vegas. Journal of Health Disparities Research and Practice. Select an issue: All Issues Vol. Digital Commons.Mortality rates in the United States vary based on race, individual economic status and neighborhood. Correlations among these variables in most urban areas have limited what conclusions can be drawn from existing research. At enrollment, African American and White participants lived in 46 unique census tracts in Baltimore, Maryland, which varied in neighborhood economic status and degree of income inequality.

Current Issue: Volume 13, Issue 3 (2020)

While racial and economic disparities in mortality are well known, this study suggests that several social conditions associated with health may unequally affect African American men in poverty in the United States. Beyond these individual factors are the influences of neighborhood economic status and income inequality, which may be affected by a history of residential segregation.

The significant association of neighborhood economic status and income inequality with mortality beyond the synergistic combination of sex, race and individual poverty status suggests the long-term importance of small area influence on overall mortality. Editor: Donald R. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.

The work is made available under the Creative Commons CC0 public domain dedication. Data Availability: Data are available upon request to researchers with valid proposals who agree to the confidentiality agreement as required by our Institutional Review Board. Requests for data access may be sent to Alan Zonderman co-author or the study manager, Jennifer Norbeck at norbeckje mail. The funders had no role in the study design, data collection and analysis, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist. Mortality disparities across racial and economic groups in the United States US are well established [ 1 ]. InAfrican Americans had a 1. Low socioeconomic status SES is also associated with an increased mortality risk for the US population. For adults over age 50, those in the lowest quartile of SES had 2. The influence of race and SES on mortality are difficult to parse because African Americans bear a disproportionate burden of US poverty and low education.

The influence of economic status on overall health and mortality extends beyond the individual to the neighborhood [ 6 ]. Place of residence in the US follows patterns of race and economic position, often due to residential segregation [ 7 ].

While racial segregation has decreased over the last 40 years [ 8 ], income segregation, especially for African Americans, has increased [ 9 ]. Low neighborhood economic status has been associated with an increased risk of overall mortality [ 10 ], and mortality from cancer [ 11 ] and cardiovascular disease [ 12 ]. The influence of neighborhood can be direct, through walkability or violent crime, or indirect, through social position or discrimination. Due to the complex ways in which neighborhood can influence health, researchers have proposed composite indices which include multiple aspects of the neighborhood milieu e.Suggested citation for this article: Jack L Jr.

Everything is Public Health - 2020 in Review: COVID-19 Impact on Healthcare

Prev Chronic Dis ; This year has been challenging in numerous ways, and it has been imperative for all of us in the public health field to respond decisively to the COVID pandemic emergency in the short-term and in the long-term to look for new ways to address health disparities that have been highlighted by COVID Now more than ever, Preventing Chronic Disease PCD is committed to its mission to provide peer-reviewed content that promotes dialogue among researchers, practitioners, and policy makers worldwide and advances the field of public health as a whole.

PCD is also ranked third of 19 open access US journals in this category. In turn, PCD has sought even more opportunities in to publish timely content that contributes to the field at a critical time. This year PCD is publishing peer-reviewed content in 3 collections around timely topics that address 1 the public health response to COVID and chronic disease, 2 the role of pharmacy and public health in improving population health, and 3 insights into research and evaluation that improve oral health among people who are at increased or higher risk for chronic conditions.

The COVID pandemic presents a worldwide public health challenge to understand not only how to mediate its spread but also how to continue maintaining and promoting chronic disease management and control.

The impact of COVID on the overall health of individuals who are at increased risk for or living with chronic conditions such as cardiovascular disease, diabetes, and chronic lung disease has become even more apparent, because these conditions contribute to poorer health outcomes and mortality 1,2.

PCD recognizes that a great amount can be learned from efforts occurring around the world; one discipline alone cannot offer solutions to this complex global public health threat. The journal brought together a wide variety of perspectives and expertise from around the world to share emerging public health approaches that address the intersection of COVID and chronic disease.

In addition to this recently released supplement, PCD plans to publish peer-reviewed content generated by experts in medicine, public health, psychology, health systems, community engagement, school health, infectious disease, nursing, pharmacy, oral health, environmental health, and other areas related to COVID and chronic disease. PCD is interested in continuing to receive submissions from around the world that provide timely insights around the topics featured in the supplement.

In advance of submitting a manuscript, authors are invited to submit a brief inquiry to determine whether the proposed topic would be within the scope and interest of the journal.

For more information on how and where to submit an inquiry, please visit the PCD author web page. Preventing and controlling chronic disease remains a global public health challenge. Over the past decades, a range of innovative community- and clinical-driven strategies in public health and pharmacy have evolved to prevent and reduce the burden of chronic conditions.

Health Disparities: About

The articles in this collection provide examples of pharmacies and pharmacists improving population health through health screenings and disease management diabetes, cholesterol, blood pressure in health care and community settings. PCD is also seeking to publish more peer-reviewed articles that identify ways to improve access to care, eliminate health disparities, and understand the importance of public health infrastructure as it relates to oral health.

To that end, PCD is planning to release a collection of articles focusing on tooth loss in a Medicaid adult population, predictors of oral health behaviors among low-income children, changes in health disparities in use of dental care among US children and adolescents, impact of increased reimbursement for preventive dental care on tertiary oral health, and more. This collection will feature several peer-reviewed articles and is scheduled for release in December In addition to these 2 important collections, PCD would like to bring 3 future collections to your attention as an author, reader, or both.

PCD has received submissions from around the world and is interested in learning about a range of community-based, clinically driven, and technology-informed innovations for strategies used to prevent and reduce the burden of chronic conditions worldwide. Papers accepted for this collection will be published on a rolling basis, and all accepted papers will be bundled into a collection in PCD has announced another Call for Papers for an upcoming collection that focuses on the impact of chronic disease on poor health outcomes, reduction in quality of life, and increases in health care costs.

Authors interested in submitting manuscripts to the journal for consideration may do so on or before the December 31,due date. Accepted papers are being published on a rolling basis, with the final collection published in Over the years, PCD has offered students opportunities to further develop their science-writing abilities by submitting research papers to the journal for consideration. Students interested in submitting research-oriented papers must be sure to read and follow all submission requirements.

Please stay tuned as the journal publishes content of interest to its readers and identifies future timely topics around which authors can submit manuscripts for consideration. Stay up to date on the latest calls for papers and PCD collections. Receive the latest articles and journal news directly in your inbox by subscribing to the journal through CDC. We thank you for your continued support of the journal. Your support ensures that PCD can continue to remain a viable resource to researchers, evaluators, and policy makers worldwide.

Email: ljack cdc.

The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U. Skip directly to site content Skip directly to page options Skip directly to A-Z link.

Preventing Chronic Disease. Section Navigation. Facebook Twitter LinkedIn Syndicate.We all rely on health care services at some point in our lives, and many of us take them for granted. But not everybody has the same access to medical advice and treatment. As a result, certain populations suffer poorer health outcomes. Nearly three in 10 transgender people reported that providers would not see them because of their gender identity.

The CDC also states that anal sex is the riskiest type of sex for getting or transmitting HIV, and most gay and bisexual men get HIV from having anal sex without protection—such as using a condom or taking medicine to prevent or treat HIV.

Gay and bisexual men are also at a higher risk for other sexually transmitted infections STIssuch as chlamydia, syphilis, and gonorrhea, which can all greatly increase the chance of getting or transmitting HIV. According to a study published in The Journal of Infectious Diseases ingay, bisexual, and MSM are about 20 times as likely as heterosexual men to develop anal cancer, of which HPV is a recognized cause. In addition, it's linked to head and neck malignancies, due to transmission of the virus via oral sex.

Smoking increases the risk for coronary heart disease, stroke and lung cancer, and a host of other health conditions. People who identified as lesbian or gay were more than twice as likely as people who identified as heterosexual to have a "severe" alcohol or tobacco use disorder, while people who identified as bisexual were three times as likely to have this kind of substance use disorder.

One study published in the Journal of School Health found that transgender students were about 2. And trans and non-binary folks still need a diagnosis of "gender dysphoria" previously known as "gender identity disorder" so they can access life-saving and life-affirming treatment, like hormone therapy or feminizing or masculinizing surgery.

A study published in the International Journal of Environmental Research and Public Health in looked at data from — Behavioral Risk Factor Surveillance System BRFSS surveys and found that bisexual and lesbian women were more likely to be overweight or obese than women who identify as heterosexual.

However, gay men had significantly lower odds of being obese as opposed to straight men there was no significant difference when it came to bisexual men. In addition, eating disorders and body image disorders may be more common among gay and bisexual men than heterosexual men, per a study published in the Archives of Pediatrics and Adolescent Medicine.

A study analysis of data from more than 93, women between ages published in the Archives of Family Medicine suggests that lesbian and bisexual women have higher rates of breast and cervical cancer compared to heterosexual women.

According to a comparative study of data on more thanmen and women published in the American Journal of Public Health inwomen in same-sex relationships were less likely to have had a recent mammogram or Pap test than heterosexual women.

Ina systematic review of all US and UK evidence on whether there is a higher rate of breast cancer in lesbian and bisexual women concluded that the only realistic way to answer this question is to collect sexual orientation within routine statistics, including cancer registry data, or from large cohort studies.

A study published in the journal Circulation in found that lesbian, gay, and bisexual adults have a higher risk of heart disease and other cardiac problems than heterosexual adults. The Center for American Progress survey showed that once people experience discrimination in some form, they are more likely to avoid doctor's offices. Abbott tells Health. And the LGBT National Help Center provides free, confidential peer support and information on local resources to help with anything from coming out issues to sexual abuse.

Due to COVID, with many health care services still not fully open, telehealth access could be an option, suggests Dr. To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter. By Claire Gillespie June 12, Save Pin FB ellipsis More. Close Share options. Close Close Login.Health disparities are differences in health outcomes between socially disadvantaged and advantaged groups.

This essay provides a brief review of the voluminous literature on health disparities, with a focus on several major threads including populations of interest, incidence and prevalence of morbidity and mortality, determinants of health, health literacy and health information seeking, media influences on health disparities, and efforts to reduce disparities.

Determinants of health can be categorized along a number of dimensions, but common designations consider behavioral, social, and environmental factors that lead to health disparities, as well as differences in access to health care and health services. Of central interest to communication researchers, differences in health literacy and health information seeking are revealed between advantaged and disadvantaged groups.

Media influences involve the effects of access or exposure to different kinds of health information on the health behavior and health outcomes of different groups, as well as the effects of health disparity media coverage on public support for initiatives to reduce health disparities. Efforts to reduce health disparities are extensive and involve government and foundation efforts and research-driven interventions.

Taking a broader view, this essay briefly discusses trends in scholarship on health disparities, noting the precipitous increase in academic journal article publications on the topic, including the publication of journals specifically focused on publishing health disparities scholarship.

Future directions for research are suggested, and recommendations for interventions to improve health disparities offered by the Principal Investigators of the 10 Centers for Population Health and Health Disparities are presented. Finally, an annotated list of primary sources books, special issues of journals, reports and a list of sources for further reading are offered to provide a starting point for beginning scholars to orient themselves to research in health disparities.

Broadly speaking, health disparities are differences in health outcomes between socially disadvantaged and advantaged groups. There are multiple definitions of health disparities available. The U. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion.

A definition from Braveman highlights the role of policy and social advantage in potentially ameliorating health disparities:.

Advancing Health Disparities Research in Population Health

Central to all of these definitions is the idea that health disparities stem from disadvantage and, as such, they are unnecessary and avoidable and, therefore, unjust and unfair Whitehead, Braveman emphasizes this point in her discussion of health disparities and health equity, noting that in this context, health disparities are not merely differences in health status; rather, they are differences stemming from inequity:.

Health equity and health disparities are intertwined. Health equity means social justice in health i. Health disparities are the metric we use to measure progress toward achieving health equity. A reduction in health disparities in absolute and relative terms is evidence that we are moving toward greater health equity.

The following sections address each of these fronts. Health disparities are a global issue, and many different groups of people are affected by them. Of course, many of these factors tend to be correlated, both complicating and exacerbating the problem.

peer reviewed articles on health disparities

Socioeconomic status, as defined by income and education, may be the most important factor underlying health disparities. Simply put, poorer, less educated populations are less healthy than more affluent, educated populations.

peer reviewed articles on health disparities

These results hold globally. A study investigating socioeconomic inequalities in health in 22 European countries found that mortality rates were higher and self-assessments of health were lower for groups with lower socioeconomic status Mackenbach et al. Of course, factors beyond socioeconomic status also come into play. For example, racial and ethnic minorities tend to be less healthy than their majority counterparts.

In its latest comprehensive report on health disparities, the CDC considered a wide spectrum of health behaviors and outcomes ranging from environmental hazards and behavioral risk factors to various markers of morbidity and mortality.

In terms of sex differences, women tend to fare better than men. The clearest indicator is in mortality rates, where women consistently live longer than men, and the difference holds internationally Harvard Medical School, Morbidity refers to illness and disease, whereas mortality refers to death. This section reviews a sample of meta-analytic studies that explore different aspects of disparities in morbidity and mortality.

It reveals the extent to which disparities pervade all aspects of health, including physical health, mental health, and survival.Suggested citation for this article: Jack L Jr. Prev Chronic Dis ; As part of its mission, PCD has published papers identifying the effect of behavioral, psychological, genetic, environmental, biological, and social factors on health outcomes.

PCD has also sought out research on the effectiveness of interventions addressing these factors, with the focus on reducing the disproportionate burden of chronic diseases among at-risk populations.

This collection features 9 articles that address this topic from multiple perspectives:. Childhood obesity continues to be a national concern, especially among low-income households 4. Researchers shared important insights on the role that key implementation outcomes such as fidelity, cost, reach, and sustainability played in school participation and sustainability of intervention activities.

The effect of short-term and long-term economic strain on the health and well-being of individuals and families is well established in published literature 6.

6 Major Health Disparities Affecting the LGBTQ+ Community

Economic factors have been linked to food insecurity and obesity across the life stages 7. Using a spatial-based approach, Kim and colleagues identified new insights into the relationship between county-level income inequality, poverty, and obesity prevalence across New York State 8. Researchers found that higher income inequality was associated with lower obesity rates and that higher percentages of poverty were associated with higher obesity rates. High obesity rates among African Americans continue to be a tremendous public health concern 9.

High obesity rates have been linked to numerous factors, including biology, dietary consumption, population characteristics, access to care, socioeconomic status, and environment Sterling and coauthors conducted research that monitored and analyzed changes in nut intake, other obesity-related foods red or processed meats, added sugarsand body mass index during a 2-year weight loss intervention The weight loss intervention targeted overweight and obese African American women living in rural Alabama and Mississippi.

Researchers found that nut consumers had a lower body mass index than non-nut eaters. Even after accounting for kilocalorie consumption and physical activity engagement, weight loss by the end of the intervention was significant among nut consumers but not among non-nut consumers.

Researchers found that intervention results were linked to nut consumers consuming less red meat than non-nut consumers and greater amounts of other nutritionally rich foods, such as fruits and vegetables. The existence of disparities in the use of health care services by men and women has been the subject of increased empirical study in recent years 12, Mesa observed patients with type 2 diabetes aged 45 or older who lived in Ventura County, California, to compare differences in health care services hemoglobin A 1c test, cholesterol test, and retina examination between men and women During 1 year, although men and women had access to similar health care services for diabetes, men had higher hemoglobin A 1c levels and lower rates of showing up for appointments.

Findings from this study provide evidence that continued efforts are needed to identify motivating factors to increase appointment scheduling and attendance among men. Researchers found that most The authors discussed how economic development and job creation may decrease the prevalence of chronic disease in tribal communities. Falls and fall-related injuries are the leading cause of injury and death among adults aged 65 or older 17especially among those with chronic kidney disease Kistler and colleagues performed a secondary analysis ofadults aged 65 or older in the Behavioral Risk Factor Surveillance System Researchers found that adults aged 65 or older with chronic kidney disease were at increased risk of falling compared with adults in the same age range without chronic kidney disease.

Researchers also found that modifiable factors such as physical function and recent exercise were most closely related to reduced risk and could be an appropriate target for fall prevention and rehabilitation programs. Diverse factors, including family history, behavior, dietary habits, and environmental characteristics, simultaneously influence obesity among children in the United States McDonald and her team of researchers examined sedentary behavior and the use of electronic screen devices among low-income Mexican-origin children aged 6 to 10 years living in rural communities near the US—Mexico border Through interviews of parents, researchers found that increased odds of heavy screen use were associated with having a television on while children ate.

Parents reported that children also had access to electronic devices, social media, and the internet. Consistent with previously published research, this research affirmed the need to reduce screen time among children, particularly those at high risk for obesity. Diabetes is a major public health crisis in Mexico, with mortality rates among the highest in the world Diabetes is associated with complications, such as diabetic retinopathy, that impede quality of life among patients These researchers developed the screening tool after analyzing biochemical, clinical, anthropometric, and sociodemographic information on 1, adults living with diabetes in low-income communities in Mexico.

They developed a low-cost and easy-to-use screening tool that accounted for risk factors for diabetic retinopathy such as time since diabetes diagnosis, high blood glucose levels, systolic hypertension, and physical inactivity. And finally in this collection, PCD examined the unique position of public health workers in state and local health departments to address social determinants of health, health inequities, and population health improvements across a range of chronic conditions in the United States The authors discussed how these assignees provide assistance in critical areas including conducting epidemiologic studies, building surveillance systems, evaluating chronic disease prevention and control programs, analyzing data, and training entry-level and mid-level chronic disease epidemiologists.