scholarly journals Cultural trauma as a fundamental cause of health disparities

2021 ◽  
pp. 114574
Author(s):  
Andrew M. Subica ◽  
Bruce G. Link
Keyword(s):  
Health Disparities ◽  
Cultural Trauma ◽  
Fundamental Cause

scholarly journals Can Health Disparity Be Eliminated? The Role of Family Doctor Played in Shanghai, China

2020 ◽  
Vol 17 (15) ◽  
pp. 5548
Author(s):  
Jiaoling Huang ◽  
Qin Zhu ◽  
Jing Guo
Keyword(s):  
Socioeconomic Status ◽  
Health Disparities ◽  
System Dynamics ◽  
Health Disparity ◽  
Health Management ◽  
Family Doctor ◽  
Dynamics Modeling ◽  
Positive Role ◽  
Policy Interventions ◽  
Fundamental Cause

Background: Globally, the elimination of health disparity is a significant policy target. Primary health care has been implemented as a strategy to achieve this target in China for almost 10 years. This study examined whether family doctor (FD) policy in Shanghai contributed to eliminating health disparity as expected. Methods: System dynamics modeling was performed to construct and simulate a system of health disparity formation (business-as-usual (BAU) scenario, without any interventions), a system with FD intervention (FD scenario), and three other systems with supporting policies (Policy 1/Policy 2/Policy hybrid scenario) from 2013 to 2050. Health disparities were simulated in different scenarios, making it possible to compare the BAU results with those of FD intervention and with other policy interventions. Findings: System dynamics models showed that the FD policy would play a positive role in reducing health disparities in the initial stage, and medical price control—rather than health management—was the dominant mechanism. However, in this model, the health gap was projected to expand again around 2039. The model examined the introduction of two intervention policies, with findings showing that the policy focused on socioeconomic status improvement would be more effective in reducing health disparities, suggesting that socioeconomic status is the fundamental cause of these disparities. Conclusions: The results indicate that health disparities could be optimized, but not eliminated, as long as differences in socioeconomic status persists.

scholarly journals Racial and Ethnic Disparities in Health

2019 ◽  
Author(s):  
Samia Tasmim ◽  
Sarah Collins
Keyword(s):  
Health Disparities ◽  
Healthcare Access ◽  
Ethnic Disparities ◽  
Well Being ◽  
Racial And Ethnic Disparities ◽  
Individual Level ◽  
Fundamental Cause ◽  
Race Ethnicity ◽  
Unequal Opportunities ◽  
Racial Ethnic

Racial and ethnic disparities in health stem from the historical legacy and continued patterns of unequal resources and treatment on the basis of race/ethnicity in society (Hummer and Hamilton 2019; Williams and Sternthal 2010). Health disparities encompass differences in physical health, mental health, all-cause and cause-specific mortality risk, activity limitations, healthcare access and utilization, and other metrics of well-being. Researchers have identified a variety of explanations for racial/ethnic health disparities, including socioeconomic inequality, institutional- and individual-level discrimination, residential segregation, early-life circumstances, and health behaviors, among others. However, unequal opportunities on the basis of race/ethnicity remain the fundamental cause of health disparities (Hummer 1996; Phelan and Link 2015).

scholarly journals Call to Action: Structural Racism as a Fundamental Driver of Health Disparities: A Presidential Advisory From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 142 (24) ◽  
Author(s):  
Keith Churchwell ◽  
Mitchell S.V. Elkind ◽  
Regina M. Benjamin ◽  
April P. Carson ◽  
Edward K. Chang ◽  
...  
Keyword(s):  
United States ◽  
Health Disparities ◽  
Ethnic Groups ◽  
Professional Education ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Structural Racism ◽  
Fundamental Cause

Structural racism has been and remains a fundamental cause of persistent health disparities in the United States. The coronavirus disease 2019 (COVID-19) pandemic and the police killings of George Floyd, Breonna Taylor, and multiple others have been reminders that structural racism persists and restricts the opportunities for long, healthy lives of Black Americans and other historically disenfranchised groups. The American Heart Association has previously published statements addressing cardiovascular and cerebrovascular risk and disparities among racial and ethnic groups in the United States, but these statements have not adequately recognized structural racism as a fundamental cause of poor health and disparities in cardiovascular disease. This presidential advisory reviews the historical context, current state, and potential solutions to address structural racism in our country. Several principles emerge from our review: racism persists; racism is experienced; and the task of dismantling racism must belong to all of society. It cannot be accomplished by affected individuals alone. The path forward requires our commitment to transforming the conditions of historically marginalized communities, improving the quality of housing and neighborhood environments of these populations, advocating for policies that eliminate inequities in access to economic opportunities, quality education, and health care, and enhancing allyship among racial and ethnic groups. Future research on racism must be accelerated and should investigate the joint effects of multiple domains of racism (structural, interpersonal, cultural, anti-Black). The American Heart Association must look internally to correct its own shortcomings and advance antiracist policies and practices regarding science, public and professional education, and advocacy. With this advisory, the American Heart Association declares its unequivocal support of antiracist principles.

scholarly journals Fundamental Cause Theory, Technological Innovation, and Health Disparities: The Case of Cholesterol in the Era of Statins

2009 ◽  
Vol 50 (3) ◽  
pp. 245-260 ◽  
Author(s):  
Virginia W. Chang ◽  
Diane S. Lauderdale
Keyword(s):  
Health Disparities ◽  
Research Literature ◽  
Income Disparities ◽  
Cholesterol Levels ◽  
Fundamental Cause ◽  
Dynamic Perspective ◽  
Fundamental Cause Theory ◽  
Nationally Representative ◽  
The Relationship

Although fundamental cause theory has been highly influential in shaping the research literature on health disparities, there have been few empirical demonstrations of the theory, particularly in dynamic perspective. In this study, we examine how income disparities in cholesterol levels have changed with the emergence of statins, an expensive and potent new drug technology. Using nationally representative data from 1976 to 2004, we find that income gradients for cholesterol were initially positive, but then reversed and became negative in the era of statin use. While the advantaged were previously more likely to have high levels of cholesterol, they are now less likely. We consider our case study against a broader theoretical framework outlining the relationship between technology innovation and health disparities. We find that the influence of technologies on socioeconomic disparities is subject to two important modifiers: (1) the nature of the technological change and (2) the extent of its diffusion and adoption.

scholarly journals The Enduring Association between Education and Mortality

2011 ◽  
Vol 76 (6) ◽  
pp. 913-934 ◽  
Author(s):  
Richard Miech ◽  
Fred Pampel ◽  
Jinyoung Kim ◽  
Richard G. Rogers
Keyword(s):  
United States ◽  
Health Disparities ◽  
Causes Of Death ◽  
The United States ◽  
Mortality Rates ◽  
Social Forces ◽  
Educational Disparities ◽  
Fundamental Cause ◽  
Almost All ◽  
Over Time

This article examines how educational disparities in mortality emerge, grow, decline, and disappear across causes of death in the United States, and how these changes contribute to the enduring association between education and mortality over time. Focusing on adults age 40 to 64 years, we first examine the extent to which educational disparities in mortality persisted from 1989 to 2007. We then test the fundamental cause prediction that educational disparities in mortality persist, in part, by shifting to new health outcomes over time. We focus on the period from 1999 to 2007, when all causes of death were coded to the same classification system. Results indicate (1) substantial widening and narrowing of educational disparities in mortality across causes of death, (2) almost all causes of death with increasing mortality rates also had widening educational disparities, and (3) the total educational disparity in mortality would be about 25 percent smaller today if not for newly emergent and growing educational disparities since 1999. These results point to the theoretical and policy importance of identifying social forces that cause health disparities to widen over time.

Stigma as a Fundamental Cause of Health Inequality

2017 ◽  
Author(s):  
Bruce G. Link ◽  
Jo C. Phelan ◽  
Mark L. Hatzenbuehler
Keyword(s):  
Health Disparities ◽  
Population Health ◽  
Health Inequalities ◽  
Health Inequality ◽  
Social Factor ◽  
Multiple Outcomes ◽  
Life Chances ◽  
Fundamental Cause ◽  
Biomedical Interventions ◽  
Over Time

Accumulating evidence shows that stigma has health-harming consequences that build health disparities between those who are stigmatized and those who are not. However, most research has considered one stigmatized status at a time as it affects (generally) one outcome at a time. Moving from this singular focus to consider all forms of stigma as they affect multiple outcomes suggests a large and pervasive effect of stigma on life chances. This chapter considers whether stigma should be classified as a “fundamental cause”—an especially pernicious social factor that remains persistently associated with health inequalities over time. The chapter concludes by observing that if the stigma-as-a-fundamental-cause idea is supported, it follows that reductive efforts to address disparities via biomedical interventions will fail. Stigma stands as a factor that needs to be addressed in its own right if health inequalities are to be addressed and population health improved.

scholarly journals Training Public Health Students in Racial Justice and Health Equity

2021 ◽  
pp. 003335492110156
Author(s):  
Caroline E. Chandler ◽  
Caitlin R. Williams ◽  
Mallory W. Turner ◽  
Meghan E. Shanahan
Keyword(s):  
Public Health ◽  
Health Disparities ◽  
Health Equity ◽  
Future Research ◽  
Racial Justice ◽  
Race And Racism ◽  
Structural Racism ◽  
Rigorous Evaluation ◽  
Public Health Professionals ◽  
Fundamental Cause

In an attempt to move the field of public health from documenting health disparities to acting to rectify them, in 2001, the American Public Health Association (APHA) recognized racism as a fundamental cause of racial health disparities. Both APHA and the Council on Education for Public Health have moved to incorporate new competencies in health equity for public health professionals. As schools and programs of public health work to establish curricular offerings in race and racism, a need exists to identify approaches currently in use that can be replicated, adapted, and scaled. This systematic review sought to identify pedagogical methods and curricula that exist to support the training of US public health students in understanding racism as a structural determinant of health. We found 11 examples from peer-reviewed literature of curricula, lessons, and competencies that have been developed by public health faculty and departments since 2006. The articles discussed a range of approaches to teaching about structural racism in public health, suggesting that little consensus may exist on how to best teach this material. Furthermore, we found little rigorous evaluation of these teaching methods and curricula. The results of this review suggest future research is needed on public health pedagogy on structural racism.

Foreword: Envisioning Health Disparities

2003 ◽  
Vol 29 (2-3) ◽  
pp. 151-158
Author(s):  
Scott Burris
Keyword(s):  
Health Disparities
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