1. Disparities in Health and Health Care: The Distinction and Why It Matters
Erika Blacksher, PhD
Bioethics & Humanities
University of Washington
October 16, 2013

2. Objectives Health care disparities vs. health disparities
Definitions
Causal pathways ... social determinants of health
Why the distinction matters

3. Health Care Disparities
Differences in the quality of health care across racial, ethnic, and socioeconomic groups

4. Health Care Disparities
Racial or ethnic differences in the healthcare that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention...
Institute of Medicine, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, 2003.

5. Health Disparities
Differences in the incidence, prevalence, mortality, and burden of disease, illness, and injury that exist among specific population groups in the United States.
National Institute on Minority Health and Health Disparities

6. Health Disparities
“A population is a health disparity population if there is a significant disparity in the overall rate of disease incidence, prevalence, morbidity, mortality or survival rates in the population as compared to the health status of the general population.”
Minority Health and Health Disparities Research and Education Act United States Public Law (2000).

7. Determinants of Health

8. Social Determinants of Health
‘the circumstances in which people grow, live, work, and age and the systems put in place to deal with illness ...
shaped by political, social and economic forces’
Commission on the Social Determinants of Health (2008) Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. Final Report.

9. Social Determinants of Health
Web of personal resources and nested environments:
Income, poverty, unemployment
Education
Wealth
Built environment
Food environment
School/learning environment
Housing stock
Toxin exposure
Health care (geographic proximity, quality, insurance/access)
Social support, social capital, social security
Racism and discrimination
Sexism, misogyny
Political environment (vote, voice)

10. The job of justice has just begun...
Why It Matters
The job of justice has just begun...

11. Thank You