On December 5, 2014, the Robert Wood Johnson Foundation (RWJF) held a forum on “Disparities, Resilience, and Building a Culture of Health” and published this paper on the state of racial inequalities in health authored by Thomas LeVeist, director of the Center for Health Disparities Solutions at the Johns Hopkins Bloomberg School of Public Health. Dr. LeVeist moderated the discussions at the forum.
The paper provides an overview of recent efforts to address health inequalities in the United States, beginning with the 1985 publication of the first report on racial and ethnic minorities from the Department of Health and Human Services. The paper then describes the health costs (quantified by years of potential life lost) and economic costs (measured by direct medical costs as well as costs associated with illness and premature death) of racial and ethnic inequalities. The paper presents the social determinants of health framework (conditions in the environments in which people live, work, learn, and play that affect health, physical functioning, and quality of life risks and outcomes).
The paper references the World Health Organization’s Commission on Social Determinants of Health strategies for addressing health inequalities:
- decrease social stratification (e.g., power, prestige, wealth, human capital, etc.)
- decrease exposure to risk
- lessen the vulnerability and increase the ability of disadvantaged persons to cope with risk (by adopting a “health in all policies” approach)
- intervene through health care to reduce the unequal consequences of social determinants.
The paper notes that while the fourth approach is the most common, it also is likely the least effective in addressing racial and ethnic disparities. For example, while necessary and appropriate, expanding access to health care alone will not solve health inequalities. Broad partnerships and collaborations are essential to eliminating risks, transforming communities, and ending health inequality for all.
Videos from the forum and blog postings from some of the speakers and participants also are available on the RWJF website.
Ignatius Bau 