Defining Health Disparities and What They Mean

Health disparities occur when people and communities experience higher rates of breast cancer, obesity, heart disease, and other challenges for specific reasons that include race and ethnicity, access to care, poverty, and environmental risk. These health disparities have many causes.

Mistrust in the health care system, for example, can contribute to human immunodeficiency virus (HIV) prevention challenges among Black people. Transportation can be a barrier for older adults, making it hard to keep appointments, but also for those living in food deserts (neighborhoods without grocery stores that offer healthy foods).

This article discusses health disparities, the definition, and the impacts they can have on affected people. It explains the causes and how that connects to public health in the community.

What Is the Definition of Health Disparities?

The Office of Health Equity in the United States defines health disparities as the preventable factors and differences that disproportionately affect certain people and groups. They contribute to health consequences because of disease, injury and violence, and the lack of prevention opportunities.

These factors include:

• Socioeconomic status or income
• Race or ethnicity
• Age
• Sex or gender
• Geography (both rural and urban settings)
• Disability
• Sexual orientation
• Immigrant status
• Religion
• Mental health status

Historically, these characteristics have been linked to discrimination or exclusion. When a particular group of people doesn’t have the same kind of access to health care, education, or healthy behaviors, it can cause them to fall behind their peers on all kinds of health measures. These disparities can often persist for generations.

Examples of Health Disparities

The root causes of health disparities are complex. Health is influenced by so many factors that it can be difficult to pinpoint just why gaps among people and groups can be so wide. Some examples from the Centers for Disease Control and Prevention include:

• Infant mortality: Babies born to Black women in the United States die at more than double the rate of babies born to white women.
• Dementia: Access to care for Alzheimer’s disease is more difficult for Black Americans, who report a 50% rate of discrimination in seeking health care, and other minorities facing dementia.
• Cancer: There are many examples. Black women are less likely than White women to live 5 years after being diagnosed with cervical cancer. Native people are more likely to face colorectal cancer, in part due to access issues with screening.
• Obesity: Childhood obesity is far more common in Black and Latinx kids (25% or more) than White kids (17%), as reported through 2020 data.
• Smoking: Low-income people use tobacco more often, have higher risk of related illness, and may live and work in environments where secondhand smoke exposure is more common.
• Binge drinking: Young people ages 18-34 are more likely than other groups to binge drink and it’s more common in males.
• Mental health: Racial and ethnic minorities may experience more stress in their lives, due to racism or its indirect consequences, like poverty and violence.

Disparities often are due to the distribution of resources, both now and in the past. Black people in communities historically limited in their housing options due to segregation and redlining (banking and loan denials) often have fewer affordable neighborhoods today. That can mean a higher risk of lead in the paint or water, limited healthy food access, or poor access to parks and recreation.

Transportation challenges can mean it’s hard to schedule mental health therapy, and lack of quality jobs and health insurance mean that it’s not accessible or the cost is out of reach. These health disparities lead to new consequences and general challenges affect the wider community, too.

Parents too sick to work, for example, can face income loss. Unemployed, low-income individuals are less likely to have access to health insurance. If they’re unable to afford health care, the lack of treatment for existing conditions can make them worse (and less likely to find a new job).

Maternal health is an example of health disparities with generational impact. Access to quality prenatal care, the ability to afford vitamins and healthy foods, and environmental and social factors like chronic stress all influence the health of a developing fetus. In addition, the limited care of gestational diabetes can contribute to the risk of developing type 2 diabetes in low-income people.

Causes of Health Disparities

Disparities often have multiple root causes, but there are a few major inequities in the United States that are known to contribute to health gaps between groups.

Income Inequality

The U.S. healthcare system is one of the most expensive in the world, spending roughly twice as much on healthcare as other high-income nations. Americans pay more for health services like clinic visits, hospital stays, and prescription drugs. A growing income gap between the wealthy and poor, many of whom have limited healthcare access, contributes to health disparities.

Systemic Discrimination or Exclusion

Social drivers—like racism, sexism, ableism, classism, or homophobia—can perpetuate inequities by prioritizing one group over another through factors like housing policies that affect long-term health.

Environmental Factors

Health outcomes can be shaped by lifestyle choices including diet and exercise. Some of those choices are shaped by the environment. Unsafe neighborhoods, with sidewalks that are in poor condition, can prevent older people from healthy walking if they fear falls or experiencing crime.

Access to parks, bike lanes, clean public transportation, supermarkets, social opportunities, and more (for people of all ages) can help to shape the choices people have available to them.

Strategies for Reducing Health Disparities

Closing the gap in health outcomes is no easy task. Causes are often multi-layered. Solutions would need to address not only the root cause of a given disparity but also the original context.

For its part, the Healthy People 2030 objectives—a set of goals laid out by the U.S. government to improve the health of Americans—aims to reduce health disparities by addressing key factors known as social determinants of health.

These include economic stability, education, and other factors that contribute to health disparities. The initiative is aligned with others from the Office of Health Equity, medical professionals and organizations, social and community activists, and countless others seeking to improve health care access and provide remedies to health disparities.

Summary

Health disparities are an underlying cause of many medical disorders and mental health diagnoses, with vulnerable populations affected disproportionately because of race, income, and other factors.

These causes of health disparity can be changed with intentional polices and approaches to establish health equity. Initiatives and interventions vary widely, from basic approaches to improve healthy food access to more complex policies to improve access to affordable care and complex procedures.