What are Health Disparities?
The World Health Organization conceptualizes health disparities, or inequalities, as “unjust patterns in the distribution of disease burden that are avoidable and preventable”.
Health Disparities in the United States
- Blacks/African Americans are more likely to die prematurely from stroke and coronary heart disease than Whites. 1
- Those with low income and education are more likely to be obese, increasing their risk for diabetes and heart disease. 2
- Sexual and gender minority groups have higher rates of mental health problems and substance use. Lesbian, gay, and bisexual youth are four times more likely to attempt suicide compared to those who are straight. 2
- Immigrants face multiple challenges, such as poverty, low health literacy, lack of health insurance, and other limitations in accessing health care, as well as other barriers to optimal health such as acculturative stress and anti-immigrant discrimination. 3
- Rural communities have higher rates of disease and disability compared to more urbanized areas. Health barriers facing rural populations include those tied to poverty and fewer socioeconomic opportunities. 2
What is Health Equity?
Healthy People 2020 defines health equity as “the attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and outgoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and healthcare disparities”.
What are the Causes of Health Disparities?
Healthy People 2020 states that “powerful, complex relationships exist between health and biology, genetics, and individual behavior, and between health and health services, socioeconomic status, the physical environment, discrimination, racism, literacy levels, and legislative policies”. These factors, known as the social determinants of health, are the root causes of health disparities and include the availability of and access to:
- High-quality education
- Nutritious food
- Decent and safe housing
- Health insurance
- Culturally sensitive health care providers
- Clean water and non-polluted air
- Affordable, reliable public transportation
Health Disparities in Alabama
- Alabama ranks 46th in terms of overall health (life expectancy and quality of life) compared to the rest of the United States. 4
- Every year, 2,900 deaths in Alabama could be avoided if all residents in the state had a fair chance to be healthy. 4
- In addition to poorer overall health in Alabama compared to other U.S. states, there is also wide variation in health within Alabama. For example, average life expectancy in Alabama is 75.3 years. In Lee County, life expectancy is 77.5 years, whereas in neighboring Macon County it is almost six years earlier. 4
- The infant mortality rate for Blacks/African Americans is twice that of Whites. Blacks/African Americans are most likely to be overweight or obese compared to all other race groups. 5
- Rural Alabama is characterized by challenges in access to healthcare, a shortage of healthcare providers, as well as transportation limitations. 5
Lee County Demographics and Disparities
- Lee County is healthier compared to other areas in Alabama. It ranks 3rd in terms of overall health (life expectancy and quality of life) compared to other counties in Alabama. 4
- However, average life expectancy in Lee County (77.5 years) is still over a year less than that for the U.S. as a whole (78.9 years). 7
- Blacks/African Americans and Whites in the Auburn-Opelika metropolitan area live in different neighborhoods. The dissimilarity index is 34.2%, meaning that more than 1/3rd of Blacks/African Americans would need to relocate to another neighborhood in order to be distributed evenly with Whites. 8
- In the Auburn-Opelika metro area, Black/African American children live in areas where poverty rates are almost twice that of the areas White children live in (22.8% vs. 14.1%). 8
- Black/African American infants are more than twice as likely to have low birthweights and almost twice as likely to be born preterm than White infants. 6
Racial Segregation 10
Addressing Health Disparities with the Aim of Addressing Health Equity
Healthy People 2020 initiatives focus on promoting physical, mental, and social well-being in communities that are particularly vulnerable to poor health outcomes. Objectives include improvements in five key areas:
- Economic Stability (poverty, employment, food security, and housing stability)
- Education (high school graduation, enrollment in higher education, language and literacy, early childhood education and development)
- Social and Community Context (social cohesion, civic participation, discrimination, incarceration)
- Health and Health Care (access to health care, access to primary care, health literacy)
- Neighborhood and Built Environment (access to healthy foods, quality of housing, crime and violence, environmental conditions)