Module Introduction Why are some people healthy and others not? This is a question that has gained increasing attention in the United States. In trying to improve health in developed societies, we have focused most of our attention in on improving the quality and availability of health care. Such massive efforts reflect a widespread belief that the availability and use of health care is central to the health of both individuals and populations. However, most of the variability in health status we find in the United States and other developed countries has little to do with health care and everything to do with one’s position in the social hierarchy. Some of the best-kept secrets of longevity and good health are to be found in one’s social, economic, and cultural circumstances. The largest gap lies between the richest and the poorest. But the middle classes are also affected. The lower one is situated on the social hierarchy, the lower one’s probability of staying in good health and the lower one’s life expectancy. Social justice refers to equal treatment of all people regardless of factors such as race, age, socioeconomic status or gender. However, social injustice is a major contributor to health disparities. Social injustice has a wide variety of manifestations: For children in urban slums and depressed rural areas, it means few teachers, crowded classrooms, functional illiteracy, and no development of marketable skills. For unemployed youth, it means a lower probability of getting a permanent job. For minority workers, it means reduced income, reduced opportunities for promotion, and increased exposure to on-the-job health and safety hazards. For women, it means increased risk of being violently attacked or sexually abused. For people forced to migrate within or between countries, it means profound stress and less security. For many people throughout the world, it means unsafe food and water, poor sanitation, substandard housing, environmental hazards, violation of their human rights, inadequate access to medical care and public health services, and illness, injury, and premature death that could have been prevented. Social injustice creates conditions that adversely affect the health of individuals and communities. It denies individuals and groups equal opportunity to have their basic human needs met. It violates fundamental human rights. It leads to health disparities, which is the focus of this course. In module one, we will explore health disparities and set the foundation for the remainder of the term. Specifically, through your readings and assignments, you will explore the various definitions of health disparities, the concept of medical exploitation, barriers to seeking care, diversity, cultural competence, and assess health disparities within a historical context. Module Summary Racial and ethnic disparities in health care persist despite considerable progress in expanding healthcare services and improving the quality of patient care. Many factors contribute to these disparities in complex ways, but the quality of health care can be improved for all patients with a comprehensive strategy that includes ensuring that strategies are implemented to not only reduce healthcare disparities, but also to improve the efficiency and equity of care for all patients. This effort includes taking into consideration the improvement of communication and comfort levels between healthcare providers and their patients/customers. Many healthcare organizations are facing dramatic demographic shifts in their customer patient populations and, therefore, are challenged to provide quality healthcare services to an increasingly diverse patient base. A diversity plan is an essential step toward enhancing diversity in healthcare and academic institutions. In developing a diversity plan, the term diversity must be defined. This module has discussed complex, sensitive, and challenging issues related to health disparities, emerging majorities, and the health status gap that has historically existed in the United States between different racial groups, with special focus on the substandard health status of Black people, with insight regarding contributing factors.
