remain after adjusting for these
factors. We cannot eliminate the
gap without addressing both.”
OTHA “SKIP” SPRIGGS: “There
are many factors, including gender,
race, ethnicity, socioeconomic status,
education, insurance status and
OTHA “SKIP” SPRIGGS
health literacy, that contribute to
disparities in health outcomes. All
these factors need to be considered
when trying to address disparities.”
DR. JOSEPH R. BETANCOURT: “We
know people of lower socioeconomic
status tend to live in communities
that may have great environmental
hazards. Three of the five largest
landfills are in predominantly poor
and minority communities. Other
factors such as diesel bus routes
take an incredible toll on kids with
asthma. Clearly, class plays a large
role in the prevalence of asthma.No
matter what your stripe, if you live
in a poor community, you’re affected … We also know, unfortunately,
that minorities are overrepresented
among those in lower socioeconomic status. So if you make that
connection, of course class matters
when it comes to health disparities.
Any efforts to improve the health of
the American people need to be
attentive to those of lower socioeconomic class.”
KALAHN TAYLOR-CLARK: “We have
reason to believe that viewing much
of the problems that racial and ethnic
minorities face in terms of access
to and quality of healthcare may be
explained through class-based
analyses … I believe that discrimination and racism play a significant
role in the creation of class-based
inequalities (e.g., income, wealth
and education), which may alone
lead to healthcare-access … inequalities for racial minorities. Further,
once patients have access to care—
if they get access to care—racism,
bias or stereotyping may act to exacerbate healthcare-quality [treatment]
inequalities. Thus, I believe that
healthcare inequalities are ultimately
race-based because the etiology of
many of these problems is based in
a foundation of individual, institutional and structural racism.”
DR. ANNE C. BEAL: “There is significant evidence that low-income individuals face greater barriers to access
to healthcare and experience poorer
health outcomes than those with
higher incomes in the United States.
International studies also show that
higher income and social status are
associated with better health outcomes, so this is not just a U.S. phenomenon. However, we also know
that race matters. For example, studies show that even when patients
have the same type of health insurance, members of racial and ethnic
minority groups receive lower quality of care … It is likely that disparities are due to a combination of
social and economic factors, as well
as race-based inequality.”
DR. NICOLE LURIE: “If you look at
most of the research, it suggests that
both play roles and sometimes the
roles overlap. One of the reasons it’s
been helpful to talk about it in a
race framework is it then is much
easier for many people to see this
as an issue of fairness to everybody
and as an issue of civil rights and
not an issue of income distribution.”
DIVERSITYINC: What’s the
biggest challenge facing those
working to close the gap?
SPRIGGS: “Lack of information.
The National Health Care
Disparities Report has concluded
that gaps in information exist and
that as knowledge of disparities in
healthcare and commitment to
reducing disparities continue to
grow, the ability to monitor and
track improvements in disparities
will become critical.”
NEWT GINGRICH: “The biggest
challenge is to recognize that the
current system simply does not work
and that its cultural assumptions,
NEWT GINGRICH
financial incentives and very
structure of organization have to
be changed. All too many reformers
want very big changes in results from
very small changes in behavior.”
