Lesson 2. Exploration of Health Disparities Across Different Populations Based on Socioeconomic Status, Race/Ethnicity, Gender, and Geographic Location

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Headshot of Robert (Bob) Lutz, MD, MPH · Public Health course director
Robert (Bob) Lutz
MD, MPH · Public Health course director
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Headshot of Jaime Bowman, MD · Vice Chair, Family Medicine
Jaime Bowman
MD · Vice Chair, Family Medicine
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Headshot of Chaise Zozaya, MPH MBA · Course director
Chaise Zozaya
MPH MBA · Course director
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Table of Contents

Health equity

Health is influenced by where people live, work, learn, and play.

Inequities in housing, education, income, employment, transportation, food access, etc., deeply affect health outcomes.

Health care accounts for only ~10%–20% of modifiable contributors to health outcomes.

Racial/ethnic minority and low-income populations are disproportionately impacted due to structural and historical inequities.

CDC’s Five Equity-Centered Principles

  1. Prioritize Equity: Make equity a goal from the start.
  2. Engage Communities: Center the voices of impacted populations.
  3. Consider Context: Recognize systemic inequities that shape how messages are received.
  4. Address Power Imbalances: Avoid deficit framing and dehumanizing language.
  5. Reflect + Adopt: Reassess messaging strategies and correct mistakes.

Health injustice stems from structural racism, disinvestment, and historical trauma.

Clinicians can

  1. Recognize bias in clinical decision-making (e.g., race-based algorithms).
  2. Advocate for institutional reform (e.g., equity-focused quality metrics).
  3. Build trusting relationships with marginalized patients and communities.
  4. Commit to lifelong learning about equity and anti-racism.

readings and resources

Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity.

CDC’s Guiding Principles to Promote an Equity-Centered Approach to Public Health Communication.

AMA Ed Hub: Health Equity Education Center. “Confronting health injustice and advancing equity”.

Socioeconomic status and health disparities

Housing as a SDoH

There is strong evidence characterizing housing’s relationship to health. Housing stability, quality, safety, and affordability all affect health outcomes, as do physical and social characteristics of neighborhoods. 

  • Systematically collecting, analyzing, and making available information on the health of a community.
  • Assess and monitor population health.
  • Investigate and diagnose hazards and root causes.
  • Promoting the use of scientific knowledge in decision making about public health policies.
  • Communicate effectively to educate public to strengthen health.
  • Strengthen and mobilize communities and partnerships.
  • Create, champion, and implement policies.
  • Utilize legal and regulatory actions to protect health.
  • Ensuring that services necessary to achieve agreed upon public health goals are provided.
  • Enable equitable access to health services and care
    Build diverse and skilled workforce.
  • Innovate through evaluation research and quality improvement.
  • Build and maintain strong public health infrastructure.

The 10 essential Public Health services

  • Monitor health: Assess and monitor population health status, factors that influence health, and community needs and assets.
  • Diagnose and investigate: Investigate, diagnose, and address health problems and hazards affecting the population 
  • Inform, educate, empower: Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it.
  • Mobilize community partnerships: Strengthen, support, and mobilize communities and partnerships to improve health.
  • Develop policies: Create, champion, and implement policies, plans, and laws that impact health.
  • Enforce Laws: Utilize legal and regulatory actions designed to improve and protect the public’s health.
  • Link to/provide care: Assure an effective system that enables equitable access to the individual services and care needed to be healthy.
  • Assure a competent workforce: Build and support a diverse and skilled public health workforce.
  • Evaluate: Improve and innovate public health functions through ongoing evaluation, research, and continuous quality improvement.
  • Research: Build and maintain a strong organizational infrastructure for public health.

Source

CDC


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