Health and health care are distributed unevenly in this country and minority populations often get less of both. Members of minority communities have higher rates of chronic illnesses such as diabetes and hypertension. They have higher rates of many cancers and those cancers often reveal themselves at later stages when they are harder to treat. A black male child born in 2006 will live on average to age 70, but a white male child born the same year will live to 76. A black female child will live to 77, but a white female child will live to 81.
There are no simple reasons for these disparities and there are no simple solutions either. This is not just about health care access, but health care access is important. This is not just about income and education, but income and education are important. This is not just about social class, but social class is important. This is not just about a history of prejudice and discrimination, but that history, and its enduring and painful legacy, are important.
What is known is that it will take a campaign to address and reverse these disparities—a campaign that will require combinations of research and management, evidence and commitment, science and activism. In 2001, the Department of Veterans Affairs created the VA Center for Health Equity Research and Promotion with the explicit goal of identifying, explaining, and eliminating disparities in health and health care in veteran populations and others. Interventions to reduce disparities in joint replacement, in the management of hypertension, in the treatment of mental illness, and in the care of veterans at the end of their life, reflect CHERP’s efforts to advance equity in the health and health care of our country’s veterans and to serve as a model for the nation.
There are no easy solutions to redressing health disparities, but those goals are advanced by sustained efforts, informed by thought and scholarship, and motivated by commitment and passion.
Dr. David A. Asch works for Veterans Affairs Center for Health Equity Research and Promotion.