A few days ago, I gave my final lecture in my epi class, partly an overview of social epidemiology, and partly a rip on health disparities research.
The short version:
Identifying and describing health disparities:
- is a great way to get grant money.
- seems like a great way to raise awareness-
--- in order to mobilize greater resources to address the problem &
--- in order to mobilize members of the 'target population' to take preventive action.
- can be demoralizing to the 'target population'.
- can induce feelings of helplessness in the 'target population'.
- can make ill health seem inevitable & expected in the 'target population',
--- potentially reducing the urgency for action.
- describes the result, not the causes-
--- if you believe genetics is the cause, the existence of health disparities supports that notion
--- if you believe lifestyle is the cause, the existence of health disparities supports that notion
--- if you believe racism is the cause, the existence of health disparities supports that notion.
- don't identify potential public health actions to address health disparities
Furthermore, the almost exclusive focus on adverse health disparities:
- is demoralizing to the 'target population'.
- enhances the sense of social distance between the 'target' and 'majority' populations.
- obscures the true picture of a mixture of adverse health disparities, health similarities and advantageous health disparities.
Ignoring advantageous health disparities
- blinds us to the possibility of understanding the mechanisms for these advantages
--- which could lead to more effective public health measures built upon those mechanisms to address the adverse health disparities
--- or could lead to building on those mechanisms to improve the health of populations other than the 'target population', including the 'majority' population.