A gentleman awaits to be seen by his primary medical care provider. Health inequalities within the United States is diminishing. However, gaps are continually seen between minorities, people who live in rural areas and have increased levels of poverty.

Photo by Thomas Barwick

Health inequality on the decline but gaps still exist between american citizens

By Justin K. Thomas

May 20, 2017

Research by College of William & Mary shows that there remains a high degree of variations in health equality among certain demographics even though health inequality is steadily diminishing in the U.S., due to advancements of modern medicine, according to a Department of Health and Human Services report.

Health disparity expert and assistant professor of sociology Elyas Bakhtiari said that his research continually sees variations among African-Americans, people living in rural parts of the country, and within lower-income and education brackets.

“I think it’s accurate to say that health inequalities have improved some,” Bakhtiari said. “But the trend depends on which type of inequality. Income-based mortality inequalities have been increasing in recent years, and there is a long way to go.”

Bakhtiari explained that health disparities are not just a problem for America, but are also a challenge for nations around the world, he said.

“Health inequalities are a problem everywhere,” he said. “Even in countries with universal health care coverage. Researchers still find inequalities in health outcomes which are tied to income, education, and often minority status.”

Bakhtiari also said that the concept of health disparity in the United States affects every single person in the country to some extent or another.

“People often assume that health inequalities refer to the gap between those without health insurance and everyone else,” he said. “But, in reality, we see inequalities even among those who have access to health care. Sociologists often use a ‘ladder’ metaphor. If we think of societal inequality as a ladder, with the richest at the top and the poorest at the bottom, every rung of the ladder has better health than the one below it and worse health than the one above it.”

Quoting a recent study conducted by the Virginia Commonwealth University, Bakhtiari noted two neighborhoods in Richmond, Virginia, as an example of where a gap between health disparities may exist at a local level. Statistically speaking, residents in the Westover Hills area live longer than residents of the Gilpin area of the city.

“Life expectancy in the city’s healthiest neighborhood is about 83 years,” he said. “In the unhealthiest neighborhood of the same town, the life expectancy is only 63 years or a 20-year difference and that’s pretty significant.”

George Jones, a public information officer for the city of Richmond, acknowledged that there are health disparities within the city and listed factors for causes including poverty, negative cultural habits, lack of knowledge and practice of healthy lifestyles, adoption of unhealthy behaviors, and lack of health insurance.

However, Jones also said that the municipal government and its community partners are proactively taking measures to shrink the gap for all residents through policy development, public education, and interventions to encourage healthier mindsets and adoption of healthy behaviors.

A lower life expectancy isn’t the only outcome of health inequality. Bakhtiari states that people affected by significant health inequalities in America also have decreased chances of attaining a stable socioeconomic future, therefore, limiting personal and professional achievement.

“It is not hard to imagine how being sick can lead to missed work and fewer job prospects,” Bakhtiari said. “But there is also evidence to suggest that poor health early in life, or even the health of your parents, can have long-term effects on economic success and mobility.”

As the new presidential administration settles into the White House, experts in the fields of medical sociology say that future policies regarding healthcare may increase the number of health disparities between people of the United States, according to Bakhtiari.

“I can’t speak for [everyone in the field of medical sociology], but I would say that many experts who do study public health in America are concerned with the new administration’s plans,” he said. “Future policies could worsen health inequalities, not only through the government’s attempts to repeal the Affordable Care Act without a viable replacement but also through other strategies and executive orders that may make life harder for vulnerable groups of people in the United States.”

As of May 4, the American Health Care Act of 2017 was approved by the House of Representatives and awaits endorsement from the Senate which only needs 51 votes to pass instead of the usual threshold of 60 votes prior to being signed or vetoed by the president, according to NBC News.

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