Racial and ethnic disparities in the health and health care are well documented in the United States. Minority communities fare far worse than their white counterparts across a range of health indicators—such as life expectancy, infant mortality, prevalence of chronic diseases, self-rated health status, insurance coverage, and many others.1 Systemic discrimination is a major driver of these disparities as are individual-level issues surrounding culture, language, and trust. Beyond the social and moral imperative to reduce racial/ethnic health disparities, the economic burden of disparities to the United States as a whole is immense. Researchers estimate that, between 2003 and 2006, the cost of racial/ethnic disparities in direct medical costs and lost productivity exceeded $1.24 trillion.2 As the nation continues to grow increasingly diverse (i.e., people of color are projected to comprise 54% of the U.S. population by 2050 and more than half of the children in the nation by 2023),3 these disparities are likely to grow if left unaddressed.
REPRESENT- The Black Heterosexual Men’s Health Study: Under the leadership of Associate Professor Lisa Bowleg, PhD, REPRESENT is a multi-phase NIH-funded study on HIV/AIDS among heterosexual African American males. The study examines how social factors—such as poverty, racial discrimination, and incarceration—shape Black men’s gender role norms (i.e., expectations about what it means to be Black men), sexual scripts (i.e., beliefs about what should happen in sexual situations), and sexual risk behaviors with women.
Professor Lisa Ulmer, MSW, ScD has experience designing and testing preventive interventions in underserved populations, including early childhood interventions, school-based interventions, environmental interventions to prevent youth access to tobacco, and interventions to prevent heart disease, stroke and cancer. She is currently the Principal Investigator of three statewide chronic disease prevention evaluations, investigating the impact of interventions designed to transform public systems of care towards prevention, with specific research activities investigating health disparity reduction: the Pennsylvania Cancer Education Network evaluation, the Pennsylvania Colorectal Cancer Control Program evaluation, and the Pennsylvania WISEWOMAN evaluation. Dr. Ulmer is also the Principal Investigator of the Pennsylvania Osteoporosis, Physical Activity, Nutrition and Cardiovascular Disease (OPANAC) evaluation methods grant, developing a participatory evaluation system for statewide projects using a socio-ecological approach to disease prevention through modifications in the built environment and interventions within community, healthcare system, school and worksite settings. The system includes methods for measuring disparity reduction following implementation of environmental prevention strategies.
Associate Professor Nancy Epstein, MPH, MAHL has worked extensively with community-based projects and policy initiatives that address health care disparities related to access to care. She has developed and implemented model state health and social services programs. Her current area of focus is forging partnerships between faith-based and public health communities.
Assistant Professor Michael Yudell, PhD, MPH seeks to document historically stigmatized populations, the challenges they face in public health and medicine, and how this history impacts contemporary health challenges. He is currently completing the book Making Race: Biology and the Evolution of the Race Concept in 20th Century American Thought.
Reducing Racial/Ethnic Disparities in Environmental Health:
Environmental hazards are an inevitable by-product of the industrialized society in which we live, however exposure to these hazards are not equitably distributed among all segments of the population. As evidenced by numerous studies, low-income and racially/ethnically diverse communities suffer disproportionate exposure to deleterious substances—such as industrial toxins and household allergens like dust and mold.
Hernando Perez, PhD, MPH, CIH, CSP conducts research on housing, indoor air quality, and children’s environmental health with a focus on asthma. Among other projects, he has led training programs for workers involved in a community-based participatory asthma intervention project in housing choice as well as an environmental health education program for low-income individuals in urban settings.
Reducing Disparities in Interpersonal Violence:
Persistent disparities exist in rates of interpersonal violence between socio-demographic groups—particularly along racial/ethnic lines. Homicide is the leading cause of death for African American males between the ages of 15-34, accounting for about half of all deaths among those ages 15-24. 4
Center for Nonviolence and Social Justice: The Center is directed by Department Chair John A. Rich, MD, MPH and Co-Directed by Departmental faculty members Theodore Corbin, MD, MPP and Sandra Bloom, MD. The Center’s mission is to promote health, nonviolence, and social justice through trauma-informed practice, research, professional development, and policy change.
Healing Hurt People: HHP is a community-focused, hospital-based program designed to reduce recidivism among youth ages 8-30. The Drexel College of Medicine program uses a trauma-informed approach to address the needs—physical, emotional, and social—that victims of violence face after discharge from the emergency department. HHP was recently featured in a story which aired on WHYY Radio.
Commission on The Impact of Trauma and Violence on the Health of African American Men: Lead by Dr. Rich, this Commission is intended to raise awareness about issues of violence and trauma as they affect the health of African American men, and to improve health outcomes for these men by producing trauma-informed policy recommendations that will guide and inform funding and program development by the USDHHS Office of Minority Health.
Reducing Disparities in Public Health Emergencies:
As shown by Hurricanes Katrina and Rita, the 2007 Southern California Wildfires, the H1N1 pandemic, and countless other disasters and public health emergencies, racial/ethnic minorities suffer disproportionately adverse outcomes before, during, and after an emergency. These disparities are driven by individual-level barriers, such as limited-English proficiency and cultural isolation, as well as structural barriers, such as poverty.
The National Resource Center on Emergency Preparedness and Cultural Diversity: This web-based clearinghouse serves as the central source for resources and information on preparedness and diverse populations. The National Resource Center contains over 700 individually classified, annotated, and cross-referenced resources to help public health professionals, emergency management officials, and other stakeholders develop and carry out preparedness and response plans that are inclusive of the distinct needs of diverse communities.
Reducing Disparities in Health Care:
Variations exist in the quality of health care delivered to different population sub-groups. Whether the cause be the legacy Jim Crow-era segregation laws or quality health care providers who are reluctant to practice in low-income areas, such disparities are evident in the quality of care provided in primary care settings, hospitals, and long-term care facilities.
Research Professor David Barton Smith, PhD conducts research on the racial segregation of health care. He is the author of Health Care Divided: Race and Healing a Nation (1999) and has conducted research on racial/ethnic disparities in nursing home care.
1. Smedley, B, Stith, A., Nelson, A. (eds). (2001). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Institute of Medicine Washington, DC, 2001.
2. LaVeist, T.A., Gaskin, D.J. & Richard, P. (2009). The economic burden of health inequalities in the United States. Washington, DC: The Joint Center for Political and Economic Studies. Retrieved June 21, 2010, from http://www.jointcenter.org/hpi/sites/all/files/Burden_Of_Health_FINAL_0.pdf.
3. US Census Bureau. (Thursday, August 14, 2008) An older and more diverse nation by midcentury. Retrieved June 16, 2010, from http://www.census.gov/newsroom/releases/archives/population/cb08-123.html.
4. Centers for Disease Control and Prevention. Leading Causes of Death by Age Group, Black Males-United States, 2006.