I've noticed recently a lot of folks have been talking about "health equity". In the pas,t it used to be more about health disparity. Now we focus on "equity." Maybe some people thought “disparity” sounds too negative and more people might be interested if we talked about equality. After all, who is really going to object to equality?
It turns out that by not acting upon disparities, we tolerate inequity. And quite frankly, there are plenty of people that don't see the inequality because they have access to health care and assume everyone else does too. No one is complaining to them -- other than to whine about how long it takes to see a dermatologist to have a mole removed!
Don't believe me? Well, consider Boston, MA -- the bastion of medical advancement. It boasts 3 world class medical schools and over 30 hospitals. In some neighborhoods, it seems like there are more teaching hospitals than there are Starbucks!
With all that medical knowledge and access to the best and brightest doctors, nurses, and pharmacists surely there can't be a lot of health disparity there, right?
Where you live in Boston determines how long you will live, and likely what you will die of. Just as all politics is local, so too is health.
You may hear nationally that there are improvements in the number of heart attacks, as well as improvements in some cancer rates. And we are even making some progress in the fight against obesity. Yet, not everyone benefits equally from these advances. Even when there are advances, disparities typically still exist -- and sometimes get worse. And it's important to know the heath statistics for your community -- in fact, I would argue you should know the health data for your zip code!
If I told you that asthma rates for women was twice the rate for men living in Boson -- would that get your attention? Or if you knew that obesity in Hispanics was nearly 1.5 times that of whites -- would it really make you mad?
Now consider this: The rate of asthma in Roxbury is 5x the rate in Back Bay. The rate of being hospitalized is twice as high in Roxbury as it is in Back Bay, and if you are concerned about dying prematurely, living in Roxbury doubles your chances. And for those of you not familiar with Boston, these two neighborhoods are about 3 miles from each other --- that's right -- just 3 miles. One area is mostly where African Americans live and the other is where mostly affluent Caucasians live. Can you guess which one is which?
It's true that access to the health care system is not the only factor that determines our health. Numerous factors that determine how long one lves and what diseases one might have to deal with and these Includes education opportunities, affordable housing, access to fresh fruits and vegetables and a safe environment to work and play.
If we really want to eliminate health disparities, we need to understand the data in our community. We need to do analysis of what's happening in our town -- and the data are out there. And then we need to develop solutions that work for our area. To have such stark differences in how long we live that can largely be determined by zip code simply isn't acceptable. Can we please get upset about this?!