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Disparities, Inequality, and Inequity

Disparities, Inequality, and Inequity. DISPARITY = INEQUALITY and implies differences between individuals or population groups (UN-equal) INEQUITY refers to differences which are unnecessary and avoidable but, in addition, are also considered unfair and unjust.

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Disparities, Inequality, and Inequity

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  1. Disparities, Inequality, and Inequity DISPARITY = INEQUALITY and implies differences between individuals or population groups (UN-equal) INEQUITY refers to differences which are unnecessary and avoidable but, in addition, are also considered unfair and unjust

  2. Tips for Staying Health:A Lifestyle Approach • Don’t smoke. If you do, stop. • Eat a balanced diet, include fruits/vegetables. • Keep physically active. • If you drink, do so in moderation. • Cover up in the sun and protect your children. • Practice safe sex. • Participate in appropriate health screenings. • Drive defensively; don’t drink and drive. • Manage your stress. • Maintain social ties.

  3. Health Outcomes by Race 5

  4. BostonNeighborhoods 6

  5. Place Matters Asthma Hospitalizations for Children under Age 5, by Neighborhood 2006, 2007, 2008 Combined 7

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  12. Infant Mortality in Boston by Race

  13. Infant Mortality and Cigarette Smoking Per 1,000 Live Births African American Non-Smokers White American Smokers NCHS 2002

  14. Infant Mortality and Prenatal Care Per 1,000 Live Births African Americans 1st Trimester Prenatal Care White Americans Prenatal Care After 1st Trimester or None NCHS 2002

  15. Racial & Ethnic DisparitiesInfant Mortality & Education 10.2 6.8 NCHS 2002

  16. Racial & Ethnic DisparitiesInfant Mortality & Household Income 16.6 11.2

  17. Tips for Staying Healthy:A Social Determinants Approach • Don’t be poor. If you can, stop. If you can’t, try not too be poor for too long. • Don’t have poor parents. • Don’t live in a poor neighborhood. • Own a car – but use only for weekends and walk to work. • Practice not losing your job and don’t become unemployed. • Don’t be illiterate. • Avoid social isolation. • Try not to be part of a socially marginalized group.

  18. Social Determinants of Health Inequities Education Job Opportunity Socioeconomic Status Health Outcomes Racism Environmental Exposure Health Behaviors Access to Health Services Safe and Affordable Housing Reducing Violence

  19. States using the “Reactions to Race” module 2002 to 2009 BRFSS Arkansas, California, Colorado, Delaware, District of Columbia, Florida, Indiana, Massachusetts, Michigan, Mississippi, Nebraska, New Hampshire, New Mexico, North Carolina, Ohio, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, Washington, Wisconsin

  20. General health status and “race” Being perceived as White is associated with better health Even within non-White self-identified “race”/ethnic groups Even within the same educational level Being perceived as White is associated with higher education

  21. Racial & Ethnic DisparitiesLow Birth Weight & Racism 20% P < 0.01 12%

  22. What is racism? A system of advantage based on race. David Wellman, Portraits of White Racism

  23. Levels of Racism INTERNALIZED Interpersonal MICRO LEVEL INSTITUTIONAL STRUCTURAL MACRO LEVEL Adopted from the Applied Research Center

  24. Our tasks Put racial justice/racial equity on the agenda Name racism as a force determining the distribution of other social determinants of health Routinely monitor for differential exposures, opportunities, and outcomes by “race”

  25. 4-year Graduation Rate: Grades 9-12 Boston, 2006 Percentage of High School Students Massachusetts Department of Education

  26. “Pilot Program Aims to Reduce Infant Deaths” In an effort to drive down the disproportionately large number of deaths among black and Latino infants in Boston, city leaders yesterday unveiled a campaign to provide housing, counseling, and other critical support for pregnant women who are homeless or living on the edge.

  27. Jamaica Plain Equity Collaborative • Brookside, Martha Eliot and Southern Jamaica Plain Health Centers • Bromley Health TMC • JPNDC • ESAC • Hyde Square Task Force • Teen Empowerment • Spontaneous Celebrations • Tree of Life/Arbol De Vida

  28. March and Rally February 2010, 2011

  29. Youth Racial Healing & Reconciliation Project

  30. Documenting the Work Dfdsfmadf.,mf.,dasmf.sd,amf.,asdmf.sd,mf.sda,mf.asd,fm.sd,fmd.s,fmsd,.fmsd,.fmsd.,fmsd,.fmsd,.afmsd.a,fmds,.fmsd.a,fmsda,.fmsd.,fmd.as,fmd.as,mf.asd,mf.ad,smf.,asdmf.asd,mfasd.,mas.,fmasd.,fmas.,mf.asd,mf.,asdmf.asd,mfa.s,.a,smfd.s,afmasd,.fmsd.a,fma.sd,fmasd.,fmas.d,fm

  31. Taking it to the JP Community

  32. Loretta Ross Educating Us About a Frame… http://www.youtube.com/watch?v=82vl34mi4Iw

  33. Thank You!Questions/Feedback???

  34. Abigail Ortiz , MSW, MPH Southern Jamaica Plain Health Center 640 Centre Street Jamaica Plain, Ma 02130 (617) 983-4104 land (857) 203-1202 cell aortiz3@partners.org

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