Understanding the Nature and Causes of Disparities

Conceptualizing the intricacies of what actually encompasses health disparities lacks consensual agreement in health care literature. Health disparities and health inequalities are used interchangeably and refer to the gaps in health status (i.e. life expectancy, infant and maternal mortality rates, disease, and other measures) among groups of people based on differences in factors such as gender, race or ethnicity, education, income, disability, geographic location, or sexual orientation that are systemic, avoidable, unfair and unjust. Several researchers suggest comparing one group's health status with the majority, the population average, or the healthiest groups to determine health disparities as others argue for examinations of census tracks to identify area-based health disparities. Arguments against any ideologies associated with racial differences in health care caused from genetic variations among races are countered by arguments suggesting health disparities result from both biological vulnerability and social disparities.

Debate over which paradigm is precedent over others in academic literature and to what extent one defines its meaning has important policy implications on how to measure and monitor collaborative efforts to improve the quality of health provision, financing, and eliminating disparities. Regardless of which paradigm one selects to observe, institutionalized discrimination is a dominant theme in the practice of our current health care system and demands drastic change. Individual and joint considerations of these paradigms of study are necessary to understand the nature of health disparities in America and help to convey corresponding responses that offer a possibility of giving a holistic/comprehensive formulation to a total transformation in the health care policy arena. The subsequent section expands on the two major underlying determinants of health disparities: race/ethnicity and class/socio-economic status.