Class and Socioeconomic-Related Disparities (SES)

Sentiments of economic, political, and social differences among people entrap every aspect of American life. This leads to another major determinant of health outcome in America, class and socioeconomic status (SES), also referred to as the ignored determinant of health in the United States. Research on SES disparities has been overshadowed by racial and ethnic-related disparities. One could argue suppressing SES-based disparities to racial disparities is a strategic approach used by the government to avoid providing health care subsidies to the less fortunate. Linking SES to health disparities draws too much attention to the government and forces interventions to regulate health provision.

Economic and social barriers to quality health care create a strong divide between middle and low income Americans: the haves and the have-nots. Health care policies tend to favor the wealthy and ostracize those with strong barriers to health services (i.e., no insurance, limited, or no access to services). This rationale helps to categorize class and SES as important predictors of variations in health. A research study illustrated how socioeconomic barriers account for more than half of the reported health cases.

Figure 1. Distribution of Core Quality Measures for Which Members of Selected Groups Experienced Better, Same, or Worse Quality of Care Compared with Reference Group

TABULAR OR GRAPHIC MATERIAL SET FORTH AT THIS POINT IS NOT DISPLAYABLE

Financial barriers directly affect the use and quality of health care and health outcomes. In 2005, federal standards did not require medical providers to collect data on SES, income, or education level--just race. No rationale was provided for this practice; however, the lack of a tracking system challenges monitors and measures of SES-related disparities. Undocumented occurrences and reporting of SES-related disparities severely impede efforts to understand and monitor capabilities to reduce disparities, from a holistic perspective. In other words, data should be collected for both SES and race to truly understand the nature of health-related disparities, which could also guide federal, state, and local government form a comprehensive set of policies to end health care disparities.