"No one wants health disparities. So, to eliminate them, we need to know what they are and where they came from. In my presentations on health disparities to students, residents, and health care providers, I use 3 definitions of health disparities. My definitions are slightly different from those proposed in the seminal report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, from the National Academy of Medicine (then Institute of Medicine). I like to think that my definitions elicit the information needed to guide change. The first definition focuses on health statistics. When there are different outcomes for different demographic groups for the same disease, that is a disparity. This could be Black vs white, male vs female, or 1 zip code vs another. We owe ourselves an explanation for these differences if we are to be able to propose solutions. Second, there are disparities in the provision of health care. If there are 2 individuals who present with the exact same symptoms, we need to ask ourselves why they would be treated differently. Even in systems where insurance status is the same, there are documented differences in care. A well-studied example of this is pain. In such study, a meta-analysis showed that Blacks were less likely than whites to receive medication for acute pain in the emergency department (OR = 0.60 [95% CI, 0.43-0.83]). Other examples of differences by race include cardiac services, lung cancer screening, and stroke interventions. The third definition of health disparities involves differences in health seeking behavior. This is not to blame the “victim,” but to understand the reason why the difference exists so that adequate interventions can be designed to improve outcomes." Johnson MS. Systemic racism is a cause of health disparities. J Fam Pract. 2021 May;70(4):162-164. doi: 10.12788/jfp.0189. PMID: 34339356.
