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Understanding Healthcare Disparities: What Premeds Need to Know
Articles
June 15, 2024
As a future physician, you need to understand the challenges facing medicine as well as the science needed to practice it. One critical aspect of this context is healthcare disparities—differences in health outcomes and access to care that stem from social and economic disadvantages. Awareness of these disparities is essential for anyone entering the medical field, because they will play a role in the lives of the patients you treat. It’s also possible that you may be asked about healthcare disparities in a medical school interview.
This article looks at some of the causes of healthcare disparities, and how you can engage with the issues surrounding them during your pre-med (or post-bacc) years.
Defining Healthcare Disparities
Healthcare disparities refer to differences in the quality of health and healthcare across different populations. These differences often correlate with race, ethnicity, socioeconomic status, geographic location, gender, sexual orientation, and disability status.
Differences in healthcare due to disparities have major effects. Research from the University of Wisconsin’s Population Health Institute indicates that the impact of disparities can determine 50% or more of a patient’s overall health. With the U.S. on track for a population that is majority-minority in the next decades, addressing disparities is critical to ensure the health and prosperity of all communities.
Disparity #1: Economic and Educational Factors
The cost of healthcare is a major concern. However, the effect of a person’s economic status goes beyond being able to afford a medical bill. Income and job security, for example, impact access to healthy foods, stable housing, and leisure time for pursuing exercise.
Higher levels of education are also linked to better health outcomes. A 2020 study that compared levels of education to a range of healthcare outcomes like infant mortality and lifespan found a direct correlation between educational attainment and better health. This connection may be due to the fact that people with higher rates of education are more likely to hold jobs with good health benefits. In addition, people with higher rates of education may be more “health literate” – that is, aware of how to monitor their health, care for their health, and where to seek treatment.
Disparity #2: Racial and Ethnic Factors
Bias toward racial and ethnic minorities persists in medicine, often unconsciously. These biases can lead to poorer-quality treatment. For example, a 2021 study found that Black children with appendicitis did not receive as much pain medication as White children, and that part of this disparity was likely due to unconscious bias. As future physicians, premeds must learn to recognize and mitigate their own biases to provide equitable care.
Disparities based on race are frequently rooted in historical injustices and systemic inequities. The Tuskegee Syphilis Study, conducted by the U.S. Public Health Service from 1932-1972, is just one of many examples of how racism has been institutionalized in the medical field: African American men were recruited to a study that promised to treat them for “bad blood”, and then given only placebos or other ineffective treatments. This continued after the introduction of penicillin, the first antibiotic and an effective treatment for syphilis. More than 100 men died as a result.
Events like this have led to a deep mistrust of the healthcare system in some communities. Premeds should be aware of this history to better understand the fears some patients might have.
Disparity #3: Gender
Women and LGBTQ+ people are disproportionately impacted by health disparities due to their gender or sexual identity. A 2023 World Economic Forum article about health disparities for women reports that women treated in hospitals wait longer to see a doctor and are less likely to be given pain medication than men.
Additionally, the article reported that women are greatly underrepresented as subjects in clinical trials. This leads to a lack of understanding about how women experience different health conditions – for example, heart attacks can present differently in women compared to men.
Disparity #4: Disabilities
The National Institutes of Health have only recently designated people with disabilities as a population impacted by health disparities. However, disabilities can impact healthcare for other conditions in many ways. The World Health Organization reports that people with disabilities are disproportionately likely to die earlier due to preventable health conditions unrelated to their disability.
This disparity may be due to a range of factors:
- Lack of accessible facilities
- Information presented in a format the patient can’t process (e.g., not having a sign language interpreter present for a person with a hearing disability)
- Negative attitudes of healthcare providers
It’s estimated that 12% of all U.S. citizens live with a disability, and people can become disabled at any time due to accident or illness. Understanding how disability affects access to care is crucial for premeds.
Disparity #5: Language Barriers
America is a nation of immigrants. An American Medical Association article from 2021 notes that as many as 25 million people in the U.S. have limited English proficiency. The article describes research which shows that differences in language proficiency can negatively impact provider-patient communication – patients may not understand instructions, and providers may misunderstand patient complaints, leading to significant medical errors.
Research also shows that language barriers can cause significant psychological stress for patients, even with a family member acting as interpreter. Premeds can familiarize themselves with working across language barriers by making efforts to pursue volunteer or clinical experience within immigrant communities.
Equipping Yourself to Recognize Disparities
While healthcare disparities are a significant challenge, they are not insurmountable. As a future doctor, you can:
- Proactively work to develop an understanding of different cultures
- Seek clinical experience that exposes you to communities impacted by disparities
- Get involved with efforts to promote policies that address healthcare disparities for different communities
- Keep up with research into health disparities and their impact
Understanding healthcare disparities is not just about improving statistics; it’s about providing compassionate, equitable care to every patient who walks through the door. By educating yourself early in your healthcare career about these disparities, you can prepare to help build a healthcare system that truly serves everyone, regardless of their background or circumstances.
As a future physician, you need to understand the challenges facing medicine as well as the science needed to practice it. One critical aspect of this context is healthcare disparities—differences in health outcomes and access to care that stem from social and economic disadvantages. Awareness of these disparities is essential for anyone entering the medical field, because they will play a role in the lives of the patients you treat. It’s also possible that you may be asked about healthcare disparities in a medical school interview.
This article looks at some of the causes of healthcare disparities, and how you can engage with the issues surrounding them during your pre-med (or post-bacc) years.
Defining Healthcare Disparities
Healthcare disparities refer to differences in the quality of health and healthcare across different populations. These differences often correlate with race, ethnicity, socioeconomic status, geographic location, gender, sexual orientation, and disability status.
Differences in healthcare due to disparities have major effects. Research from the University of Wisconsin’s Population Health Institute indicates that the impact of disparities can determine 50% or more of a patient’s overall health. With the U.S. on track for a population that is majority-minority in the next decades, addressing disparities is critical to ensure the health and prosperity of all communities.
Disparity #1: Economic and Educational Factors
The cost of healthcare is a major concern. However, the effect of a person’s economic status goes beyond being able to afford a medical bill. Income and job security, for example, impact access to healthy foods, stable housing, and leisure time for pursuing exercise.
Higher levels of education are also linked to better health outcomes. A 2020 study that compared levels of education to a range of healthcare outcomes like infant mortality and lifespan found a direct correlation between educational attainment and better health. This connection may be due to the fact that people with higher rates of education are more likely to hold jobs with good health benefits. In addition, people with higher rates of education may be more “health literate” – that is, aware of how to monitor their health, care for their health, and where to seek treatment.
Disparity #2: Racial and Ethnic Factors
Bias toward racial and ethnic minorities persists in medicine, often unconsciously. These biases can lead to poorer-quality treatment. For example, a 2021 study found that Black children with appendicitis did not receive as much pain medication as White children, and that part of this disparity was likely due to unconscious bias. As future physicians, premeds must learn to recognize and mitigate their own biases to provide equitable care.
Disparities based on race are frequently rooted in historical injustices and systemic inequities. The Tuskegee Syphilis Study, conducted by the U.S. Public Health Service from 1932-1972, is just one of many examples of how racism has been institutionalized in the medical field: African American men were recruited to a study that promised to treat them for “bad blood”, and then given only placebos or other ineffective treatments. This continued after the introduction of penicillin, the first antibiotic and an effective treatment for syphilis. More than 100 men died as a result.
Events like this have led to a deep mistrust of the healthcare system in some communities. Premeds should be aware of this history to better understand the fears some patients might have.
Disparity #3: Gender
Women and LGBTQ+ people are disproportionately impacted by health disparities due to their gender or sexual identity. A 2023 World Economic Forum article about health disparities for women reports that women treated in hospitals wait longer to see a doctor and are less likely to be given pain medication than men.
Additionally, the article reported that women are greatly underrepresented as subjects in clinical trials. This leads to a lack of understanding about how women experience different health conditions – for example, heart attacks can present differently in women compared to men.
Disparity #4: Disabilities
The National Institutes of Health have only recently designated people with disabilities as a population impacted by health disparities. However, disabilities can impact healthcare for other conditions in many ways. The World Health Organization reports that people with disabilities are disproportionately likely to die earlier due to preventable health conditions unrelated to their disability.
This disparity may be due to a range of factors:
- Lack of accessible facilities
- Information presented in a format the patient can’t process (e.g., not having a sign language interpreter present for a person with a hearing disability)
- Negative attitudes of healthcare providers
It’s estimated that 12% of all U.S. citizens live with a disability, and people can become disabled at any time due to accident or illness. Understanding how disability affects access to care is crucial for premeds.
Disparity #5: Language Barriers
America is a nation of immigrants. An American Medical Association article from 2021 notes that as many as 25 million people in the U.S. have limited English proficiency. The article describes research which shows that differences in language proficiency can negatively impact provider-patient communication – patients may not understand instructions, and providers may misunderstand patient complaints, leading to significant medical errors.
Research also shows that language barriers can cause significant psychological stress for patients, even with a family member acting as interpreter. Premeds can familiarize themselves with working across language barriers by making efforts to pursue volunteer or clinical experience within immigrant communities.
Equipping Yourself to Recognize Disparities
While healthcare disparities are a significant challenge, they are not insurmountable. As a future doctor, you can:
- Proactively work to develop an understanding of different cultures
- Seek clinical experience that exposes you to communities impacted by disparities
- Get involved with efforts to promote policies that address healthcare disparities for different communities
- Keep up with research into health disparities and their impact
Understanding healthcare disparities is not just about improving statistics; it’s about providing compassionate, equitable care to every patient who walks through the door. By educating yourself early in your healthcare career about these disparities, you can prepare to help build a healthcare system that truly serves everyone, regardless of their background or circumstances.