Module Components

• Overview

Topics

• Definitions
• Social Determinants of Health
• Health Disparities
• Social Justice and Ethics
• Role of the Public Health Nurse

Nurs 467 - Community / Public Health Nursing

Module 2: Foundational Concepts: Social Determinants, Social Justice and Ethics

HEALTH DISPARITIES

Health disparities are gaps or differences in health outcomes in one group compared to another. Underserved populations often have less wealth, education and fewer economic opportunities, which explains some of why they experience worse health outcomes. However, health disparities occur for a number of reasons and any population is subject to differences in health. Some disparities have biologic explanations and cannot be avoided. Other differences are the result of systemic or institutional factors, and are known as health inequalities (or health inequities). Health disparities affect us all and nurses should be aware of differences in health for all population groups.

HEALTH CARE DISPARITIES

Socioeconomics provides some of the explanation for why health disparities occur but what happens when well educated; wealthy minorities suffer similar health outcomes as those who are worse off? For these minorities, racism and discrimination may explain the health disparities. This type of health disparity is related to a difference in the quality of care received rather than access and is called a health care disparity.

Health Care Disparities are an example of social injustice. Health care disparities are defined by Smedley (as cited in Maurer and Smith, 2009) as “racial or ethnic differences in the quality of health care that are not due to access related factors, clinical needs, preferences, or appropriateness of intervention. We usually think of disparities related to access, driven by factors like insurance, income, transportation and others.” Health care disparities may exist even among the insured. They exist due to biases, discrimination, stereotyping and provider uncertainty.

Not all health disparities are unjust (health inequalities), but many are. Not all health inequalities are because of differences in quality of health care, but some are. As public health nurses, we strive to make the inner circles a smaller proportion of overall disparities.

Health Equity

“Health equity is achieved when every person has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances.” (CDC, 2015).

 

Achieving health equity requires more than universal access to healthcare. It requires a commitment to creating the social, economic and educational conditions whereby all can thrive.