Event Summary | ViTAL Health Disparities Webinar
Edited by Megha Gupta, Elisa Danthinne, and Heenal Marfatia
On Tuesday, June 30th, ViTAL hosted a webinar via Zoom that discussed the topic of health disparities and systemic racism that is often seen in the American health system. Three guest speakers were invited to share their insights and experiences with members of the club and the Northeastern community, in order to better recognize and reverse health disparities within our healthcare system. As Northeastern University’s Healthcare Innovation Core, we aim to focus on all aspects of healthcare while empowering and educating the Northeastern community on the intricacies of health and well-being. In light of the growing Black Lives Matter movement and COVID-19 exposing systemic flaws, we wanted to highlight racism as not just a social issue but as an issue that is deeply concerning to public health and healthcare as a whole. Racism creates significant health disparities between populations and is embedded in public health, along with the weight of social determinants of health. The media’s profound interest in health disparities and the roots of those disparities is a topic that, we felt, deserved further exploration and resolution.
We gladly welcomed Northeastern Professors Dr. Richard Wamai, Dr. Kayoll Galbraith Gyan, and Dr. Neil Maniar to speak about the nature of health disparities from their diverse realms of expertise. Dr. Richard Wamai is a professor of Global Health, Cultures, and Societies at Northeastern in the college of Social Sciences and Humanities with research interests in HIV and AIDS, health systems and policy, as well as neglected tropical diseases in Kenya. Dr. Kayoll Gyan is an assistant professor in the School of Nursing at the Bouvé College of Health Sciences with research experience in cervical cancer and HPV prevention among African American women. Dr. Neil Maniar is a professor of public health practice and director of Northeastern’s Master of Public Health program with interests in social determinants of health, cancer prevention, as well as Urban Health. Four core questions framed our discussion:
- “How would you define health disparities in the United States?”
Dr. Maniar began by stating that there is a key distinction between differences versus disparities in health. Health differences may be due to biological variation between groups or other non-preventable factors. Disparities, however, arise when unequal health outcomes between groups are preventable. Some preventable barriers include access to and quality of care. These addressable conditions can lead to worse health outcomes among populations, and can be characterized by three words summarized by Dr. Wamai: “avoidable, unnecessary, and unfair”.
2. “What are some major misconceptions about health disparities in the U.S.?”
Dr. Wamai shared that a major misconception is the overall perception of health in that these disparities are much larger than most people assume. In fact, the U.S. has the highest variation of life expectancy between populations in the world. The few people aware of this stark variation, namely those working in policy, oftentimes inadequately address the gap and issue of variation. Dr. Gyan highlighted the misconception that people often think disparity is solely caused by race or individual decision. Statements such as “the black population has higher rates of dying from cancer” take away the historical context of health disparities and the racism that underlies them. Conventionally, quality of health is seen as the responsibility of the individual, instead of their larger health system. But persistent funding disparities across healthcare systems serving different communities can be traced as far back as slavery, and in turn, the quality and funding of a healthcare system is a clear contributor to individual health. Furthermore, racism is but a social construct that was created as a way to categorize people and generalize stereotypes and misconceptions. Dr. Gyan deconstructs all this to show that the main cause of health disparities lies in racism, not race itself. Dr. Maniar continues this idea by showing that while health disparities are the product of different domains, from insufficient education to health insurance, the root cause is racism. When we think of health disparities, we are only looking at the tip of the iceberg. Racism constitutes the majority of the iceberg and lays the foundation for disparity. Dr. Maniar ends by explaining how this cycle continues by negatively impacting the biology of individuals, further leading to worse health outcomes.
3. “How have you seen health disparities in the communities that you’ve worked in or completed research on?”
Dr. Gyan began by explaining educational differences in rural and suburban areas, primarily differentiated by levels of funding. The education a child receives is an indicator for their health as they become an adult. For example, higher education leads to higher job income which generally equates to more opportunities and better health insurance. In Boston, home to world-renowned, top-tier universities, some Black and Hispanic students growing up in this same city may be less likely to attend and graduate from such institutions because, as Dr. Gyan put it, “some opportunities provided to some are not given to others”. Dr. Wamai again reiterated the causes of health disparity are low income and low levels of education. Similarly, Dr. Maniar likened education to a tool that can ensure good health for everyone. Education is the fundamental base to acquire knowledge, to develop health literacy, and to allow people to navigate the complex health system. Education acts as social support and social capital — the latter being “the locus of control at the community level” — for the community to advocate for themselves to prevent and address the health disparity. He concludes with the statement: “we need to change the structure of our health system, as the structures themselves are embodiments of historical racism.”
4. “How effective can telehealth or telemedicine interventions be in reducing disparities?”
To introduce the question of whether innovations in healthcare can help mitigate some of the health disparities discussed, ViTAL then brought up telehealth interventions. According to Dr. Gyan, however, individuals from lower socioeconomic classes are less likely to access these sources of health information, sometimes not even having access to the technology and internet behind it, potentially exaggerating the health disparities that already exist. Dr. Maniar added that technology has become a social determinant of health, along with other social factors, such as housing, nutrition, and occupation. In addition to disparities stemming from access to technology, level of trust is also an issue that impacts the willingness to introduce new technologies, especially given historical breaches of trust powered by racism, like the Tuskegee Study. Patients may fear losing their data and privacy, so trust needs to be earned. As new technologies and tools are developed, we must continuously ask ourselves questions: “can the patients effectively use the tools?”, “can the providers and all the other sectors of the health system collaborate with the tools?”, and “would it widen the disparity gaps or help close them?”
The biggest takeaway from the event is that deconstructing health disparities must be tackled head-on from the policy to individual levels, and even addressed in the development of innovative healthcare technology. As aspiring healthcare professionals, we should seek to immerse ourselves in combating injustices in healthcare in a strategic, sensitive, and meaningful way. When asked how we as students can address these health disparities, Dr. Gyan closed with a powerful message referencing the former president of the American Public Health Association, Dr. Camara Jones, who has done extensive work in the role of dismantling racism in achieving health equity. She provided us with 3 of Dr. Jones’ underlying principles to aid in achieving health equity: (1) Believing in the fact that we should provide resources according to need, (2) Valuing all individuals and populations equally, and (3) Recognizing and rectifying historical injustices.
. . .
Thank you to the 60+ attendees for tuning in, and a very special thanks to Dr. Maniar, Dr. Gyan, and Dr. Wamai for such an insightful event!
The event recording is available at this link.
