Ex­treme dis­par­i­ties

Ac­cess to care, health lit­er­acy blamed for gaps

Modern Healthcare - - THE WEEK IN HEALTHCARE - Mau­reen Mckin­ney

It won’t sur­prise many that poor health is linked to lower lev­els of in­come and ed­u­ca­tion, but the mag­ni­tude of the dis­par­i­ties sur­prised the lead au­thor of a fed­eral re­port. “There are three- and four- and five-fold dif­fer­ences in some ar­eas, and I don’t think I was ex­pect­ing them to be that large,” said Amy Bern­stein, a health ser­vices re­searcher at the Cen­ters for Dis­ease Con­trol and Preven­tion’s Na­tional Cen­ter for Health Sta­tis­tics, which re­cently re­leased its 35th an­nual re­port on the na­tion’s health, a com­pi­la­tion of data from a num­ber of sources. A sum­mary of the key find­ings is high­lighted in the chart be­low.

This year, the Na­tional Cen­ter for Health Sta­tis­tics ded­i­cated a sec­tion to the im­pact of so­cioe­co­nomic sta­tus on health in­di­ca­tors in­clud­ing obe­sity, de­pres­sion, and to­bacco use.

For ex­am­ple, the rate of eden­tulism, or lack of nat­u­ral teeth, was 23% for peo­ple liv­ing be­low poverty, five times the rate among the high­est in­come group. De­pres­sion rates also were five times higher among those be­low poverty level.

The gaps arise from a con­flu­ence of fac­tors, in­clud­ing lack of ac­cess to care and poor health lit­er­acy, said Mar­cie Wright, di­rec­tor of re­search sup­port ser­vices at Virginia Com­mon­wealth Univer­sity’s Cen­ter on Health Dis­par­i­ties.

“It’s not just one thing,” Wright said. “It’s the re­la­tion­ship of all of these to­gether—ac­cess to care, ac­cess to sup­port, com­mu­ni­ca­tion with physi­cians—that lead to dis­par­i­ties and make them hard to ad­dress.”

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