Jan 21 2013
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‘Of all the forms of inequality, injustice in health care is the most shocking and inhumane.’

-- Dr. Martin Luther King Jr., in a speech to the Medical Committee for Human Rights, 1966

Nalo Hamilton, PhD, RN, WHNP/ANP-BC, is an assistant professor of nursing at the University of California, Los Angeles School of Nursing; and Cheryl Woods Giscombé, PhD, RN, PMHNP-BC, is an assistant professor in the School of Nursing at the University of North Carolina at Chapel Hill.  Both are Robert Wood Johnson Foundation Nurse Faculty Scholars.

file Nalo Hamilton

The New Year has begun and for some 2013 marks a time of celebration and progress, while for others it is a time of uncertainty and despair. As we pause to remember the rich contributions of Dr. Martin Luther King, Jr., we should also reflect on how his legacy can be used to eliminate the health care disparities that so disturbingly affect the underserved and underrepresented in our nation today.

The World Health Organization has determined that geographic locale, ethnicity, education, environmental stress, and access to a health care system are social determinants of health and health inequities. These factors are influenced by the disparate distribution of resources, wealth, and power.

In the United States:

file Cheryl Woods Giscombé
  • African Americans, Hispanic Americans, and Native Americans have rates of diabetes that far exceed those in non-Hispanic whites.
  • African American women are more likely to be diagnosed with advanced stage breast cancer compared to white women and have the highest rate of mortality.
  • Native Americans report more alcohol consumption and binge drinking than other racial/ethnic groups.
  • Hispanic males age 20 or younger have the highest prevalence of obesity compared to non-Hispanic whites and African Americans.
  • African American men and women are more likely to die of cardiovascular disease than non-Hispanic whites.
  • Infant mortality occurs in African Americans 1.5 to 3 times more than in other races or ethnicities.

These health inequities not only affect individuals or specific populations but they also impact the overall health status and health care costs facing our nation. Ethnic disparities in health care cost this nation more than $6 billion per year—a staggering amount in light of the fact that many conditions are preventable. 

For many ethnic minorities, chronic health conditions significantly impact their quality of life.  A reduction in one’s quality of life influences personal, familial, and community wellness.  It also reduces an individual’s ability to contribute to the economy and ultimate well-being of the nation.

‘Life’s most urgent question is:  What are we doing for others?’

-- Dr. Martin Luther King Jr.

Eliminating disparities in health care will require input from all stakeholders: health care providers, educators, community and faith leaders, policy-makers, scientists, funding agencies, corporate leaders, and everyday people. The social determinants that are at the foundation of these existing disparities necessitate system change. An amalgam of economic resources, environmental facilitation, scientific evidence, human compassion, and a healthy dose of inspiration are all essential components.

The African proverb states that it takes a village to raise a child. With regard to health disparities, it will also require ‘all hands on deck.’  But how do we get potentially divergent entities to come together?  How can we avoid procrastination—looking to our left and our right, waiting for someone else to take the lead?

According to Dr. Martin Luther King, Jr.,A genuine leader is not a searcher for consensus but a molder of consensus.  Let’s allow the leader in ourselves to be awakened.  Our nation’s health depends on it.

Tags: Barriers to care: cultural, gender and racial, Black (incl. African American), Cost of care, Human Capital, Latino or Hispanic, Nurse Faculty Scholars, Social determinants of health, Voices from the Field