Jan 22 2014
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Overcoming Health Disparities: Promoting Justice and Compassion

By Janet Chang, PhD, an alumna of the Robert Wood Johnson Foundation (RWJF) New Connections Program and an assistant professor of psychology at Trinity College in Hartford, Connecticut. Chang received a PhD from the University of California, Davis, and a BA from Swarthmore College. She studies sociocultural influences on social support, help seeking, and psychological functioning among diverse ethnic/racial groups. Her RWJF-funded research project (2009 – 2012) examined the relationship between social networks and mental health among Latinos and Asian Americans.

“Injustice anywhere is a threat to justice everywhere.”  
Dr. Martin Luther King, Jr. (Letter from Birmingham Jail, April 16, 1963)

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Dr. Martin Luther King, Jr. is well known for his fight against racial injustice, but he also advocated for socioeconomic justice. In particular, Dr. King said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane” (Second National Convention of the Medical Committee for Human Rights, March 25, 1966). His profound words still resonate with us today.

While strides have been made in the past several decades, there continues to be inequality and unequal treatment. In 1978, the President’s commission reported ethnic/racial disparities in health services, and this is still a vexing societal problem in the United States. Compared to non-minorities, American Indians, Latino Americans, Asian Americans, African Americans, and other ethnic/racial minorities are significantly less likely to receive the care that they need and more likely to receive lower quality health care. Ultimately, these disparities compromise the quality of life of most Americans.

The factors that contribute to heath disparities are complex. As a social-cultural psychologist, I also believe that our tolerance for injustice stems in part from larger cultural forces that shape our psychological tendencies, which simplify our world and constrain our ability to take the perspective of others. In the United States, the cultural values that make our society distinctive, independent, and strong may also serve to limit our potential for greater growth—a healthier, happier, and more productive society. 

This individualistic worldview sometimes undermines our ability to focus on the needs of others and be more compassionate. In the face of injustice, too often people have difficulty reconciling their awareness of disparities with their view of a just and fair world. Too often that means less compassion for disadvantaged and vulnerable communities. In the face of disparities, too often people have difficulty talking about differences because they fear that differences divide us.

Despite these challenges, we must persevere and do the work to dialogue and engage others in research, policy, and other applied settings.

We also know that it is not enough to simply talk about health equity. What is most troubling is that, even when ethnic/racial minorities have equal access to insurance or health care, there are vast gaps in health outcomes and health care between non-minorities and ethnic/racial minorities (2002 Report of the Institute of Medicine). This suggests that there are multiple determinants of health outcomes and health care. For example, the lack of professional translators in medical settings can be a major barrier to accessing treatment or receiving quality care among non-English speaking patients. Additionally, stereotypes potentially influence interactions between providers and patients, adversely affecting medical decisions and the nature of care. The bottom line is that ethnic/racial minorities experience significant social disadvantage, and public awareness of the problem is necessary but not sufficient.

Yet, I remain hopeful that positive changes can be made—because of the work of the Robert Wood Johnson Foundation, health care providers, policy-makers, scientists, and countless others. Together we can take action and advance multiple strategies to tackle health disparities.

Dr. King’s legacy reminds us that, to overcome health disparities, we need to promote not only justice but also compassion. Dr. King’s crusade was in part a call for compassion. Rather than resist or deny suffering, all Americans have the capacity for compassion—what makes us fundamentally human. As we honor Dr. King, let us remember that we have to open our minds and our hearts to justice for all Americans. 

Tags: Disparities, Social determinants of health, Barriers to care: cultural, gender and racial, Black (incl. African American), Latino or Hispanic, Asian/Pacific Islander, Human Capital, Voices from the Field, New Connections