A core aim for improving health care is to provide equitable care or "care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status" (IOM, 2001). We believe that an essential ingredient in the effort to increase health equity and reduce health disparities is eliminating health literacy barriers. The challenge of aligning health care system demands and complexities with individual skills and abilities across the spectrum of public health and clinical delivery will be difficult, but critical in the effort to achieve health equity.In this paper, we intend to demonstrate that the concepts of health literacy, health equity, and health disparities are connected, both in practice and in research. We also explore work that can be done at their intersection through the use of examples and selective review of data. Finally, we intend to convey three important messages:
Achieving Health Equity by DesignDisparities in health outcomes by race and ethnicity and by income status are persistent and difficult to reduce. For more than a decade, infant mortality rates have been 2 to 3 times higher among African American populations, rates of potentially preventable hospitalization have been substantially higher among African American and Latino populations, and the complications of diabetes have disproportionately afflicted African American and Latino populations. 1 These and other disparities have persisted despite recognition that inequity costs the economy an estimated $300 billion per year. 2 In addition, health disparities threaten the ability of health care organizations to compete fiscally as insurers increasingly base payments on quality and outcomes, such as reducing preventable admissions and readmissions.A common explanation for long-standing disparities is the challenge of addressing social determinants of health, including income inequality, poor access to transportation, inadequate educational quality, and substandard housing.
The National, Heart, Lung, and Blood Institute convened a Think Tank meeting to obtain insight and recommendations regarding the objectives and design of the next generation of research aimed at reducing health inequities in the United States. The panel recommended several specific actions, including: 1) Embrace broad and inclusive research themes; 2) Develop research platforms that optimize the ability to conduct informative and innovative research, and promote systems science approaches; 3) Develop networks of collaborators and stakeholders, and launch transformative studies that can serve as benchmarks; 4) Optimize the use of new data sources, platforms, and natural experiments; and 5) develop unique transdisciplinary training programs to build research capacity. Confronting health inequities will require engaging multiple disciplines and sectors (including communities), using systems science, and intervening through combinations of individual, family, provider, health system, and community-targeted approaches. Details of the panel’s remarks and recommendations are provided in this report.
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