Health Inequalities: Trends, Progress, and Policy

I have selected 2 discussion posts from my peers, based on the previous writing, please write 100 word response each to both.
1)Health Inequalities: Trends, Progress, and Policy
The Bleich et al. (2012) paper introduction provides a well-cited approach to describing the use of terms like health inequalities and health inequity by Organisation for Economic Co-operation and Development countries. Throughout the paper, the United States and the United Kingdom sections include trends, policy efforts, and policy commitments on race/ethnicity and socioeconomic status. Lastly, Bleich et al. (2012) conclude the paper with examples of progress and neutrality by policy commitments to eliminate health inequalities and the need for further research to capture differences between subpopulations.
Views and Impressions
The topic of health inequalities is often controversial due to its ties with political and social views. Bleich et al. (2012) allude to this distinction in the first sentence of the paper’s abstract. The definition of health inequalities can differ based on the individual or country. Still, a common understanding is a disproportionate or underserving of health resources to a particular population (whether racial or socioeconomic). These statements are solely based on my lived experiences and may differ from my health data management peers. Before reading portions of this paper, I was aware that health inequalities exist outside of the United States, just not privy to the facts. After reading the paper, I had to acknowledge my bias when searching for portions to read. I was very interested in how the United States was portrayed and compared. I was not surprised by the time trends for the United States presented in this paper.
When reading this week’s discussion, my first impression was ambivalent because health inequalities have an emotional connection to me. Personally, I did not want this discussion post to present an emotional response. However, I failed to write a post that seemed authentic without including some portion of my perspective. In 2021, this paper holds relevance regarding healthcare inequalities and social justice in the United States.
Bleich, S. N., Jarlenski , M. P., Bell, C. N., & Laveist , T. A. (2012). Health Inequalities: Trends, Progress, and Policy.
2)The article on Health Inequalities: Trends, Progress, and Policy was fascinating. It beautifully describes the time trends in health inequalities and commitments made by various developed countries, including the USA, to eliminate health inequalities and progress.
Health inequalities generally have been described in terms of disproportionate disease burden or behavioral risk factors experienced by subgroups of the population. Apart from the view that health inequalities represent a societal injustice, inequalities are also harmful from an efficiency viewpoint. Adding to the burden are the direct costs( i.e., medical spending) and indirect costs (i.e., lower productivity due to illness and premature death).
The article used a series of national-level data sets to describe the trends in health inequalities beginning in 1980 among adults aged 20 and older. The data were age-adjusted and stratified by gender, race/ethnicity. or SES, where population subgroup information is available. Three broad categories of health indicators -mortality (i.e., infant mortality, all-cause mortality, and life expectancy at birth), behavioral risk factors (i.e., smoking, drinking, physical activity, and fruit/vegetable consumption), and metabolic factors (e.g., obesity, hypertension, and diabetes) were used, and data were presented in tables. U.S data was obtained from the National Center for Health Statistics (mortality), National Health Interview Survey and Behavioural Risk Factor and Surveillance System (behavioral risk factors), and National Health and Examination Nutrition Survey (metabolic conditions). There were two limitations to the data presented. First, data sets lacking information by subgroup may mask important differences by gender, race/ethnicity, or SES. Second, the data presented here do not distinguish between native-born and immigrant populations.
I wanted to focus on the table on policy commitments to address health inequalities by country and especially that of the US. The first one dates back to 1980 with recommendations and priority setting. The action step was started in 1991 with the policy ‘Healthy people,’ which is every 10 years and was presented again in 2001 and 2011. Healthy people 2020 (2011) set a national health objective to achieve health equity, eliminate disparities, and improve all groups, by 2020 and also identified four key health measures. It recommended that national health objectives be measured by health status, health-related quality of life, determinants of health, and health disparities. . Affordable Care Act was also part of the policy commitments made in 2010.
Methods to measure and infer relationships between stated policy goals and observed trends in health inequalities will need more research. Despite a wealth of literature describing health inequalities and policy commitments to address them, there is surprisingly little high-quality evidence for the effectiveness of policy interventions to address them. There is also no universal agreement about which types of data collection and methods can best connect policy-making to practice. The article also highlights some key methodological and data collection issues. Measuring policy effects over time is a challenge, as seen by Spain’s example where Gini Coefficient was used to study socioeconomic inequalities. Although the policy objective of reducing social inequalities was achieved in Spain, Spain did not achieve a concurrent decline in health inequality between different strata. One explanation for the disconnect was the time lag between implementing policies to reduce social inequalities and health inequalities. Large gaps remain in our understanding of the mechanisms underlying health inequalities and the most effective methods for evaluating progress toward reducing or eliminating health inequalities. The article also gives some directions for future research to address the gaps. Finally, the article indirectly tells us the immense potential of data mining knowledge, interpretation, and practical uses.
Bleich, S. N., Jarlenski, M. P., Bell, C. N., & LaVeist, T. A. (2012). Health inequalities: trends, progress, and policy. Annual review of public health, 33, 7–40.