Читать книгу The Science of Health Disparities Research - Группа авторов - Страница 78

The very high cost Americans pay for healthcare, almost $10 000 per person annually, does not buy longevity [1]. Investigators attribute 50% of health overall and more than 75% in certain diseases to behavior. Though health‐adverse behaviors may contribute to a majority of the causes of mortality, we have no comprehensive explanation of why and how the behaviors begin or are sustained. Structural drivers, including social context, environment, money, and power, are not neutral forces. Populations at risk include racial and ethnic minority groups; those of low socioeconomic position; those who live in rural, underserved areas; and members of the SGM communities. To seek elimination of health disparities is to seek health equity. Promising practices include creating consortia to make advances against a specific priority and create a new cadre of investigators; adapting and adopting readily available technology to health‐enhancing purposes; listening to underresearched communities and acting on their needs; and promoting positive health behaviors through multilevel approaches that advance the cycle of better care, better health, and lower costs. Understanding mechanisms and pathways responsible within the social and environmental context for behavior may afford new approaches to health disparities. Inequalities in health are a measure of any country, and failing to eliminate those disparities risks allowing them to widen.

The potential fallout from failing to change the status quo is not inconsequential. President and CEO of the Joint Center for Political and Economic Studies Ralph B. Everett said in the organization's report on managing chronic disease by mobile phone, “What is clear … is that … innovations are vitally important and needed as part of a comprehensive strategy to reduce and eventually eliminate health inequities” [37].

We cannot fail to accept the challenge posed by the significant contribution of behavioral determinants to health. We must act on what the research tells us about how to recognize, attack, and eliminate health disparities. Just as the public health advances of the twentieth century advanced longevity, public health initiatives of the twenty‐first century must work to ensure that those gains are not eroded but extended, and that the health quality improvement achieved is not only sustained but enhanced.