Despite technological advances and changes in healthcare delivery, some groups in the United States continue to have better health-related outcomes than others. This article discusses health disparities and inequities—differences in health status and healthcare utilization that are influenced by complex social, structural, economic, and cultural factors. It begins by exploring the “problem” with health disparities—what makes them problematic and for whom they are problematic. Factors contributing to health inequities, commonly referred to as social determinants, are then reviewed. Finally, the article considers early 21st-century policy and programmatic responses as well as future directions, including social workers’ role as macro practitioners.
Article
Health Disparities and Inequities
Sandra Wexler and Valire Carr Copeland
Article
HIV/AIDS and People of Color
Michele Rountree and Courtney McElhaney Peebles
Communities of color are disproportionately burdened by the prevalence of HIV/AIDS. Research has shown that race and ethnicity in the United States are population characteristics that correlate with other fundamental determinants of health outcomes. This entry will chronicle the history of the epidemic, report the disparate impact of the disease affecting communities of color, and acknowledge the social determinants of health that contribute to the vulnerability of risk. A call to address the imbalance of health inequities, with a complement of individual-level interventions and new approaches that address the interpersonal, network, community, and societal influences of disease transmission, is discussed.
Article
Suicide and Public Policy
Janelle Stanley and Sarah Strole
The historical context of suicidal behavior and public policies addressing suicide arose simultaneously within the United States, and both reflect a culture of discrimination and economic disenfranchisement. Systems of oppression including anti-Black racism, restrictive immigration policy, displacement of American Indigenous communities, religious moralism, and the capitalist economic structure perpetuate high-risk categories of suicidality. Suicidal behavior, protective factors, and risk factors, including firearms, are examined in the context of twentieth and early twenty first century public policy. Recommendations for public policy will be discussed with consideration for policies that impact communities disproportionately and social work ethics, such as right to die laws and inconsistent standards of care.
