It has only been within the last 25 years that the extent of health disparities in America has been fully appreciated. Increasingly, the scientific community has devoted significant attention to the causes—both the simple and the complex—of these life-limiting inequities. We have done a good job in identifying and bringing awareness to the health disparity gaps in America. Now it is time for us as a nation to seriously address and eliminate those gaps. Eliminating health disparities should certainly be at the top of our national health agenda; in addition, it should also be a subset of all our health priorities.
My service on the National Center on Minority Health and Health Disparities Advisory Council at the National Institutes of Health allowed me to see a new vision for health disparities science on a national and global level. However, my work as a family physician in Bayou La Batre, Alabama, allowed me to see the need to translate health disparities science and research into practice.
While the incidence of many diseases and conditions are similar throughout the nation, the rates and outcomes are so much worse in ethnic, racial, and low-income areas. There are also large and increasingly well-identified health disparities suffered by rural populations, the chronic mentally ill, and the economically disadvantaged. The work of many investigators on the social determinants of health, as referenced in this Supplement, has brought new perspectives to the disparities field, suggesting that health and longevity are much more closely linked to economic and social circumstances than ever before realized. This understanding reinforces the importance of connecting research to policy in this area. It is not enough to know: we must also act. The question we need ask today is not whether disparities exist, but whether our hard-earned scientific advances are being transformed into practice effectively—whether neighborhoods have safe playgrounds, walking paths, and access to farmers' markets; and whether families enjoy an equitable share of societal benefits, can find jobs at decent wages, medicines they can afford, and good educational opportunities.
Our success in eliminating health disparities will depend on the reach of our efforts through translation and outreach and on our ability to inspire behavior change for better health outcomes for everyone, especially marginalized and vulnerable populations. Our change will not be done simply out of acts of charity or social justice, but because it is our moral obligation and it benefits the entire nation. We must use our burgeoning knowledge about America's health disparities (knowledge that we've learned over the last 25 years) to design strategies to reduce disparities, extend life, and reduce suffering—the age-old goals of the healing professions. We have new tools and new determination. As scientists and citizens, let the science reported in this volume instruct and stimulate our national commitment to eliminate health disparities in America.