April is National Minority Health Month, a time to remember that achieving universal access to health care does not mean we will have eliminated health disparities. Much of health care is about trying to fix the damage done by people’s unhealthy physical and social environments. The impact of the social determinants of poor health still falls disproportionately on people who face historical disadvantages—including African-Americans, Native Americans, Latinos and other minority groups.
For example, the Department of Public Health reports that adjusting for age, Latinos in Massachusetts are three times as likely as white non-Hispanics to report being in poor general health, almost twice as likely to have been diagnosed with diabetes (and the true rate is probably higher), almost twice as likely to have a disability that limits their daily activities and almost two-and-a-half times as likely to have had a stroke. This is in spite of lower rates of smoking and problem drinking. These disparities are not primarily attributable to health care, but to lack of economic opportunity and the social and physical environments in which people live.
Universal, high-quality health care is essential, but it is only one element of a just and healthy society. Health equity is the central civil rights issue of our time. It means creating a society where everyone can be healthy regardless of race, ethnicity or other personal characteristics. When everyone’s potential can be fulfilled, we’ll all be better off.
The writer, a medical sociologist, is an assistant professor of medicine at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston.