New Research Sheds Light on Health Disparities

health equity

Five recent publications by Thomas LaVeist, PhD, offer new insights into equity and health, a topic for which he is known as a national and global leader. 

LaVeist, a professor and chair of the George Washington University Milken Institute School of Public Health’s Department of Health Policy and Management has played a key role in documenting the major gaps existing between African Americans and whites in rates of mortality due to heart disease, prostate cancer, diabetes, and stroke. He has been at the forefront of research investigating the persistent differences and the role that social issues play in fostering them.

“Addressing health inequalities has become increasingly important as the United States trends toward becoming a majority-minority nation,” LaVeist and colleagues at the Johns Hopkins University and the University of California at Berkeley wrote in a recent publication in Annual Review of Public Health. LaVeist was the lead author of that paper, “Relative Roles of Race Versus Socioeconomic Position in Studies of Health Inequalities: A Matter of Interpretation.”

“An abundance of research has documented health inequalities by race and socioeconomic position (SEP) in the United States,” LaVeist and his colleagues said in the Annual Review of Public Health publication. “However, conceptual and methodological challenges complicate the interpretation of study findings, thereby limiting progress in understanding health inequalities and in achieving health equity. Fundamental to these challenges is a lack of clarity about what race is and the implications of that ambiguity for scientific inquiry.”

Nationally representative data highlights health disparities

A recent publication in the Annals of Epidemiology describes a study LaVeist led using data from the U.S. Centers for Disease Control and Prevention’s (CDC’s) nationally representative National Health and Nutritional Examination Survey. The research team, including members from Johns Hopkins University and the University of Maryland at College Park, calculated racial differences in hypertension, high cholesterol, diabetes, and obesity and assessed interactions between race and socio-economic status.

Their paper, “Race disparities in cardiovascular disease risk factors within socioeconomic status strata,” shows that African Americans had significantly higher rates of hypertension, diabetes, and obesity than whites. The analysis also revealed that race disparities in obesity were larger among those with incomes greater than $100,000 and those who are college graduates. Disparities in diabetes were observed among in the highest, but not the lowest socioeconomic status groups. 

Two other recently published studies report data from the Exploring Health Disparities in Integrated Communities (EHDIC) study in Southwest Baltimore, for which LaVeist served as the principal investigator. The Journal of Urban Health published a study led by LaVeist titled “The Role of Social Context in Racial Disparities in Self-Rated Health.” He and his colleagues at Johns Hopkins University and the University of Maryland at College Park compared the self-rated health reported by EHDIC community members with responses from the CDC’s National Health Interview Survey (NHIS). The research team reported that while African American respondents to the NHIS had higher odds of reporting fair or poor health compared to whites, the EHDIC participants reported no differences in self-rated health.

LaVeist served as a coauthor on “Race, Vigilant Coping Strategy, and Hypertension in an Integrated Community,” published in the American Journal of Hypertension. He and his Johns Hopkins University colleagues found that the prevalence of hypertension was high in the racially integrated EHDIC community and there were no racial differences. In stratified analyses, however, bothersome discrimination alongside vigilant coping was associated with higher odds of hypertension among African-Americans and lower odds among whites.

LaVeist also served as a coauthor on “Prevalence and correlates of major depressive symptoms among black men with prostate cancer.” Published in Ethnicity and Disease with colleagues from Johns Hopkins University and Texas A&M, the article defined major depressive symptoms as ≥16 on the 20-item Center for Epidemiological Studies-Depression (CES-D) scale. The team reported that approximately one-third of the African American men in the study had major depressive symptoms. “Clinicians should pay closer attention to the mental health status of Black men with prostate cancer, especially those who are younger and those who have undergone radiation beam treatment,” the team wrote.