DNP 835 Reflecting on the “IHI Module TA 102: Improving Health Equity,” describe two causes of health disparities in the United States, or in your local community, that lead to health inequity Re: Topic 3 DQ 1

Increasing rates of obesity are thought to be a major contributor to disparity trends. Obesity rates have risen significantly over the last three decades in all women. While African American women weigh more than whites do on average, part of the BMI difference is explained by height differences. Byrd (2018), evaluates studies using birth cohorts from the mid-1940s through 2002, African American females were found to grow faster throughout childhood and reach their adult height at a younger age, resulting in a shorter final height. Recent evidence also suggests that the stature of African American females may be decreasing. An additional noteworthy trend, thought to be associated with rising obesity rates, is the declining age of menarche in all race/ethnic groups. However, the decline in age of menarche has been greater in African American girls than in whites. These findings present a mixed picture with respect to trends in African American and white women’s overall health. Although life expectancy has increased, except for the most disadvantaged white women, there is some evidence that chronic disease prevalence has increased, especially for those conditions associated with obesity. Some initiatives to help with this are lifestyle and behavioral changes. I propose we make physicians aware of these facts so they can start to implement changes early on in life and not just base everyone off the same BMI scale.

Another issue identified is Aging. Health is an invaluable resource for optimal aging, so much so that some scholars use terms such as “healthy aging” to draw attention to the advantageous position of growing older unencumbered by disease or disability. Some individuals and human collectivities, however, are noticeably challenged to age well because they face a host of threats to health. Within gerontology, research on minority health comparing the health of historically underrepresented minority groups to the majority population has revealed how structural disadvantages challenge individuals to age well. According to Ferraro et al (2017), despite higher health risk profiles than their non-Hispanic counterparts, Hispanic Americans displayed better mental health outcomes, lower prevalence of many chronic diseases, and even lower mortality rates. Given the diversity of human experience, it is crucial to consider physical, social, and historical context, but also to account for the conjoint influence of structure and agency in explaining racial and ethnic gaps in health.

Byrd AS, Toth AT, Stanford FC. Racial Disparities in Obesity Treatment. Curr Obes Rep. 2018 Jun;7(2):130-138. doi: 10.1007/s13679-018-0301-3. PMID: 29616469; PMCID: PMC6066592.

Ferraro KF, Kemp BR, Williams MM. Diverse Aging and Health Inequality by Race and Ethnicity. Innov Aging. 2017 Mar 1;1(1):igx002. doi: 10.1093/geroni/igx002. Epub 2017 May 26. PMID: 29795805; PMCID: PMC5954610.