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Mace & Crown | February 19, 2018

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Health Inequality in America Diminishing?

Justin K. Thomas | Contributing Writer

Health disparities between citizens in the United States are diminishing, but there still continues to be gaps. Photo by Thomas Barwick


According to the World Health Organization, health inequality, or what is defined as the differences in health statuses or the distributions of health determinants between population groups in the U.S., is steadily diminishing due to advancements in modern medicine.

The U.S. Department of Health and Human Services stated in its annual report that, “access to health care has improved dramatically led by the reductions in the number of Americans without health insurance and increases in the number of Americans with a usual source of medical care.”

However, researchers like College of William & Mary assistant professor of Sociology and health disparity expert, Elyas Bakhtiari, are continually seeing a high degree of variations within certain demographics like African-Americans, people living in rural parts of the country and other factors such as income and education level.

“I think it’s accurate to say that racial health inequalities have improved some,” Bakhtiari said. “But the trend depends on which type of inequality. Income-based mortality inequalities have been increasing in recent years, and there is a long way to go.”

Bakhtiari states that health disparities are not just a problem for America, but are also a challenge for other nations around the world.

“Health inequalities are a problem everywhere,” he said. “Even in countries with universal health care coverage. Researchers still find inequalities in health outcomes which are tied to income, education and often minority status.”

According to Bakhtiari, the concept of health disparity in the United States affects every single person in the country to some extent or another.

“This is an issue that affects everyone,” he said. “People often assume that health inequalities refer to the gap between those without health insurance and everyone else. But in reality, we see inequalities even among those who have access to health care. Sociologists often use a ‘ladder’ metaphor. If we think of societal inequality as a ladder, with the richest at the top and the poorest at the bottom, every rung of the ladder has better health than the one below it and worse health than the one above it.”

Quoting a recent study conducted by the Virginia Commonwealth University, Bakhtiari noted two neighborhoods in Richmond, Virginia as an example of where health disparities may exist at a local level. Statistically speaking, residents in the Westover Hills area live longer than residents of the Gilpin area of the city.

“Life expectancy in the city’s healthiest neighborhood is about 83 years,” he said. “In the unhealthiest neighborhood of the same town, the life expectancy is only 63 years a 20-year difference.”


A Public Information Officer for the city of Richmond, George Jones acknowledged that there are health disparities within the city and listed factors for causes. However, Jones also stated that the municipal government and its community partners are proactively taking measures to shrink the gap for all residents.

“Contributors to health disparities in Richmond generally include poverty, negative cultural habits, lack of knowledge and practice of healthy lifestyles, adoption of unhealthy behaviors, and lack of health insurance,” Jones said. “There have been and presently are several efforts to mitigate health disparity in Richmond. The city administration, community partners, local health services institutions, and the public health department are working together to reduce health disparities through policy development, public education, interventions to encourage healthier mindsets and adoption of healthy behaviors.”

Bakhtiari also notes that people affected by significant health inequalities in America have diminished chances at a stable socioeconomic future, therefore, limiting personal and professional achievement.

“Health inequalities impact other aspects of life,” he said. “It is not hard to imagine how being sick can lead to missed work and fewer job prospects. But there is also evidence to suggest that poor health early in life, or even the health of your parents, can have long-term effects on economic success and mobility.”

As the new presidential administration settles into the White House, some experts in the fields of medical sociology believe that future policies regarding health care may actually increase the number of health disparities between people of the United States, according to Bakhtiari.

“I can’t speak for [everyone in the field of medical sociology], but I would say that many experts who do study public health in America are concerned with the new administration’s plans,” he said. “Future policies could worsen health inequalities, not only through the government’s attempts to repeal the Affordable Care Act without a viable replacement but also through other strategies and executive orders that may make life harder for vulnerable groups in the United States.”

As of May 4, the American Health Care Act of 2017 was approved by the House of Representatives and awaits endorsement from the Senate which only needs 51 votes to pass instead of the usual threshold of 60 votes prior to being signed or vetoed by the president, according to