When does a difference become a disparity? Conceptualizing racial and ethnic disparities in health

Abstract

Definitions of racial and ethnic disparities fall along a continuum from differences with little connotation of being unjust to those that result from overt discrimination. Where along this continuum one decides that a racial difference becomes a disparity is subjective, but the magnitude of the injustice is generally proportional to how much control a person is perceived to have over the cause of the difference in health. The degree to which one sees environmental factors and social context as shaping choices has important implications for the measurement of disparities and ultimately for directing efforts to eliminate them.