Prioritizing health disparities in medical education to improve care

Abstract

Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities.

Figure 1

Proportional contributions of determinants of health to premature death.

Figure 2

Health and social service expenditures by nation as percent of gross domestic product (GDP).

Figure 3

A model for the embrace of diversity and inclusion as a significant component of the mission to achieve health equity.

Figure 4

The healthcare continuum from research to translation to implementation. Training a new workforce in translational research may be key to addressing disparities in health care.