LOVELL’S FOOD FOR THOUGHT – Do We Really Want To Successfully Address Health Inequities?

Are we really addressing the health disparities/inequities gap in a serious and meaningful way?

Dr. Lovell Jones | 1/21/2018, 10:34 p.m. | Updated on 1/21/2018, 10:34 p.m.
Answer this question, given the number of centers focused on health disparities/inequities and the emphasis by major foundations on this ...
Dr. Lovell A. Jones retired as Professor Emeritus from the University of Texas M.D. Anderson Cancer Center

Given the data by some of the most independent agencies, we are lacking leadership in addressing health inequities. I did not say leaders, but true leadership. This country, when it truly wants to solve a problem, accomplishes it. I may be dating myself, but I use the Marshall Plan or the Soviet Union launch of the first orbiting satellite as examples of marshalled and concentrated responses. In both cases, the United States led the rest of the world. Europe was rebuilt and we became number one in space exploration.

In health, we have eradicated basically every communicable disease. We have built a network of cancer centers. I could go on. I truly believe that there is nothing this nation can’t do when it sets it mind to do it. Why not conquering health inequities? Don't set a date like Healthy People (you put in the year, and then move the goal post. Mean what you say and say what you mean.

Some might say I am playing the race card, but it does come down to how we value the lives of human beings. For more than 400 years, we enslaved one group of people in this nation and considered them animals. Even with the passage of the 13th, 14th, and 15th Amendments to the US Constitution, little changed in terms of how we viewed these individuals. As Harold Freeman once said, “The existence of health disparities is not just a scientific and medical issue but a moral and ethical issue.” Addressing health disparities as scientific and medical issues is overly simplistic, and will not result in any significant closing of the health disparities gap. I have been making this argument for more than three decades. Is anyone listening?

Another excellent example is our effort to create centers for research on health inequities/health disparities focused on solving them by bringing a medical and/or public health approaches to addressing health inequities. Starting the early 2000s, the National Institute of Minority Health & Health Disparities launched its first group centers focusing on addressing minority health. Today, there are more centers/institutes funded by the federal government and/or other governmental agencies and foundations than ever before. Yet, as I stated earlier, the gap, with all of this money being directed to addressing health disparities/inequities, the gap is no smaller than it was before 2000.

This is not to say that the people involved are not sincere in their efforts to address this issue; most are. Yet despite all the sincerity and commitment by caring individuals, we must admit that the issue of health inequities among people of color, as well as the poor, still confronts us. What we are doing is NOT working. Yes, we are publishing papers, obtaining more funds and employing more people to work on addressing health inequities. But again, what we are primarily doing is NOT working. For the last decade I have been writing editorial trying to point this out. One of those articles talked about “Street-light Science", that is looking for your wallet under the light, but having lost it in the dark hoping that someone would kick it into the light. We continue to work in our silos, and just by accident we work with others outside of health-related fields who might provide essential methods and/or answers in moving us closer to solving the issue of health inequities. This should not be by accident. It need to be by design.