Journal
MOUNT SINAI JOURNAL OF MEDICINE
Volume 77, Issue 2, Pages 166-177Publisher
WILEY
DOI: 10.1002/msj.20174
Keywords
access to health care; disparities in health care; ethnic disparities; health disparities; institutional racism; racial disparities; residential segregation; social determinants of health
Categories
Funding
- Northeast Minority Faculty Consortium
- New York State
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Racial and ethnic disparities in health are multifactorial; they reflect differences in biological vulnerability to disease as well as differences in social resources, environmental factors, and health care interventions. Understanding and intervening in health inequity require an understanding of the disparate access to all of the personal resources and environmental conditions that are needed to generate and sustain health, a set of circumstances that constitute access to health. These include access to health information, participation in health promotion and disease prevention activities, safe housing, nutritious foods, convenient exercise spaces, freedom from ambient violence, adequate social support, communities with social capital, and access to quality health care. Access to health care is facilitated by health insurance, a regular source of care, and a usual primary care provider. Various mechanisms through which access to health and access to health care are mediated by race and ethnicity are discussed; these include the built environment, social environment, residential segregation, stress, racism, and discrimination. Empirical evidence supporting the association between these factors and health inequities is also reviewed. Mt Sinai J Med 77:166-177, 2010. (C) 2010 Mount Sinai School of Medicine
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