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PBC Library

The NAU library website for the Phoenix Biomedical Campus Library

Health and Healthcare Disparity

 Defining healthcare disparities 

Healthcare disparities refer to the differences in health experienced by people who belong to traditionally underserved social groups. Although the experience of disparities in care is intersectional, persons are most likely prone to disparity due to their race/ethnicity, religion, socioeconomic status, age, location, gender, able-bodiedness, and sexual orientation. (Kaiser Family Foundation, 2018)

In order for practitioners and scholars to best serve healthcare needs, it's important to recognize healthcare disparities, how and why they happen, why they matter, and how they can be addressed. 


 Recognizing disparities 

From the Kaiser Family Foundation:

A complex and interrelated set of individual, provider, health system, societal, and environmental factors contribute to disparities in health and health care. Factors include (but are not limited to):


 Social determinants of health 

Social Determinants of Health by Social Cluster


Federal efforts to reduce disparities include a focus on designated priority populations who are particularly vulnerable to health and health care disparities. These priority populations include people of color, low-income groups, women, children, older adults, individuals with special health care needs, and individuals living in rural and inner-city areas. Again, these disparities do not occur in isolation; rather, they are intersectional, and prone to overlap.

 Patient + Research + Provider 

Even though healthcare disparities are far-reaching, the American Medical Association insists that all providers should address disparities such that they ensure equitable, appropriate, effective, safe and high quality care for all, with no gaps in services based on any medically irrelevant factor (2007, p. 3). In short, providers should seek to end disparities rather than striving primarily to reduce them.​ The AMA has developed 10 guiding principles to assist providers in making evidence-based decisions to battle healthcare. Policies and actions should be:

  1. relationship centered | supportive of the delivery of patient-centered, family-focused, community-oriented care to individuals throughout the life span

  2. culturally and linguistically appropriate | strategies tailored to the unique needs of diverse patient populations

  3. targeted | with a focus on recognized and demonstrated gaps in access to health prevention, health care, safety, and quality

  4. data-driven | making use of both quantitative and qualitative information to inform

  5. transparent, participatory and collaborative | designed in open processes with the input of all key stakeholders and interested constituency groups

  6. both long and short-term | quick fixes are important, but solutions should also aim to resolve underlying causes of disparities and should create permanent structural and financial incentives to prevent the reemergence of disparities

  7. comprehensive | because health care disparities are intersectional, a set of policies to eliminate disparities must be broad-based

  8. judicious in the use of incentives and requirements | both incentives and mandates might have a role in ending disparities, but policy-makers should recognize a preference for incentives, since mandates often risk backlash and long-term failure

  9. fiscally responsible and bi-partisan | eliminating health care disparities is a non-partisan goal that can be accomplished in fiscally responsible ways

  10. monitor and revise | policies to end disparities should be tracked closely over time for both intended and unintended effects so that they can be revised in the future

Inherent in these guidelines are the core principles of evidence-based practice, in which providers should concern themselves with patient interactions by askingaligningacquiring, and appraising information while balancing their expertise with the level of knowledge conveyed in research, and the patients' values and circumstances. Arguably, providers should take particular care to their patients' values and circumstances, as these are both complexly associated with the disparities attributed to a patient's social grouping. 


 Finding the best available research 

PubMed/MEDLINE

The NLM has dedicated resources to helping researchers and providers find information that can help them make informed decisions that best suit patients prone to inequity in treatment and health. The following search terms are recommended by NLM to assist in accessing information relevant to healthcare disparities research:

  • "health disparities"
  • "healthcare disparities"
  • "health status disparities"
  • "inequalit*"
  • "inequit*"
  • "socioeconomic factors"
  • "minority groups"
  • "social determinants of health"
  • racism
  • sexism
  • ageism
  • "ethnic groups"

Collapsed into a search string, they appear as such: "Health disparities" OR "healthcare Disparities" OR "health Status disparities" OR inequalit* OR inequit* OR "socioeconomic factors" OR "Minority groups" OR "Social Determinants of Health" OR racism OR sexism OR ageism OR "Ethnic groups"

The NLM has also created a much more cohesive search strategy that includes MeSH, filters for title and abstract([TIAB]), major topics with no explosions (ie: [MAJR:noEXP]), and a more diverse array of search terms. The complete search strategy can be accessed here. Search results can be accessed by clicking here


The following online resources can help providers make evidence-based decisions that fall within the guidelines set by the AMA and NIH:

 Understanding implicit bias 

Leveraging empathy and humanities to combat bias

Current and emerging research supports the use of empathy and empathic thinking as an intervention to reduce bias in patient-provider interactions (Stewart, 1995; Stewart, et al., 2000; Reiss, 2015; Ariso, 2018). This is a fairly unsurprising idea, in general, but even as empathy is regarded as necessary to care, it is increasingly less likely to be taught in biomedical education. As a result, students are actually less empathetic after leaving medical school than entering it. 

Students at the Phoenix Biomedical Campus are invited to integrate empathy more fully into their education and future practice. Through programs like University of Arizona's College of Narrative Medicine and Health Humanities, students from both NAU and UA learn to "promote compassionate clinical care and value for the patient’s story through narrative medicine methods." In other words, students are encouraged to build empathy, and in doing so, to acknowledge biases (Ross & Lypson, 2015). Cross-institutional opportunities include Celebrating the Humanities through Art (ChArt), a peer-reviewed literary journal published by the Phoenix Biomedical Campus community, and Stories in Medicine, a narrative medicine blog.

Resources for integrating empathy with care

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