The Importance of Health Education in Reducing Health Disparities

The data on health and health care disparities in the U.S. is both staggering and somber.

According to KFF, a nonprofit, nonpartisan organization that conducts health policy research and polls:

• Nonelderly Alaska Native (21%) and Hispanic (19%) people were more than twice as likely as their White counterparts (7%) to be uninsured as of 2021.
• Roughly, 6 in 10 Hispanic (62%), Black (58%), and Alaska Native (59%) adults went without a flu vaccine in the 2021–2022 season — compared to less than half of White adults (46%).
• At birth, Alaska Native and Black people had a shorter life expectancy (65.2 and 70.8 years, respectively) compared to White people (76.4) as of 2021, and Alaska Native, Hispanic, and Black people experienced larger declines in life expectancy than White people between 2019 and 2021.
• Black infants were more than two times as likely to die as White infants (10.4 vs. 4.4 per 1,000), and Alaska Native infants were nearly twice as likely to die as White infants (7.7 vs. 4.4 per 1,000) as of 2021.
• Black (13%) and Hispanic (11%) children were over twice as likely to be food insecure as White children (4%) as of 2021.

Unfortunately, statistics such as these are not uncommon. How can we reduce health disparities in this nation? We sat down with Rikki Byrd, PhD, faculty member in the School of Health Sciences at Purdue Global, to discuss what health disparities are and how we can reduce them.

What Are Health Disparities?

Healthy People 2030, an agency within the U.S. Department of Health and Human Services, defines a health disparity as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.”

The U.S. Centers for Disease Control and Prevention (CDC) define health disparities as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.”

Health care disparities, Byrd says, “refer to differences in health care that different groups of people have access to that stem from broader inequities.”

According to Byrd, these disparities are preventable with the right resources and interventions. “However, systemically, it has been very challenging to make much of a difference,” Byrd says. “Those disparities typically affect marginalized populations and their ability to achieve their optimal state of health and wellness in comparison to other populations.”

Disparity Factors

Byrd identified six main factors affecting both health disparities and health care disparities:

1. Race and Ethnicity

There is evidence that racial and ethnic minorities tend to receive lower quality of care than nonminorities. According to the Center for Medicare Advocacy, the populations that have customarily been underserved in the American health care system include African Americans, Latinos, Native Americans, and Asian Americans.

“Black and Hispanic Americans are more likely not to have health insurance or be underinsured. They also have less access to the same level of quality care than White Americans have,” Byrd says.

According to the CDC, minority patients also experience greater morbidity and mortality from various chronic diseases than nonminorities. “There are higher rates of chronic diseases such as heart disease, hypertension, obesity, asthma, stroke, cancer, and diabetes,” Byrd says. “A lot of these diseases have a genetic component, but there are some social determinants of health that are part of the norm in some of those populations that also affect health.”

2. Socioeconomic Status and Income Ability

The CDC defines “socioeconomic status” as “the absolute or relative levels of economic resources, power, and prestige closely associated with wealth of an individual, community, or country.” It comprises such things as income, education, employment status, and other factors.

According to the CDC:

• Low socioeconomic status is associated with higher risk of developing and dying from cardiovascular disease.
• Socioeconomic factors affect one’s ability to engage in health activities, afford medical care and housing, and manage stress.
• At the community level, lower-income neighborhoods are less likely to have access to high-quality health care.

“People with lower incomes and less education are more likely to be underinsured or uninsured and therefore have different access to quality health care,” Byrd says.

“If they are of a lower economic status, they may not have easy access to transportation. They're limited to public transportation or walking. All of these factors play a role: where these individuals are living, the quality of the air, the quality of the water, the quality of the buildings, access to being able to go outside to a park or gym that is not out of their price range,” says Byrd.

3. Living in a Rural Area

“When you live in a rural area, you may not have access to specialists who are located far away,” Byrd says. “There could be a transportation issue. People who live in an urban area may be able to access public transportation if there isn't a specialist in their immediate area.”

In a 2023 report titled “Why Health Care Is Harder to Access in Rural America,” The U.S. Government Accountability Office found:

• Many hospitals in rural areas are closing or have closed, and rural areas without hospitals also generally had fewer health care providers overall.
• Rural residents often lack insurance coverage, which is associated with reduced access to care and increased risk of poor health outcomes.
• Many rural residents may turn to telehealth services when care isn’t available locally. However, as of 2019 (the latest year for which data is available), at least 17% of people living in rural areas lacked broadband internet access, compared to 1% of people in urban areas.

4. Having a Native Language That Is Not English

The ability to communicate well with one’s health care provider is vital. When a patient and provider don’t speak the same language, Byrd says it can lead to misunderstandings and missed care.

According to a report from BMC Public Health, research demonstrates that those whose preferred language is not English have worse health and health care outcomes, including:

• Decreased access to health insurance
• Longer lengths of stay in the hospital
• Greater readmission rates
• Worse management of chronic disease
• Greater risk of having adverse medical events
• Lower overall satisfaction with their care

“There’s a trust component to this as well,” says Byrd. “If a health care provider is not communicating in a patient’s native language — the language they are most comfortable speaking in — that patient may be less likely to trust the provider.”

5. Physical and/or Mental Disabilities

“People who are differently abled may have difficulty accessing care,” says Byrd. “They may have difficulty navigating the physical environment, or maybe they lack comprehension of follow-up care instructions.”

According to a report published by the National Library of Medicine, adults with disabilities are 4 times more likely to report their health to be fair or poor than people with no disabilities.

“People with disabilities consistently report higher rates of obesity, lack of physical activity, and smoking,” the report states. “Some also have higher rates of newly diagnosed cases of diabetes, and their percentages of cardiovascular disease are 3 to 4 times higher. Although they have higher rates of chronic diseases than the general population, adults with disabilities are significantly less likely to receive preventive care.”

6. Sexual Orientation and Gender Identity

According to multiple studies, lesbian, gay, bisexual, and transgender (LGBT) people are more likely to face health-related challenges and disparities, including discrimination.

“They may not trust health care providers,” Byrd says. “They may not feel like health care providers are listening to their unique needs. Many of the questions on the intake forms are directed to those who are heterosexual and cisgender” (NPR defines “cisgender” as “an adjective that describes a person whose gender identity aligns with the sex they were assigned at birth”).

The Office of Disease Prevention and Health Promotion confirms this: “Collecting population-level data is key to meeting the needs of LGBT people, but not all state and national surveys include demographic questions on sexual orientation and gender identity. Adding comprehensive demographic questions to surveys can help inform effective health promotion strategies for LGBT people.”

Is There a Solution to the Health Disparity Crisis?

What’s the solution? How do we reduce and eliminate these disparities? This is a complicated, multifaceted problem, and a comprehensive and multilevel strategy is needed to eliminate these disparities. Byrd recommends a three-pronged approach:

1. Increase representation of different ethnicities and backgrounds in the health care field and raise providers' awareness of disparities. Improving the cultural and racial diversity of the health care workforce and offering cultural competency training to health care providers is an excellent start.

“Train health care providers to interact with underserved populations,” Byrd says. “Build health care communication from a more culturally humble approach. Help address the systemic challenges, inequities, and specific health education interventions that can truly make an impact.”

2. Increase health literacy in affected communities. Health care systems and public health agencies should shoulder the responsibility of implementing or expanding educational programming in at-risk communities.

“[Doing so may require] taking specific steps and putting on a different lens specific to certain demographics and what their challenges may be,” Byrd says. “For example, maybe part of a community’s traditional way of cooking uses a lot of salt. Health educators can develop very specific interventions for that population with individuals who look like them and talk like them. Make sure the community is represented not only in outreach but in print and digital ads, too.”

3. Address systemic inequities. To fulfill the vision of a nation free of disparities in health and health care, the entire system needs an overhaul.

“Equitable resources are needed to address systemic inequities, but there’s no cookie-cutter approach,” Byrd says. “We can begin by looking at specific communities and developing a more individualized approach regarding which health education interventions are best suited to the population.”

On a larger scale, health care providers and organizations should be encouraged to engage with lawmakers to begin remedying the systemic inequities. One example is expanding internet access in rural areas; numerous bills have been introduced in Congress to expand broadband to rural communities, and in July 2022, the U.S. Department of Agriculture announced that it was investing $401 million to provide access to high-speed internet for 31,000 rural residents and businesses in 11 states.

“I think we're doing a much better job at this than we have in the past,” Byrd says. “We must continue to vary the approach to make sure these communities are represented.”

Health Education Programs Make a Difference

Community-based health education programs are designed to reach people outside of traditional health care settings, including schools, worksites, and community-based organizations. The people who administer these programs go by many titles, but “health education specialist” is the most common one.

Workers in this field usually hold at least a bachelor’s degree in health education and promotion. If you aspire to a leadership role in the field, you may need a master’s degree in health education and promotion.

These degree programs teach critical-thinking and problem-solving skills that enable you to assess the needs and resources in various settings — as well as the capacity for health education and promotion in those settings.

“Degrees focused in health education position the graduate to understand communication, the differences in communication, and health promotion strategies that are most impactful to different population groups,” Byrd says. “You learn the tools you need to apply them in the field — techniques and strategies on how to develop, implement, and evaluate health programs and education strategies specifically targeted to address health inequities.”

Who Is a Good Fit for This Field?

To find fulfillment in a health education career, the first requirement is that you have to want to make a difference.

“Good health educators have an innovative mind and can be more strategic about developing an individualized approach,” says Byrd. “We don’t need those with an antiquated thought process; we need people who understand that an individualized approach is based on different communities, demographics, resources, and mindsets. We need innovators.”

Make a Difference in the Lives of Underserved Populations

If you want to be a part of the solution to the health care disparity crisis in this nation, consider earning an online bachelor's in health education and promotion or an online master's in health education and promotion at Purdue Global. Learn how to advocate for the health and wellness of underserved populations and make a real difference in their lives. Reach out today to learn more about these programs and how earning a degree can help you reach your career goals.

---