Paths to success: optimal and equitable health outcomes for all.
Abstract:U.S. health disparities are real, pervasive, and persistent,     despite dramatic improvements in civil rights and economic opportunity     for racial and ethnic minority and lower socioeconomic groups in the     United States. Change is possible, however. Disparities vary widely     from one community to another, suggesting that they are not inevitable.     Some communities even show paradoxically good outcomes and relative     health equity despite significant social inequities. A few communities     have even improved from high disparities to more equitable and optimal     health outcomes. These positive-deviance communities show that     disparities can be overcome and that health equity is achievable.     Research must shift from defining the problem (including causes and     risk factors) to testing effective interventions, informed by the     natural experiments of what has worked in communities that are already     moving toward health equity. At the local level, we need     multi-dimensional interventions designed in partnership with     communities and continuously improved by rapid-cycle surveillance     feedback loops of community-level disparities metrics. Similarly     coordinated strategies are needed at state and national levels to take     success to scale. We propose ten specific steps to follow on a health     equity path toward optimal and equitable health outcomes for all     Americans.
National Center for Primary Care, Morehouse School of Medicine, 720 Westview Dr., Atlanta, GA 30310, USA. GRust@msm.edu
George
G
Rust
Robert S
RS
Levine
Yvonne
Y
Fry-Johnson
Peter
P
Baltrus
Jiali
J
Ye
Dominic
D
Mack
D005006:Ethnicity; D006285:Health Planning / Q000379:methods*; D054624:Health Status Disparities; D006801:Humans; D008913:Minority Groups; D044469:Racial Groups; D012935:Social Justice; D012959:Socioeconomic Factors; D014481:United States