This spring, headlines in the U.S. blared a grim statistic: Thanks to the COVID-19 pandemic, average life expectancy in the country had declined by a full year. Not only that, the report from the U.S. Centers for Disease Control and Prevention revealed a more troubling story of inequality in the pandemic’s toll. For Black, indigenous and Latinx Americans, the projected life expectancy decline was far worse than for white Americans — for Black men, it was a full three years.
That the burden of illness and death has been borne unequally across America, however, came as no surprise for Virginia Commonwealth University experts working in the field of health disparities.
“these social determinants…are shaping health outcomes,” says Marcie Wright of VCU’s Center on Health Disparities.
The CDC defines 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.” Identifying and eradicating these disparities is a monumental challenge, but VCU is committed to the effort. “At its most fundamental, health disparities contribute to a significant difference in quality of life and actual premature mortality,” says Peter Buckley, M.D., dean of the VCU School of Medicine and executive vice president for medical affairs at VCU Health. “That is anathema to health care and to our aspirations to advance the health of the nation and the health of the commonwealth.”
UNEQUAL AT BIRTH
A range of groups and individuals suffer these disparities — the elderly, the disabled, racial and ethnic minorities, immigrants, members of the LGBTQ community and those living in underserved rural communities. And a closely related factor, known as “social determinants of health,” influences who’s most likely to suffer most. Income, education level, health insurance coverage, geographical location and transportation access all factor in. But other things, less easily measured — health literacy or living through years of discriminatory housing and education policies — also contribute. The complex interconnection among these varied determinants is evident in the fact that the neighborhood where you are born can set the course of your health for life. In census tracts only a few miles apart in the U.S., life expectancy can differ by as much as 30 years.
“What we see across the board is that these social determinants, regardless of whether you live in the inner city or a rural community, are shaping health outcomes,” says Marcie Wright, Ph.D., administrative director and director of research support services for VCU’s Center on Health Disparities. “If we desire to improve health disparities, we must focus on addressing social determinants.”<
Read more in the VCU alumni magazine