10.3 Epidemiology in the US: Health Disparities by Social Location
10.3 Epidemiology in the US: Health Disparities by Social Location
Kathryn Burrows and Kimberly Puttman
Doctors and medical professionals focus most on the health of an individual. Sociologists and public health professionals focus on the health of groups. This specialty is called epidemiology, the study of disease and health and their causes and distributions. Epidemiology can focus on the differences between neighborhoods, states, or countries. As we look at health in the United States, we see a complex and often contradictory issue. On the one hand, as one of the wealthiest nations, the United States fares well in health comparisons with the rest of the world. However, the United States also lags behind almost every industrialized country in providing care to all its citizens. This gap between the shared value of health and unequal outcomes makes health and illness a social problem.
Sociologists and others who study human health have a detailed model that helps them make sense of health in groups. This model is called the social determinants of health. More specifically, the social determinants of health are the circumstances in which people are born, grow up, live, work, and age and the systems put in place to deal with illness (World Health Organization 2013). While ethnicity may seem to correlate with these elements, it is misleading to assume that all members of a specific racial group will experience the same health outcomes (Whitemarsh and Jones 2010). Instead, while certain diseases are linked to racial identity, lifestyle factors such as smoking and diet also play a role. These, of course, are also influenced by racial identity! These circumstances are shaped by a wider set of forces: economics, social policies, and politics.
Unpacking Oppression, Healing Justice: Social Determinants of Health and ACES
Sociologists and health researchers use two different models to predict health outcomes. Social determinants of health measure the social factors that may impact a community’s health outcomes. Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur in childhood (0-17 years). The ACEs model measures the amount of trauma a child experiences and describes the impact of trauma on health outcomes. Trauma is a person’s (or group) response to a deeply distressing or disturbing event that overwhelms one’s ability to cope. Trauma causes feelings of helplessness, diminishes self-esteem and limits a person’s ability to feel a full range of emotions and experiences (Onderko 2018). Let’s examine both of these models.
Social scientists and health professionals use this model of social determinants of health to describe the social factors that influence the health or lack of health of different social groups. The Centers for Disease Control (CDC) created the model in Figure 10.6. We see that access to quality health care influences how healthy you might be. Whether your neighborhood is located next to an oil refinery, as descri