Cardiovascular Disease Disparities

Paper Summary:

The number of existing cases of high blood pressure is nearly 40% higher in blacks than in whites and its effects are more frequent and severe in this population. Recent emphasis on racial/ethnic health disparities in the field of public health has led to a call for the development of socio-ecological approaches toward the elimination of cardiovascular disease disparities, however solutions to the problem are typically directed at health behavior change. This paper examines policies addressing hypertension disparities enacted at the federal level during the last five years, provides an overview of the problem definitions and solutions framed to set the agenda for these policies, explores the role of key policy actors in setting the policy agenda for the reduction of hypertension disparities, and makes recommendations for a different problem definition (less individualistic) with plausible solutions.

From the Paper:

"African Americans are disproportionately burdened with disease morbidity and mortality associated with hypertension.1 The existence of these racial disparities warrants public health policy attention for two reasons: first, the constitution delegates the "responsibility to protect and promote the welfare of the public" to the government (Scutchfield & Keck, 1997) and the existence of these disparities suggests that the welfare of some citizens is not being protected; second, the ethical framework for public policy development, which includes the egalitarian perspective of justice, holds that "everyone should have equal access to both the benefits and burdens arising from the pursuit of health" (Longest 1998); however, current research on disparities highlights inequalities in access to employment, education, housing, and healthcare as underlying reasons for gaps in health status (Office of Disease Prevention and Health Promotion, 2000; Ren & Amick, 1996; Kawachi, Kennedy & Wilkinson, 1999)."

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