Structural Inequality and Its Impact on Health: An evaluation of the structural and systemic forces that lead to unequal health outcomes in pediatric type II diabetes.
In our country, the richest in the world, a significant share of our population does not have access to the resources they need to maintain healthy lives. Health researchers have focused on addressing the impact of the social processes that determine an individual‘s health status. It is now time to look at the causes of the inequality. The escalating prevalence of diabetes in school-aged children and its consequences is a serious and unresolved challenge. When I began my examination of the issue, I focused on individual risk factors and was convinced that if we teach prevention, the pediatric diabetes rate would come down. As I have learned, prevention and treatment have had limited success to date, in part because interventions have focused on isolated factors and adopted a one size fits all approach. My examination took a turn and I became convinced that risk factors must be addressed within a complex, individualized (not generalized) system of biological, social and environmental factors. The answer was to address not only individual risk factors but social determinants of health. However, my study of health disparities has challenged me to think even larger. Beyond the basic conceptual model of how diabetes and other preventable diseases show up with more prevalence in some racial/ethnic groups, I have been forced to look at "why". And if we know how to intervene conceptually, why is it not working? Why are rates continuing to escalate upward? And finally how have inequalities in health, specifically childhood diabetes, come to be and how might we more comprehensively address them? My belief is that we cannot have any real or lasting change in devastating health inequality without addressing the system as a whole with all its components. Health disparities are rooted in the historical, social, economic, and political infrastructure of our daily lives. I have presented a framework, grounded in theory, to address health inequality at its core.Master of Public Healt
