Terms to Know
- Health disparities
- Adverse conditions
- Translational research
- Community-based participatory research
Health disparities are differences in the incidence, prevalence, mortality and burden of diseases and other adverse conditions that exist among specific population groups.
(National Institutes of Health, 2003)
Incidence refers to the actual frequency and occurrence of a particular condition. For example, one can refer to the number of cases of cancer in a particular county or group or the number of accidents in a county.
Prevalence refers to the estimated occurrence of a disease or condition in a population. Prevalence is often determined through surveys, and scientific methods of sampling are used so that the responses from survey respondents can usually be generalized to the entire population of interest.
For example, surveying carefully sampled groups about their tobacco use or a medical diagnosis (e.g., diabetes) gives a sense of how much the particular condition exists in the overall population. Prevalence data on behavioral health risks are obtained via community health surveys.
Mortality refers to deaths, whereas morbidity refers to illnesses or hospitalizations. Both are often reported as rates.
Burden is a descriptive term referring to the impact of severity of a disease or health condition in a particular group. For example, children have a higher asthma disease burden because asthma affects children more frequently than adults. Persons in rural areas are usually more burdened with issues of access to health care than persons in urban areas with more availability of clinics and health providers. Many diseases burden populations such as the very young and the very old more severely.
Adverse conditions refer to factors that negatively influence health. Adverse conditions related to health disparities are associated with socioeconomic, environmental or access-related factors. For example, poverty and low levels of education are adverse conditions related to poor health status. Barriers in accessing health care, unequal treatment and neighborhood conditions such as unsafe housing and violence are all adverse conditions that negatively impact health. Moreover, unclean water or exposure to toxic substances in the air can cause health disparities among people with different levels of exposure to these adverse environmental conditions.
Translational research is to “translate” basic science discoveries into clinical applications. The National Institutes of Health defines translational research broadly as “the process of applying ideas, insights and discoveries generated through basic scientific inquiry to the treatment or prevention of human disease.”
Translational research refers to a wide spectrum of patient-oriented research that embraces innovations in technology and biomedical devices as well as the study of new therapies in clinical trials. It also includes epidemiological and health-outcomes research and behavioral studies that can be brought to the bedside or ambulatory setting.
Community-based participatory research (CBPR) is “a collaborative process of research involving researchers and community representatives; it engages community members, employs local knowledge in the understanding of health problems and the design of interventions, and invests community members in the processes and products of research. In addition, community members are invested in the dissemination and use of research findings and ultimately in the reduction of health disparities.”
CBPR differs substantially from older research protocols that were not tailored to the concerns and cultures of participants, generally excluded participants/communities from the research process and rarely benefited them directly.
- Recognizes community as a unit of identity
- Begins with and builds on community strengths and resources
- Facilitates collaborative, equitable partnership in all phases of the research, using an empowering and power-sharing process that attends to social inequalities
- Emphasizes shared decision-making and mutual ownership of the research process and products/outcomes
- Promotes co-learning, capacity building and reciprocal transfer of expertise among all partners involved
- Integrates and creates balance between knowledge generation and action for mutual benefit of all partners
- Emphasizes local relevance of health problems and approaches that address multiple determinants of health and disease
- Disseminates findings to all partners and involves all partners in the dissemination process
- Involves a long-term commitment
There are many recognized benefits to a CBPR approach. It joins partners with diverse expertise to address complex problems and increases trust and bridges cultural gaps between such partners. It enhances the relevance and use of data and increases the quality and validity of the research. It also helps ensure that the knowledge gained and interventions developed will directly benefit the community.
Importantly, it also has a strong potential to effect social chance by building capacity within “resource-poor” communities, supporting political advocacy, increasing economic flow into communities and building relevant and sustainable interventions to address disparities in health.
Source: Center for the Study of Cultural Diversity in Health Care, University of Wisconsin School of Medicine and Public Health.