Explaining the Relationship Between Minority Group Status and Health Disparities: A Review of Selected Concepts

Purpose: There is growing concern that value-based payment for health care may disadvantage health care organizations that serve populations with social risk. In the broader investigation of social risk factors, including income, education, neighborhood deprivation, and other risks, the focus on rac...

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Main Author: Judy H. Ng
Format: Article
Language:English
Published: Mary Ann Liebert 2019-03-01
Series:Health Equity
Subjects:
Online Access:https://www.liebertpub.com/doi/full/10.1089/HEQ.2018.0035
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author Judy H. Ng
author_facet Judy H. Ng
author_sort Judy H. Ng
collection DOAJ
description Purpose: There is growing concern that value-based payment for health care may disadvantage health care organizations that serve populations with social risk. In the broader investigation of social risk factors, including income, education, neighborhood deprivation, and other risks, the focus on race and ethnicity as a risk factor for disparities in health and health care has diminished. Understanding the independent contribution of minority group status is critical to this discussion. This narrative review discusses four concepts?minority stress, resilience, epigenetics, and life course?that may help explain the contribution of minority group status and its association with health disparities. Methods: We briefly describe each concept and the supporting evidence. Results: Our results indicate that all four concepts have potential relevance for understanding and addressing health disparities. The life course perspective emphasizes the importance of understanding explanatory mechanisms and factors that contribute to health?including biological, physical, and social factors?over a person's life span. Both minority stress and resilience may influence health in either a negative or positive manner that potentially underlies health changes. Exposure to these factors and others may interact with and modify epigenetic regulation?biological processes that impact how our genes are expressed. This may increase the risk of disease and negative health outcomes, particularly among groups that may be at disproportionate risk because of social circumstances and environmental exposure over the life course. Conclusion: Despite these concepts' relevance, more research is needed to assess how they may explain the relationship between minority status and disparities in health. Such evidence is needed to focus interventions and to inform the design of delivery and payment models that can spur actions to reduce disparities.
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spelling doaj.art-a09a344124ff440e93a5bc9d66050b312024-01-09T04:19:03ZengMary Ann LiebertHealth Equity2473-12422019-03-0131476010.1089/HEQ.2018.0035Explaining the Relationship Between Minority Group Status and Health Disparities: A Review of Selected ConceptsJudy H. NgPurpose: There is growing concern that value-based payment for health care may disadvantage health care organizations that serve populations with social risk. In the broader investigation of social risk factors, including income, education, neighborhood deprivation, and other risks, the focus on race and ethnicity as a risk factor for disparities in health and health care has diminished. Understanding the independent contribution of minority group status is critical to this discussion. This narrative review discusses four concepts?minority stress, resilience, epigenetics, and life course?that may help explain the contribution of minority group status and its association with health disparities. Methods: We briefly describe each concept and the supporting evidence. Results: Our results indicate that all four concepts have potential relevance for understanding and addressing health disparities. The life course perspective emphasizes the importance of understanding explanatory mechanisms and factors that contribute to health?including biological, physical, and social factors?over a person's life span. Both minority stress and resilience may influence health in either a negative or positive manner that potentially underlies health changes. Exposure to these factors and others may interact with and modify epigenetic regulation?biological processes that impact how our genes are expressed. This may increase the risk of disease and negative health outcomes, particularly among groups that may be at disproportionate risk because of social circumstances and environmental exposure over the life course. Conclusion: Despite these concepts' relevance, more research is needed to assess how they may explain the relationship between minority status and disparities in health. Such evidence is needed to focus interventions and to inform the design of delivery and payment models that can spur actions to reduce disparities.https://www.liebertpub.com/doi/full/10.1089/HEQ.2018.0035epigeneticshealth disparitieslife courseminority stressresilience
spellingShingle Judy H. Ng
Explaining the Relationship Between Minority Group Status and Health Disparities: A Review of Selected Concepts
Health Equity
epigenetics
health disparities
life course
minority stress
resilience
title Explaining the Relationship Between Minority Group Status and Health Disparities: A Review of Selected Concepts
title_full Explaining the Relationship Between Minority Group Status and Health Disparities: A Review of Selected Concepts
title_fullStr Explaining the Relationship Between Minority Group Status and Health Disparities: A Review of Selected Concepts
title_full_unstemmed Explaining the Relationship Between Minority Group Status and Health Disparities: A Review of Selected Concepts
title_short Explaining the Relationship Between Minority Group Status and Health Disparities: A Review of Selected Concepts
title_sort explaining the relationship between minority group status and health disparities a review of selected concepts
topic epigenetics
health disparities
life course
minority stress
resilience
url https://www.liebertpub.com/doi/full/10.1089/HEQ.2018.0035
work_keys_str_mv AT judyhng explainingtherelationshipbetweenminoritygroupstatusandhealthdisparitiesareviewofselectedconcepts