The Severity of Racial Health Inequities

Guest Blogger: Tiffany Gilliam


African American women are more likely to succumb to negative health outcomes than any other race or ethnicity. Health inequities are classified as the differences in health status between one disadvantaged population and a group of advantaged. Numerous social determinants of health are related to health inequities, such as:

  • Socioeconomic status
  • Education
  • Age
  • Sex
  • Race and ethnicity
  • Lack of access to quality healthcare

These factors also increase the risk of cardiovascular disease, high blood pressure, diabetes, strokes and healthcare inequity. Nearly 50,000 African American women die each year from cardiovascular diseases. There is a significant gap in life expectancy for African American women compared to white women.

Research has shown that larger populations, like those found in metropolises, correlate to wider gaps in life expectancy. The county of Philadelphia is one of the most racially diverse counties in the United States. That same county contains one of the most racially segregated cities in terms of access to quality healthcare and positive health outcomes. The Philadelphia population is estimated at 1,560,006 residents: 44.2 per cent of which are African American. A recent study conducted by the University of Pennsylvania examined the patient ratio to primary care physician (PCP) in low socioeconomic neighborhoods. The study revealed a PCP ratio of 3,000:1  in underserved areas of Philadelphia. Given this PCP a question is raised regarding the level of care provided to patients. The patient to primary care physician ratio is high due to several reasons such as shortage of primary care physicians, increased amount of Affordable Care Act-covered patients, and the high density of elderly and chronically ill in underserved areas.

In a recent conversation with Sheila, my esthetician, she stated a previous diagnosis of ovarian cancer. The physician immediately advised a treatment of chemotherapy, without any willingness to answer questions or provide additional information.

Before that treatment occurred, however, Sheila received a second opinion from another physician, which revealed that she suffered from endometriosis, not ovarian cancer. After this conversation, numerous questions were raised.  How many other African American women were misdiagnosed and treated for illnesses they did not have? Why was it so difficult for the doctor to make an accurate diagnosis? How often are doctors encouraging participatory medicine when interacting with patients?

How can public health clinicians improve negative health outcomes amongst underserved African American women populations? It is crucial that health polices are created to enforce the overall well-being of African American women of disadvantaged populations. Health policies that promote affordable education, employment opportunities, and adequate accessible health promotion programs are needed in order to improve fair and equal treatment, along with disease prevention and detection.


 Tiffany Gilliam is a first year masters student in Public Health at La Salle University, with a focus in Maternal and Child Health, Social and Behavior Sciences and Health Equity. Her academic interest includes Global Health, Reproductive and Sexual Health and Public Health Policy. For the past three years, Tiffany has worked as a Behavioral Health Worker at Northeast Treatment Center, providing coping strategies, social skills, methods to reduce impulsive behavior at school to children with Attention Hyperactivity Deficit Disorder (ADHD), Oppositional Defiant Disorder (ODD)/Conduct Disorder and Mood Disorder.