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.

PATH Video: In Women’s Hands

First launched on World AIDS Day in 2004, this film captures what it means to be women in a world of AIDS – a world where many women have little say about relationships. About sex. About condoms. And few ways to protect themselves against HIV. The film introduces its audience to a handful of scientists and advocates who are racing to curb the loss of future generations from this epidemic through the development of microbicides.

CSIS Video: President Joyce Banda on Women’s Health & Empowerment in Malawi

When Joyce Banda unexpectedly ascended to the presidency of Malawi last April, after the death of President Mutharika, many in her country and around the world wondered what her impact would be as Malawi’s first woman president. Among the many challenges, her government faces high rates of maternal mortality, high total fertility rates, and high HIV prevalence among women and girls, combined with low levels of women’s economic empowerment and widespread violence against women.

CSIS wanted to learn more about how women leaders in Africa are bringing new attention to women’s health and empowerment in their own countries, and to bring those voices into the discussion about U.S. policy priorities for women’s global health. To do this, we sent a small team to Malawi and Zambia in December 2012.

In this video, Malawi’s President Joyce Banda talks to CSIS about the importance of women’s health and empowerment in Malawi.

To learn more visit:

Global Health Weekly News Round-Up

The weekly news round-up for last week is posted below. Apologies for the delay. The holidays keep us all busy!

CDC’s report on its contributions on women’s health is available as the “Review on Women’s Health for the Year 2011” (Source:

Politics and Policies:



Diseases & Disasters

These headlines were compiled by Vani Nanda, MPH Candidate at West Chester University PA.

Spotlight on Maryam Bibi, an extraordinary woman, on International Women’s Day

The twittersphere is abuzz today with tweets from people, government agencies, and NGOs celebrating International Women’s Day.  The call to continue working to improve health and human rights for women across the globe is loud, clear, and multi-voiced.  And although much still remains to be done for women in developed and developing countries alike, the voices of high-profile women and the tireless work of individuals and organizations committed to bettering the lives of women are making great strides.

But while governments and large aid machines attract most of the attention given to work in women’s health, it is often the work of individuals that is the most moving.  Amid all of the “#internationalwomensday” tweets over the course of the day, the one that caught my eye was the Acumen Fund calling attention to Maryam Bibi, an extraordinary woman who has worked for women’s health and education in Waziristan since 1993.

Maryam Bibi, a Pakistani woman, wearing a white shawl and holding a book.
Image courtesy of the Times Online.

Ms. Bibi set up Khwendo Kor (a phrase in Pashto meanings “Sisters’ Home”), an agency in Peshawar that works with women in Pakistan’s Northwest Frontier Province to improve their education, health, and economic well-being.  The organization began in one village with four staff members; now it works in more than 300 cities and has over 340 staffers.1,2,3  Khwendo Kor focuses primarily on social organization, community-based education for women, microcredit, primary health care, and advocacy, and it collaborates with men and local leaders to accomplish its goals.1  It has trained 180 young women as village-based teachers and established 170 community schools, and over 200 women have been given opportunities to begin small businesses through microcredit.2,3  Through her schools, approximately 6,500 girls have been educated, and 3,500 are currently enrolled.3  She has received multiple awards for her work, including the Fatima Jinah Medal (2003) for outstanding women in the social sector and the Star of Excellence National Civil Award (2001) in Pakistan, the UN’s Recognition of Services award (2000), and the ILO’s Human Rights Award (2001).1,2,3

Despite international honor and recognition for her work, Ms. Bibi still faces considerable opposition and danger close to home.  While she enjoys walking to work, she says that “the office vehicle often collects me.”4  Radical religious organizations slander Khwendo Kor through mosques and local media.  Children’s learning centers established by the organization have been blown up.  Their vehicles have been stolen, staffers have been shot at, and fatwas have been issued against them.  Ms. Bibi can no longer stay late in her office because of death threats.  Still, she is not deterred.  “Some people say that I am an elderly lady and that I should be ashamed of myself doing this work: that I should be sat at home and saying my prayers. But as an elderly woman I would like other elderly women to join me because this work is a matter of our children and our future generations and we have to do something to bring about change.” 2