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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
5031.0: Wednesday, December 14, 2005 - 9:15 AM

Abstract #103109

Can disparities be eliminated without vulnerabilities reduction? The case of syphilis and coronary heart disease

Nilesh Chatterjee, PhD, Health & Kinesiology, Texas A&M University, Mailstop 4243, READ Bldg 159H, College Station, TX 77843-4243, (979) 845 3497, nileshchatterjee@yahoo.com

The public health relevance of Healthy People 2010 goal of eliminating health disparities remains unquestionable, but its actual attainability is questionable. The cases of syphilis and coronary heart disease (CHD) are examined using research synthesis methodology and the oppositional approach of Disease Elimination (DE)/ Health Production (HP) to understand the nature of public health understanding and practice. DE is individual-reductionist method relying on early diagnosis and treatment, clinical settings, symptomatic approach to addressing diseases; HP pays attention to social, cultural, economic factors that produce health in the community. Despite waning of syphilis and CHD epidemics in the US, and reduced burden borne by the majority; both diseases have clustered into vulnerable subgroups of the population with relatively less medical and non-medical resources. Systematic examination of published literature in mainstream databases - Medline, PsycINFO and Sociological Abstracts –reveals DE as the dominant approach favored by almost four out of five public health publications. Disease epidemics exhibit the property of sedimentation with respect to populations; with certain sub-groups bearing disproportionate burden of disease as overall prevalence decreases. The sedimentation property of diseases helps clarify the inability of most control efforts to eliminate disparities. While diseases sediment our control efforts remain at the surface as dominant medical/clinical measures only tap the upper layers of the population with their much studied availability/accessibility limitations. New approaches that synthesize clinical access with vulnerability reduction programs will ensure the attainability of USDHHS goal of disparities elimination.

Learning Objectives:

Keywords: Health Disparities, Public Health Research

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Strategies for Improving Health in Underserved Populations

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA