Defining health disparity: The Alberta Context

BACKGROUND: In Canada, disparities in health remain a national concern despite being among the healthiest people in the world, with generally high standard of living and universal access to high quality health care. The increased need to address health disparities in Canada came into play following the 2002 and 2003 First Minister's Health Accord with commitments to reduce disparities, increased health system cost driver due to health disparities, inconsistency with Canadian values and its burden on individuals and groups. Studies have demonstrated that aboriginal, racial and ethnic minority populations have higher morbidity and mortality than the white, majority population. OBJECTIVE: To define health disparity in the Alberta context. SEARCH STRATEGY: Search strategies were developed from the following databases: Medline, Econlit and sociological Abstracts. Google was the primary web-based resource searched for grey literature and books. The following websites were hand-searched based on information from published literature: Healthy People 2010, US Center for Disease Control, Minority Health and Health Disparities Research and Education Act of 2000, Royal Society for Public Health London, Health Disparities Task Group of the Federal/Provincial/Territorial Advisory Committee on Population Health and Health Security Canada and Arizona Public Health. Date of last search was December 1990 and limited to articles published in English. SELECTION CRITERIA: Articles and sources were selected based on originality of their definition COLLECTION AND ANALYSIS: Two reviewers assessed all potentially relevant citations for inclusion and methodological quality. The primary outcome measure was to identify criteria for defining health disparities. The 12 determinants of health indentified by Health Canada, measurability and accessibility were the basis for the review of definitions. MAIN RESULT: Selected definitions of health disparities/inequalities from 11 sources were identified; Whitehead 1990, Carter-Porkas & Baquet 2002, Kawachi, Subramanian & Almeida-Filho 2002, Sratton, Hynes & Nepaul 2007, Graham 2004, Healthy People 2010, Center for Disease Control (US), National Center for Minority Health and Health Disparities. Most sources based their definitions on identified areas of disparities. REVIEWERS' CONCLUSION: In Alberta disparities exist in the following areas; income, unhealthy social behavior (smoking), hospitalization, mortality, gender, ethnicity, birth outcomes, mental health, employment opportunity, obesity and injury rates. Based on the areas of disparities in Alberta, health disparity is defined as Health disparities can be defined as preventable differences that occur by socioeconomic status, geographic area, health outcomes, gender, ethnicity and employment opportunities that are experienced by certain population groups”.