Racial Health Disparities and Questions of Evidence

The United States Healthy People 2010 initiative, designed to focus nationally funded health research and care on achieving a set of nationwide goals, was directed toward the elimination of racial and ethnic health disparities. While racial and ethnic disparities are complex (with the health of some minority groups surpassing the national average), the health of black Americans continues to fall short of the national average. By focusing on the presumptions embedded in the design of health disparities research, this chapter addresses why Healthy People 2010 largely failed to reduce racial health inequality. Importantly, in thinking about health inequalities, researchers initially failed to consider how race is socially constructed; how data collection is never value-neutral (see King, chapter 8, this volume); and, finally, the limits of randomized control trials (deductive methods) when it comes to making sense of complex behavioral and structural data. The chapter ends by describing how ethnographic insights can help complicate the assumptions and conclusions of health disparities research.

Promoting Health: Media Advocacy Opportunities in English- and Spanish-Language Masthead Editorials

Purpose. This study examines two newspapers' editorial coverage of issues related to the Healthy People 2010 focus areas and compares the two newspapers. Design. A qualitative study. Setting. Two Los Angeles, California, newspapers. Subjects. The masthead editorials of the Los Angeles Times and La Opinión in the year following the release of Healthy People 2010. Measures. A structured data abstraction instrument was used for descriptive coding. Correspondence to 1 of the 28 Healthy People 2010 focus areas determined whether domestic editorials were about health. Analysis. An ethnographic content analysis. Results. There were 1075 editorials from the Los Angeles Times and 361 from La Opinión; 17% were focused on domestic health issues. Three Healthy People 2010 focus areas dominated: Environmental Health, Injury and Violence Prevention, and Access to Quality Health Services. Ten focus areas did not receive a single mention in the Los Angeles Times, and 19 focus areas lacked editorials in La Opinión. Conclusion. Editorial writers regularly tackled issues related to a Healthy People 2010 focus area. Public health practitioners can meet with their local newspaper editorial board and discuss the nation's health objectives as manifested by Healthy People 2020 and the National Prevention Strategy, thereby promoting policies that support individual and population health.