Health disparities are defined in Healthy People 2020 as
a particular type of health difference that is closely linked with social, eco- nomic, and/or environmental disadvantage. They adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion. (Office of Disease Prevention and Health Promotion, 2011b)
During the past 2 decades of Healthy People, the overarching goals have focused on health disparities. In Healthy People 2000, this goal was to reduce health dis- parities among Americans. In Healthy People 2010, it was to eliminate, not just reduce, health disparities. In Healthy People 2020, that goal has been expanded even further “to achieve health equity, eliminate disparities, and improve the health of all groups” (Office of Disease Prevention and Health Promotion, 2011b).
Many dimensions of disparity exist in the United States, particularly in health and health care. If a health outcome, such as the incidence of a health problem, is seen in a greater or lesser extent between populations, there is a disparity. It is crucial to recognize that social determinants, which can also be viewed as “demographic disparities” have a profound impact on health out- comes of specific populations (Office of Disease Prevention and Health Pro- motion, 2011b). This situation will be further illustrated in the forthcoming chapters. In each of Chapters 9–12, there will be numerous examples of the existing health and demographic disparities.