Health Disparities Expert Speaks at the SPH

Studying health disparities is about correct science, not "politically correct" science, said Nancy Krieger at the school's annual Carl J. Martinson Lectureship in Preventive Medicine.

Krieger, a professor at the Harvard School of Public Health, is a widely noted authority on how race, class, and other socioeconomic factors affect health. She drew on her own work to illustrate some of the challenges of accurately accounting for health disparities in America.

For example, Krieger cited a study of menopause to show the shortcomings of measuring socioeconomic position at only one point in time. Prior research had found no connection between socioeconomic position and early onset of menopause, a risk indicator for cardiovascular disease. But that research measured status only at the time of menopause.

When accounting for socioeconomic status of earlier adult and adolescent years, Krieger's team was able to make the connection, indicating that women of lower socioeconomic position were indeed at higher risk for poor heart health.

"Use the wrong class measure from the wrong time period and you get the wrong answer," said Krieger. "Thinking clearly about class trajectory matters."

To address the notion that health disparities are inevitable, Krieger offered her study finding that the disparities gap in America actually lessened from 1965 to 1980. While noting that reasons for this trend need more examination, she hypothesized that federal initiatives like the War on Poverty and civil rights legislation played a vital role.

"The basic point is that our results refute the view that widening health disparities necessarily accompany improvements in population health," said Krieger. "As our data shows, these inequities are neither inevitable nor intractable.

"If addressing social injustice and its embodied health consequences becomes a priority, we can make progress. Otherwise the inequities will continue to grow."

A Podcast of Nancy Krieger's lecture is available at www.sph.umn.edu/podcast.