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Reaping the Fruits of Research: Promoting Health Equity for All

The desire for good health is universal, common to men and women of all cultures and races. Moreover, good health for all citizens is essential if the United States is to continue to prosper. As we approach the year 2000, it has become scientifically possible to help people become physically healthier for a greater number of years than could be dreamed of at any other time in history. Unfortunately, improvements in medical knowledge alone are not sufficient to ensure that all Americans reap the fruits of medical knowledge. Despite our success in eliminating many diseases, a myriad of health problems remains. We continue to search for cures, not only for emerging health problems such as HTV/AIDS, but also for such familiar health problems as cancer, the common cold, substance abuse, and smoking-related illnesses. These continue to pose health risks and consequences for the rich and poor alike. For certain diseases, including HIV/AIDS, breast cancer, and diabetes, the burden of morbidity and mortality falls disproportionately on the poor and medically underserved. Those particularly at risk include members of minority groups, elderly persons, those dwelling in sparsely populated rural and densely populated inner-city communities, and all those who do not have access to or the ability to avail themselves of modern medical expertise and biomedical and technological advances. Moreover, because a greater proportion of women than men lack health insurance coverage in the United States, it is not surprising that women and their dependent children are particularly vulnerable to disease and debility. Lack of access to medical care, medical knowledge, and health insurance are three barriers that explain many of the disparities in health status between poor families and those who have the economic means and knowledge to seek and receive health care. For example, women of color are only about onefourth of the female population in the United States, yet they are overly represented among the uninsured. In 1995, close to half the 19 million uninsured women in the United States were women of color. Therefore, it is not surprising that "sizable proportions of the subpopulations of women of color report that they do not avail themselves of preventive health tests such as Pap smears and mammograms on a regular basis."2