Here is some recent medical literature and news related to both the causes and effects of health care inequities and disparities. Use the RSS tool on the JAAPA website to have this column delivered personally to you each month, and be sure to let us know of related developments or information you may come across by writing to j.eddy.anderson@gmail.com. For regular updates on health disparities and inequity literature and news, follow us on Twitter at EquityPA.

From the January 2010 Philosophy, Ethics and Medicine comes Principlism, Medical Individualism, and Health Promotion in Resource-Poor Countries: Can Autonomy-Based Bioethics Promote Social Justice and Population Health? This provocative critique examines the bioethical model of disease and focuses on the possible implication of the bioethical emphasis on individuality and individual-based framing of disease. The authors argue that such a focus risks missing the societal and root causes of disease and health disparity.

The July 2010 Journal of Transcultural Nursing features an insightful look at what the authors call a hidden epidemic of substance abuse in older African-Americans. By examining the interface of environmental, institutional, family, social, and media factors, The Social Determinants of Substance Abuse in African American Baby Boomers: Effects of Family, Media Images, and Environment contextualizes why, according to the authors, there will be 5 million older Americans with substance use disorders by 2010, and almost half will be of African descent.

Black: White Infant Mortality Disparities are Not Inevitable: Identification of Community Resilience Independent of Socioeconomic Status from the winter 2010 Ethnicity and Disease offers an inspiring take on the persistent gap between white and black infant mortality rates. The study identifies particular areas from Massachusetts, New York, and Oregon where data indicate a reduction in racial disparities in infant mortality. The authors conclude with this hopeful statement: “Models for reduction/elimination of racial disparities in US infant mortality, independent from county-level contextual measures of socioeconomic status, may already exist.”

Finally, AMA's monthly Ending Disparities E-Letter features their usual array of compelling items focused on health disparities. The May issue includes a look at the roles of language, culture, and communication; special needs of small practices working on reducing disparities; disparities in treatment of colorectal cancer and epilepsy; the impact of health reform on Asian and Pacific Islanders; and the role of bias in health disparities.
Jim Anderson is a physician assistant in the Department of Neurological Surgery at Harborview Medical Center in Seattle. He is a former chair of the AAPA's Committee on Diversity and a member of the JAAPA editorial board.