Differences in health among population groups are called health disparities. Health disparities that are deemed unfair, or stemming from some form of injustice, are called health inequities. Different groups and communities can have markedly different levels of health. Some populations can have higher rates of cancer, for example, while others might be more likely to be obese or use tobacco. These differences in health or medical conditions can have a profound impact on the public health of a community. Health disparities negatively impact whole groups of people that already face significantly more obstacles to maintaining good health, often because of specific social or economic factors, such as gender, socioeconomic status, disability, religion, mental health status, and many others. The causes of health disparities are numerous and complicated in the broad field of public health. Since health in poorer countries is a comprehensive notion that is strongly correlated with many variables, it is difficult to identify the specific factors that lead to some of these differences. The complicated problem of health outcomes is a result of the complex interactions of social, economic, environmental, and cultural factors. The various factors that affect health—from socioeconomic position and environmental factors to access to healthcare, education, and water—combine to produce a nexus that affects community well-being. A renowned public health researcher Camara Phyllis Jones used a gardening analogy in the American Journal of Public Health to illustrate just how this happens. Imagine, for example, two flower boxes: One with new, nutrient-rich soil and another with poor, rocky soil. Seeds planted in the nutrient-rich soil will flourish, while seeds in the poorer soil will struggle. As the flowers go to seed, the next generation will drop into the same soil, experiencing similar struggles or success. As this happens year after year, one box of flowers will always be more vibrant than the other due to the original condition of the soil. A particular group of diseases called Neglected Tropical Diseases (NTDs) are a clear example. These diseases serve as a poignant illustration of health disparities perpetuated by environmental factors. This diverse group of over 20 conditions such as scabies, leprosy, elephantiasis, and others predominantly affects the most impoverished communities globally, creating a stark divide in health outcomes. The prevalence of NTDs is intricately tied to environmental determinants, with the lack of access to clean water and proper sanitation facilities serving as primary catalysts for their transmission. These diseases thrive in conditions where basic hygiene infrastructure is lacking, perpetuating a vicious cycle of illness and poverty. Often affecting poorer populations in low-resource settings, NTDs exemplify the intersectionality of environmental and socio-economic factors in shaping health disparities. Addressing the root causes of these neglected diseases necessitates a comprehensive approach that encompasses not only medical interventions but also concerted efforts to improve environmental conditions, thereby breaking the cycle of poverty and illness that characterises the communities most heavily burdened by NTDs. Closing the gap in health outcomes proves to be a complex challenge, as the underlying causes often exhibit multi-layered intricacies. Achieving lasting solutions demands a holistic approach that extends beyond merely treating the symptoms. It entails a concerted effort to tackle the root causes while also addressing the contextual factors that give rise to health disparities. Improving economic stability and equality stands as a crucial pillar, recognising the profound impact of socio-economic status on overall well-being. Ensuring universal access to clean water and sanitation facilities becomes paramount, recognising their pivotal role in preventing a spectrum of diseases. Quality education emerges as a transformative force, empowering communities with knowledge and resilience. Concurrently, access to medical care must be democratised, transcending socio-economic barriers. Augmenting health literacy becomes a linchpin, fostering an understanding of preventive measures and promoting informed decision-making. To bridge the gap in health outcomes, a comprehensive strategy that encompasses economic empowerment, educational equity, and healthcare accessibility is imperative, addressing the multifaceted nature of health disparities on all fronts. The concept of Health in All Policies is a collaborative approach to improving the health of all people by incorporating health considerations into decision-making across programmatic and policy areas. This, and other developments such as community-level interventions with community health workers, can be an avenue used to address health and health systems changes to reduce potential healthcare inequities. Addressing health disparities is not only important from an equity standpoint but also for improving the nation’s overall health and economic prosperity. Dr Vincent Mutabazi is an applied epidemiologist. X: @VkneeM
