Reducing Disparities in Life Expectancy: What Factors Matter?
AUTHOR: Lesley M. Russell, Ph.D. Paper presented at the Roundtable workshop on Reducing Disparities in Life Expectancy, Washington, D.C. (February 24, 2011)
INTRODUCTION: The draft National Prevention Strategy establishes a vision of improving life expectancy and quality of life for all Americans, and sets the goal of reducing and eventually eliminating, health disparities. The World Health Organization defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Individuals may subjectively define health in many ways - as the absence of disease, as psychosocial well-being, or as the ability to function physically and in social relationships. Physiological and behavioral risk factors for illness can be exacerbated by physical risk conditions (such as poverty and pollution) and psychosocial risk factors (such as low selfesteem and isolation) and modified by protective factors (such as strong social networks, meaningful paid employment, good nutrition, and access to effective health services). Together these factors affect the mortality, morbidity, disability, functional independence, well-being and quality of life of individuals, communities and populations. Despite huge spending on health care, the United States consistently receives a poor grade in international comparisons of these risk factors and health outcomes. The existence and persistence of substantial disparities in mortality and morbidity between and among racial and ethnic groups in the U.S. population have been well-documented. Moreover, relatively little progress has been made towards the goal of eliminating these disparities, and in some cases the gaps have grown.