Achieving health equity in America

Health disparities are both real and deadly, but disparities are not inevitable. The causes of health disparities are complex, and their elimination will require multi-dimensional interventions. We have developed a three-dimensional model for the elimination of health disparities. The foundation of public health is surveillance, which is the first dimension. We must continually measure racial-ethnic disparities in each specific disease, in its risk factors, and in outcome-relevant quality of care. The second dimension is research into the causes of disparities and potential intervention points to eliminate disparities. These causes and potential intervention points can be in the individual's biology or their behavior, or in their physical and social environment, or in the healthcare arena (quality and access). The third dimension is intervention, which requires moving from what we know to what we do. Translation must not only take knowledge from the bedside, but to the curbside and the countryside, into each community and into each home. We can achieve health equity in America, but first, we all must care enough, know enough, do enough, and persist long enough.