Health Disparities

By Timothy F. Murphy, MD, and Henry Louis Taylor Jr., PhD

Good health is not shared equally among the residents of the United States, New York State, and metropolitan Buffalo. African American, Latinx and indigenous populations, in addition to economically disadvantaged individuals of all races and ethnicities, experience striking health disparities. The approximately 100,000 black Buffalonians have poorer health, on average, than Erie County whites. Black Buffalonians are more likely to have serious, chronic, and often preventable diseases with a rate of premature mortality that is about 300 percent higher than whites who live in the Buffalo metro area. In 2020, according to the Robert Wood Johnson Foundation, Erie County's health outcomes ranked 57 out of 62 New York counties, as measured by the length and quality of life. Race-based health inequities are the reason for the poor ranking.

These health inequities result largely from the reality that blacks and whites in metropolitan Buffalo live in separate and unequal neighborhoods. The educational, labor and housing markets interact to produce these marginalized and underdeveloped neighborhoods in which many African Americans reside. Systemic structural racism causes the undesirable social determinants of health found in these communities, which include low wealth, distressed and lead-contaminated housing, limited internet access, under-resourced schools, dependence on public transportation, absence of grocery stores and vital services, poor access to health care, and unkept streets, sidewalks and vacant lots.

Physicians often advise people who suffer from common chronic ailments such as hypertension, diabetes and obesity to get more exercise by taking walks, eating a healthy diet with fresh fruits and vegetables and complying with antihypertensive medications. These lifestyle and pharmacological interventions are challenging when unkept sidewalks make walking dangerous, supermarkets do not exist and low-incomes force choosing between medicine and other vital needs. Blacks are also sometimes reluctant to seek medical attention because of racist encounters with the health care system.

The Jacobs School of Medicine and Biomedical Sciences and the University at Buffalo (UB) are taking a social justice perspective, which views health as a human right. Abolishing the health inequities facing African Americans will require turning their neighborhoods into good places to live, improving access to quality health care and deepening our knowledge and understanding of the health challenges they face.

UB launched the Community Health Equity Research Institute to meet this challenge. The institute’s goal is to perform research to advance understanding of the root causes of race-based health inequities and to develop and test innovative solutions to eliminate them.

The institute arose from a five-year partnership between the African American Health Equity Task Force, a community-based group led by influential pastors and community leaders, and UB. The most significant health impact will come from research and interventions that attack the social determinants of undesirable health outcomes. This community-based strategy requires an interprofessional community of faculty, students and community stakeholders to apply a community-based participatory research model. In this approach, the community guides the research agenda, contributes to the research design, serves on the research team and benefits from the research.

The great universities of the 21st century will be judged by their ability to help solve our most urgent social problems. Health inequities are one of the most urgent problems facing our nation. Our community partners and the Jacobs School are determined to meet this challenge head-on.