Health and health care are distributed unevenly in this country and minority populations often get less of both. Members of minority communities have higher rates of chronic illnesses such as diabetes and hypertension. They have higher rates of many cancers and those cancers often reveal themselves at later stages when they are harder to treat. A black male child born in 2006 will live on average to age 70, but a white male child born the same year will live to 76. A black female child will live to 77, but a white female child will live to 81.

There are no simple reasons for these disparities and there are no simple solutions either. This is not just about health care access, but health care access is important. This is not just about income and education, but income and education are important. This is not just about social class, but social class is important. This is not just about a history of prejudice and discrimination, but that history, and its enduring and painful legacy, are important.

What is known is that it will take a campaign to address and reverse these disparities—a campaign that will require combinations of research and management, evidence and commitment, science and activism. In 2001, the Department of Veterans Affairs created the VA Center for Health Equity Research and Promotion with the explicit goal of identifying, explaining, and eliminating disparities in health and health care in veteran populations and others. Interventions to reduce disparities in joint replacement, in the management of hypertension, in the treatment of mental illness, and in the care of veterans at the end of their life, reflect CHERP’s efforts to advance equity in the health and health care of our country’s veterans and to serve as a model for the nation.

There are no easy solutions to redressing health disparities, but those goals are advanced by sustained efforts, informed by thought and scholarship, and motivated by commitment and passion.

Dr. David A. Asch workPhoto of David Aschs for Veterans Affairs Center for Health Equity Research and Promotion.




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Published on Apr. 21, 2011

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  1. john w cahill April 27, 2011 at 10:05 am

    $11,830.That is what the VA says you can make before you have to pay the co-pay.I,on ss disability,make @12,216 a year.I have to borrow every month from Payday Advance to put food on the table.Forget about buying clothes.Recently,i was kept overnight at a VA hospital,due to chest pains caused by stress.My doctor ordered my meds as well as the hospital Now a $400.bill sits in front of me and they want payment.These meds are keeping me alive,but i’m wondering if it’s worth it.If the VA takes a lump sum payment from my $1,018 per month check,it will make me homeless.This is when i think about all the Foreign Aid we give out.I am not alone.Maybe suicide on the steps of the VA hospital will wake somebodt up. John W.Cahill

  2. Mike April 22, 2011 at 10:27 am

    Dear CHERP/Dr. Asch;
    Veterans’ issues abound – why do you spend VA tax dollars addressing problems outside of VA’s sphere of influence? What factors dictate that you include populations outside of VA when the need for improvement is so great within your organization? How many priority one veterans like myself have been forced out of VA care and into Medicare by the massive weight of a bureaucracy that is incapable of looking at its own need for improvement?
    When, Sir, will VA publish a study that actually addresses defects and shows some effort on VA’s part to deal with them? I have seen VA’s statistical reports and have yet to find any that are not skewed toward self-promotion.
    The last time I visited a VA doctor, he told me he’d be leaving the VA soon. I asked why. He told me that he did a rotation at a VA emergency room, had a veteran come in with heart failure, and watched the man die because no one on staff could be bothered to come in and treat him at 3:00am. I asked him if there was anything he could do about it, and he looked at me and said, “I’m only one doctor.” He went on to tell me that he had refused pain medication to an obviously-addicted veteran; had been pulled aside and told that he’d be fired if he didn’t give veterans the pain medications they requested. In addition to his upset about the death, he said he could not participate in the bureaucratic supply of street drugs any more. Of course, I suppose your own job would be threatened if you actually focused on internal VA health equity research, but until professionals stand up and act professionally, yours and other VA research jobs will be forever mired in spouting inapplicable statistics.
    VA as an organization has evolved to a point that it concentrates on self-sustaining self-promotion at the expense of the veterans it was created to serve. That, Sir is a sad situation, both for your career and for us veterans.

    I knee-jerked and sent the following tongue-in-cheek note to the person who referred me to your article. If you are capable of recognizing your position in the VA organization, you might get a kick out of it – if not it’ll just tick you off.

    Here it is:
    Interesting – VA gives a statistic unrelated to themselves and targets something outside their control for improvement – next up for solution is global warming…???


    Dr. Michael Randall Farquar announced today that most US landfills will explode by the year 2015 if American veterans do not immediately rid themselves and their neighbors of dogs and margarita blenders. Asked how VA will accomplish this goal, Farquar said that a minor VA budget increase of 400 billion dollars should cover the outreach campaign.
    “Landfills near large cities are the most vulnerable,” Farquar said, “Those little baggies used for poop-scooping will reach critical mass sometime in late 2014. Other areas, such as farm land where dogs roam freely, will simply begin to catch fire sometime in 2018.”
    Dr. Farquar had no comment on why blenders put veterans at risk, referring media to a VA telephone number which had options for English (1), Spanish (2), and Swahili (3). This reporter was able to get through to a VA representative who said he was an orderly at the VA morgue in Balderdash, Idaho and had no clue about blenders, but could direct me to the VA Public Information Office, which referred me to a Dr. Farquar of the Department of Statistical Redundancy Department.
    Congress is in emergency session and currently arguing over whether VA will include ammunition supplies in the 400 billion dollar budget increase. Republicans think it’s a good idea because many pissed-off veterans own guns, while Democrats think it’s a bad idea because they believe many pissed-off veterans own guns.
    Meanwhile, the Blender Society (BS) has hired additional lobbyists because the news has prompted the re-activation of the House Un-American Activities Committee. Most blenders are manufactured in China, and therefore are Communist. The Committee will be headed by a former B-52 tail gunner, winner of five Purple Stars.

    …and we paid taxes to employ the guy who studies what VA can do to address problems outside VA’s control…!

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