Course Unit | Session 2: Health Disparities: Definitions, Causes, Persistence

Session 2: Health Disparities: Definitions, Causes, Persistence


This session will focus on the current use of the term “health disparity” and explore its presence in early America, and throughout the 19th and 20th centuries. Factors contributing to contemporary health disparities will be explored and whether or not bias exists in the delivery of medical services today.  

Required Readings:

Edward H. Beardsley. Chapter 1, “The health of southern Blacks, 1900-1930.” In: A History of Neglect (Knoxville, TN: University of Tennessee, 1987), pp. 11-41.

Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare (Washington, DC: National Academy Press, 2003), pp. 1-12.

C.P. Jones. Levels of racism: a theoretical framework and a gardener’s tale. Amer Jou Pub Health 200:90:1212-1215.

John F. Dovidio, et al. “Disparities and distrust: the implications of psychological processes for understanding racial disparities in health and health care.” Soc Sci Med 2008;67:478-86.

2011 AHRQ Health Disparities.

Optional readings:

Lundy Braun. “Race, ethnicity and health: can genetics explain disparities?” Perspect Bio Med 2002;45(Spring 2002):159-74.

I Kwachi, N Daniels, DE Robinson. “Health disparities by race and class: why both matter.” Health Affairs 2005;24:343-352.

John Hope Franklin. “Two worlds of race.” In: Race and History: Selected Essays, 1938-1988, pp. 132-152. 


  1. What are health disparities?  Do health disparities exist today?
  2. What are the historical origins of health disparities?
  3. Were health disparities during the 19st century? Before the end of the 20th C? If not, why? If so, what actions were taken to combat them?
  4. What are the current factors that contribute to health disparities?
  5. What is bias?  Is bias conscious or unconscious?  Is there evidence that physicians are biased? Does bias contribute to health disparities?
  6. What is “environment”? Does “environment” contribute to health disparities?
  7. Should we continue to classify persons into “races” as a way to monitor progress in reducing health disparities?