Glossary – Health Equity

Health Equity

HEALTH DISPARITY is the preventible differences in the burden of disease and early death experienced by certain populations.

HEALTH DISPARITY was once considered to be primarily due to lack of access to healthcare but now increasingly recognized as due to changes in the Brain-Body from traumatic life experiences and from differences in care by healthcare providers.

Prejudice, discrimination, or antagonism directed against someone of a different race, gender, sexual orientation, ability, ethnic background, religion or other quality – based on the belief that one’s own group is superior.

EVERYDAY DISCRIMINATION is the scientific measurement of a person’s life experience of daily discrimination.

The EVERYDAY DISCRIMINATION scale was developed by David R Williams, PhD in 1997 and has been used in over 100 scientific research studies.

As described by Heather Hall, MD, the experience of DISCRIMINATION can result in a “double dose” of TRAUMA for excluded persons.

High rates of experience of EVERYDAY DISCRIMINATION have been shown to correlate with incidence of many serious diseases including hypertension, diabetes, heart disease, cancer and maternal mortality.



IMPLICIT BIAS is unconscious attitudes or stereotypes that affect our understanding, actions, and decisions.

IMPLICIT BIAS (favorable and unfavorable) is activated involuntarily, without awareness or intent.

The concepts of HISTORICAL and STRUCTURAL RACISM and DISCRIMINATION are a recognition that the experience of RACISM and DISCRIMINATION are not just individual perceptions of inequity but public policies, institutional practices, cultural images and behaviors which are built into the structure of the culture and which reinforce social inequity.

Examples include discrimination in economic opportunity, employment, education, housing, healthcare, and the right to marry.


JIM CROW Laws enforced racial segregation in 35 Southern US states from 1877 to the mid-1960’s.

These laws mandated segregation for blacks and whites in public schools, public places, and transportation plus prohibited intermarriage.
JIM CROW legal segregation ended after 1954 US Supreme Court decision Brown v Board of Ed, 1964 Civil Rights Act and 1965 Voting Rights Act – however de facto segregation still exists in America to this day.

The character called JIM CROW was a racist depiction of an African-American man performed in the 1830’s in blackface by a white traveling actor, named Thomas Rice.

For research about the HEALTH DISPARITY impact of JIM CROW SEGREGATION, see:
Krieger N et al,  Jim Crow and Premature Mortality among the US Black and White Population, 1960-2009, Epidemiology 2014.
The study showed enduring impact of a two-fold excess mortality of Blacks even 50 years post-Jim Crow.