Tuesday, November 27, 2012

Understanding Structural Inequities, Disparities and Disproportionality...

Two things always surprise me about writing a column for a newspaper: who reads it and who likes what they read.

Those who agree don't always take the time to write. But there are those who will always let me know that they agree - or disagree - with what I've written. People are free to disagree. There are some whose comments sometimes make me rethink my position. Others clearly think I have more space than I do to express an opinion (the column length is 630 words). 

This month was no exception. 

There were those who replied who clearly agreed and appreciated the perspective. Others who are obviously still smarting from their candidate's failure to win the election, were less inclined to agree, or had what they thought, were salient criticisms. 

For instance some had real problems understanding the column's references to 'structural inequities and disparities'. Which is particularly interesting since Texas' Republican dominated state legislature clearly understands what these terms mean. They even set up a address the issues resulting from the problems they create...

"The Center for the Elimination of Disproportionality and Disparities was created by Senate Bill 501 in 2011 to help address disproportionality and disparities in Texas health and human services. Senate Bill 501 established the center as the Texas State Office of Minority Health to assume a leadership role in working with state and federal agencies, universities, private groups, communities, foundations, and offices of minority health to decrease or eliminate health and health access disparities among racial, multicultural, disadvantaged, ethnic, and regional populations." 

"Senate Bill 501 provides for a comprehensive approach and allows Texas to maximize resources and produce better results through the development of recommendations for strategies that cut across every system that contributes to disproportionality and disparities for the same populations. The legislation also established the Interagency Council for Addressing Disproportionality which is composed of representatives from various state agencies and community-based interested parties, including former foster care youth, representatives from the medical community, and representatives from community- and faith-based organizations."

"Disproportionality is the overrepresentation of a particular race or cultural group in a program or system compared to their representation in the general population. Disparity is the condition of being unequal and refers to the difference in outcomes and conditions that exist among specific groups as compared to other groups due to unequal treatment or services. A health disparity is a particular type of health difference that is closely linked with social or economic disadvantage. Health disparities adversely affect people who have experienced greater social or economic obstacles to health based on their racial or ethnic group, religion, socioeconomic status, gender, mental health, physical disability or other characteristics historically linked to discrimination or exclusion."

"Disproportionality and disparity in the treatment of children, families of color, and vulnerable populations in systems is embedded in the structure, in policy, in practice and in individual relationships between workers and their clients. It has its roots in historical conditions, and it arises from factors such as poverty, education levels, income, household composition and the lack of resources."

"Significant gains have been made in reducing disproportionality within the Texas child welfare system. This work has laid the foundation for expansion and continued improvement across other health and human services agencies."

"...eliminating disproportionality and disparities calls for the reform and in depth look at all programs that serve our vulnerable citizens, including health care, education, juvenile justice, and housing. This approach cuts across every system that contributes to disproportionality and disparities for the same populations. The Center for Elimination of Disproportionality and Disparities will serve as a vehicle in addressing and eliminating disproportionality and disparities in the Texas Health and Human Services System as well as other systems that serve children, families, and vulnerable populations. Success is dependent on mutual accountability at every level so that the end result is equity and fairness in all health and human services delivery."

Were there voters across the country fearful that such an understanding at the federal level was unlikely if the President was not reelected? I think that's a reasonable conclusion. 

I think it's equally clear, that there are those who are so threatened by the prospect of changes in current systems which will result in greater opportunities for the poor and minorities that they refuse to acknowledge, let alone understand the need.

Of course, this only deals with structural (systemic) inequities in the delivery of public support services. It doesn't address inequities in the private sector - access to credit for businesses, lack of economic development in areas of concentrated poverty; the presence of food deserts and food swamps - which result both from poverty and market bias. Nor does it deal with other issues related to areas where public and private systems are linked, like, for instance, the criminal justice system and prison reentry. But disparities and disproportionalities abound in our culture and those seeking office, whether at our statehouses or the White House, cannot blithely dismiss people 'takers' in their ideology, politics or even their humanity. 

Find out more about the Center for Elimination of Disproportionality and Disparities, here. 
To learn about one of the initiatives of the Obama Administration to address disparities in education of African-Americans check here and here

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