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Health Disparities and Community Participation

Health disparities have been a longstanding feature of England’s NHS. In particular, socioeconomic and ethnic disparities remain in England despite numerous initiatives to abolish them. Initiatives to mitigate or overcome these disparities were discussed in a recent article on community participation published by myself and two colleagues in the October 2009 edition of the Journal of Ambulatory Care Management. These health disparities are the end result of complex, wide-ranging societal, healthcare-related, environmental, genetic, and individual factors. People who experience poverty, material disadvantage, poor housing, lower educational achievement, unemployment or insecure employment, or homelessness are more likely to suffer poorer health outcomes and an earlier death than the rest of the population. Hence, action to address these disparities has to be multisectoral, involving different government departments, local health services and local government, and community and charitable organizations.

The article was one of a number in the journal on community participation in healthcare, with the other articles all discussing initiatives in the USA. Although the activities to address health disparities and encourage community participation share similarities in the USA and England, the degree of input from the state varies considerably. This reflects different political and societal views on the role of the state in the two countries. In England, as in most European countries, the state is expected by the public to play a key role in addressing health disparities and working with local communities to ensure community participation.


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