As global attention focuses on the world’s largest ever outbreak of Ebola and governments and global health agencies struggle to contain the spread of the disease, researchers at the University of Maryland and University of Pittsburgh draw attention to a less explored aspect of global health pandemics: the social determinants of infectious disease spread and the disparities in morbidity and mortality among different subgroups of populations. In an article in a theme issue on global health security in Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, Dr. Sandra C. Quinn, senior associate director of the Maryland Center for Health Equity and professor of family science in the University of Maryland School of Public Health, and Dr. Supriya Kumar, research assistant professor of behavioral and community health sciences in the University of Pittsburgh Graduate School of Public Health, challenge public health and health care professionals to do more within our organizations, with communities, and with policymakers to reduce the unequal burden of disease and death among socially disadvantaged subpopulations.
They urge collaboration across multiple sectors to decrease unnecessary exposure, minimize susceptibility (e.g., by enhancing access to vaccines when available), and assure care after disease has developed. In their article, “Health Inequalities and Infectious Disease Epidemics: A Challenge for Global Health Security”, Drs. Quinn and Kumar illustrate the ways social determinants including poverty, race, ethnicity, social marginalization, and physical environment contribute to differential exposure, susceptibility to infectious disease, and access to care and treatment once exposed. Moreover, they argue that unless there is a focus on social determinants and inequalities, the goals of the Global Health Security Agenda cannot succeed.
“Today’s rapidly evolving outbreak across the West African region is a glaring example of the contribution of social determinants to outbreaks,” says Dr. Quinn.
The region already experiences significant challenges from malaria and other endemic diseases, weak health and public health infrastructure, extreme poverty, and years of civil strife.
“Although in the U.S., our media focus was heavily on the few Americans who contracted the disease and had access to the most cutting edge treatment and care, in West Africa, this outbreak continues to spread among the poor and in communities where there are not enough doctors to even track down all the individuals who have been exposed, much less be able to treat them with the limited facilities and supplies available,” Dr. Quinn explains. “Imagine for a moment how difficult it is to stop any infectious disease, especially Ebola, when some hospitals have no running water, there are insufficient public health workers, and the stigma of the disease is so powerful.”
The theme issue, and their article, was released and distributed at the Global Health Security Agency’s “The Global Health Security Agenda: Non Governmental Perspective on Addressing Emerging and Evolving Biological Threats” meeting at the Milken Institute School of Public Health at the George Washington University in Washington, DC on September 25.
“Health Inequalities and Infectious Disease Epidemics: A Challenge for Global Health Security” was written by Drs. Sandra Crouse Quinn and Supriya Kumar and published in Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science: http://www.liebertpub.com/bsp