“Ken Olden is a consummate scientist and leader who has had a storied career,” said LaVeist. “It is an honor for me to give this lecture.” (Photo courtesy of Thomas LaVeist)Thomas LaVeist, Ph.D.Tulane University’s Distinguished Lecturer in NIEHS Olden was delivered by Jeremy on February 22. His virtual presentation was titled “Segregated Spaces Are Risky Places: The Social Environment and Inequalities in Health.”
LaVeist is the Dean and Weatherhead Presidential Chair in Health Equity in Tulane’s School of Public Health and Tropical Medicine. He is a member of the National Academy of Medicine — among numerous other accomplishments — and a renowned expert on the social and behavioral factors that influence health outcomes.
The lecture series was named in his honor. Kenneth Olden, Ph.D.Former director of NIEHS, National Toxicology Program (NTP). It recognizes outstanding achievement and promotes diversity in science communities. LaVeist’s talk was hosted by Olden; Rick Woychik, Ph.D., NIEHS and NTP director; and Trevor Archer, Ph.D., the institute’s deputy director.
“I’m very impressed that Tom addressed the issue of place,” said Olden, shown here delivering the inaugural lecture in the series. “Place matters, the environment matters.” (Photo courtesy of Steve McCaw / NIEHS)LaVeist tried to shift the focus from race-based health disparities to social and environmental factors that affect health.
“African Americans live sicker and die younger than all other racial and ethnic groups,” he told attendees. “The question is why?”
Common health disparities myths
According to LaVeist: There are three myths that surround health disparities.
Myth 1 – Equal access to healthcare will solve the problem with health disparities
He cited a study on referral rates for a crucial medical procedure. All patients were covered and came in for care. The facilities had the ability to perform the procedure. 82% of whites who would have benefitted from a referral got one, while 60% of Blacks did not.
Myth 2: Differences between groups are due to biological or genetic differences
LaVeist stated that the most harmful myth is to blame biology or genetics.
“The way this idea creeps into our thinking is subtle,” he said. “It allows people to think that if disparities are biological or genetic in nature, why bother to address them?”
He mentioned the invention of the heart drug BiDil. It is effective in a slightly greater number of Black patients than it is in white patients. In 2005, its developers sought approval of the drug — for the first time — for use by only Black patients, leaving the impression that racial differences were key to its effectiveness.
Myth 3: Differences in socioeconomic status and poverty are the only causes of disparities
“Most prevalent among the myths is that poverty or socioeconomic status [is the key aspect of] health disparities,” LaVeist said. “Socioeconomic status is a powerful predictor of population health, but so is race. One does not cause the other.”
The true causes of health disparities
What is the root cause of health inequalities if genetics and access to healthcare are not the culprits? LaVeist stressed the importance of social and physical environments.
“Although we live in the country together, we experience the country very differently — and that experience makes the difference in health,” he said. “The social and physical environments between Black and white Americans are different. That is where the primary action occurs in producing disparities.”
He illustrated the differences in environmental conditions between racial groups by using city maps, including one from New York City.
“The segregation is clear, as is the lack of resources necessary for a healthy lifestyle,” he noted. “The neighborhood where I grew up, Brownsville, is 1.2 square miles, with a population density about double that for the rest of New York. It also has the lowest life expectancy in the city.”
Environmental justice
LaVeist stated that there are other environmental problems, such proximity to industrial pollutants.
“This is the environmental justice question of which I know you all are aware,” he told attendees.
LaVeist pointed out a stretch of Mississippi River between New Orleans (Louisiana) and Baton Rouge where there are many petrochemical plant locations. The area — often referred to as Cancer Alley — is home to mostly Black communities.
“When we look at national statistics, we often come to conclusions about health disparities without accounting for the fact that people live in very different risk environments,” LaVeist said. “We conclude there must be something endemic to people that’s driving the disparities rather than the possibility that it’s the environment they live in.”
John Yewell is a contract writer at the NIEHS Office of Communications and Public Liaison.
