Health Disparities

Image Source: Adapted from Wilkinson, R., & Marmot, M. (2003). Social determinants of health. The solid facts. Copenhagen: WHO Regional Office for Europe.

The sources of mental illness, like any other illness, are many, and like with any other illness, there are disparities. For example, schizophrenia is more common in black Americans than white Americans. American Indians have a high risk for alcohol dependency. Women are at a higher risk for being depressed than men. Suicide is the third leading cause of death among adolescents. Disparities do exist in the mental health field and there are many reasons behind those health disparities.

The diagram above demonstrates just that, that health outcomes depend on many different things. Although this diagram applies to health outcomes in general, it can also be applied specifically to mental health. There is no singular reason why health disparities in mental health exist. Employment plays a role. The kind of work someone does can also play a role. There is a reason why so many soldiers are dying by suicide, and it surely has to do with the type of work they do and the stresses they are under on a daily basis. The stress a CEO faces is different from the stress a waitress faces, and that can lead to different mental health outcomes. Genetics, how you were raised, if you have social support, if you have access to affordable treatment, the type of food you eat; all of these things can affect your mental health. 

Reducing health disparities doesn't begin with targeting the population that is the worst off. It begins with figuring out why that disparity exists and working to eliminate that aspect of society. We don't need to necessarily create all new programs to eliminate health disparities in mental health. Programs that may not seem like they have anything to do with mental health and do things such as provide access to healthy food, increase a sense of community, or offer employment opportunities will help to reduce mental health disparities, as well as other sorts of disparities. Everything is connected, and both mental and physical health are improved when the community is given access to healthy options. 

7 Core Responsibilities of a Health Educator

Image Source: NCHEC,1996

The above image outlines the 7 core responsibilities of a health educator, as defined by the National Commission for Health Education Credentialing. I feel like often health education is overlooked in the mental health field. Yet, mental health is so stigmatized and people believe so many myths that health educators really do need to be educating people about mental illness. Not only that, but issues like depression and eating disorders are on the rise. These issues shouldn't be dismissed, but instead should be targeted and addressed, just like any other disease or community problem.

While many may believe that mental health issues can't be addressed by health educators, I don't believe that to be the case. Let's take eating disorders, for example. If we were to assess individual and community needs, we would find that our adolescent and college-aged women are most prone to this deadly disease. We would then have a target population. Using a theory, we could implement an intervention that hopefully helps to prevent eating disorders from occurring, focusing on the things in the environment that we can change and promoting that people talk about food and weight and nutrition in a way that does not encourage eating disordered behavior. We can then evaluate whether or not the program has at least changed the perception of eating disorders. Too many people think them to be glamorous or silly, when this is clearly not the case. Perhaps it is possible to reduce the amount of people with eating disorders by showing people that the harm they will do to themselves isn't worth the benefits of thinness. If that message can be dispensed before people are engulfed by their eating disorders, then perhaps some good can be done.

As health educators, we definitely need to advocate for more prevention-based activities and education to occur that deals with mental health. We need to promote both physical and mental well being, for both contribute to our quality of life.