The COVID19 pandemic has stimulated the public conversation on health equity and disparities. At the Countway Library, we’ve been engaged in this conversation with researchers from all our affiliates through shared work on class assignments, grant proposals, and reviews.
The National Partnership for Action to End Health Disparities (U.S. Department of Health and Human Services) defines health equity as the “attainment of the highest level of health for all people.” It means that in the eyes of the health care system, everyone should be considered equally and that as a society we work to eliminate prejudice, injustice and socioeconomic disparities in our health care system. Health disparities, on the other hand, represent preventable excess morbidity and mortality among a group of people. According to the National Partnership, they are “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.” Typically, health disparities afflict groups subject to pervasive systematic obstacles because of ethnic or racial heritage, gender or sexual orientation, age, mental health status, or disabilities.
If you are interested in doing literature research on issues related health equity, health disparities, or to a particular population group or disease, we have some tools that can get you started.
Health Status Disparities, Healthcare Disparities, and Health Equity
MeSH terms are applied to records in the MEDLINE subset of PubMed and can be very useful in gathering studies on variably named topics like health equity or health disparities. There are three Medical Subject Headings related to health disparities and equity, “Health Status Disparities”, “Healthcare Disparities”, and “Health Equity”.
Use “Health Status Disparities” when you are looking for articles that focus on difference in the health status of populations: for instance, when you’re interested in the rate of asthma diagnosis in minority populations. Use “Healthcare Disparities” when you’re looking for studies addressing difference in the delivery of health care: for instance, access to breast cancer screening. “Health Equity”, on the other hand, will retrieve articles about the right to a health and a healthy life. You can use it to find articles on policies and laws that promote equity.
To use the MeSH terms, form them like this:
“Health Status Disparities”[mesh]
When a concept is the main topic of a paper, the MeSH representing the concept will be placed in a major topic index that you can invoke simply by changing the contents of the field tag to [majr]. The results will be limited to those records in which the concept is the main focus of the study:
“Health Status Disparities”[majr]
Use these terms in combination with some other concept, for instance with breast cancer, by using the AND operator:
“Healthcare Disparities”[majr] AND breast cancer
Limiting a search to MeSH will provide a focused set of results, but they will be limited to the MEDLINE subset in PubMed. If you need more sensitivity or want to include non-MEDLINE records (often newer material), we advise you to include additional keywords in your search. You can use the following search to limit a set of records to the broad concept of equity and disparity. It makes use of all of the above MeSH, plus some words in titles and abstract. As above, combine it with another healthcare topic with AND.
(“Health Status Disparities”[mesh] OR “Healthcare Disparities”[mesh] OR “Health Equity”[mesh] OR ((inequalit*[tiab] OR disparit*[tiab] OR inequit*[tiab] OR equity[tiab] OR equality[tiab] OR underrepresent*[tiab]) AND (health*[tiab] OR healthcare[tiab] OR racial[tiab] OR ethnic[tiab] OR gender[tiab] OR sexual[tiab] OR socioeconomic[tiab] OR economic[tiab])))
Although sensitive, this will miss many studies that could be construed to be about health inequity or equity. It’s a difficult topic to model. Even the best search we’re aware of misses up to 15% of the articles that can be considered to be about the topic.
Prady SL, Uphoff EP, Power M, Golder S. Development and validation of a search filter to identify equity-focused studies: reducing the number needed to screen. BMC Med Res Methodol. 2018;18(1):106. Published 2018 Oct 12. doi:10.1186/s12874-018-0567-x
As mentioned above some groups of people are more likely to be subject to pervasive systemic obstacles. You can use these searches to help identify articles on these groups. A word of caution: these searches should only be used for background research. They are neither comprehensive nor focused. They will produce large results sets unless the concepts with which they are combined are very narrow, yet they will miss relevant studies. If you have questions or comments, please contact the Research and Instruction team to work on your project.
Race, ethnicity, or skin color
("Social Segregation"[Mesh] OR "Population Groups"[Mesh] OR "Vulnerable Populations"[Mesh] OR "Continental Population Groups"[Mesh] OR "Ethnic Groups"[Mesh] OR "Minority Groups"[Mesh] OR race[tiab] OR racial[tiab] OR racism[tiab] OR ethnic[tiab] OR ethnicit*[tiab] OR nonwhite[tiab] OR non white[tiab] OR people of color[tiab] OR Black*[tiab] OR African American*[tiab] OR African descent[tiab] OR Hispanic[tiab] OR Latin*[tiab] OR Mexican American*[tiab] OR Asian American*[tiab] OR Native American*[tiab] OR American Indian*[tiab] OR minority group*[tiab])
("Ageism"[Mesh] OR age discrimination[tiab] OR ageism[tiab] OR (("Social Discrimination"[Mesh] OR "Prejudice"[Mesh]) AND “Aged”[mesh]))
Sexual minorities, sexual orientation, and gender identity
("Sexual and Gender Minorities"[Mesh] OR "Transgender Persons"[Mesh] OR "Homosexuality"[Mesh] OR "Bisexuality"[Mesh] OR "Transsexualism"[Mesh] OR lgbtq[tiab] OR lgbt[tiab] OR lbg[tiab] OR glbt[tiab] OR glbtq[tiab] OR men-who-have-sex-with-men[tiab] OR msm[tiab] OR women-who-have-sex with-women[tiab] OR transgender*[tiab] OR trans-gender[tiab] OR two-spirit[tiab] OR transsexual*[tiab] OR trans-person*[tiab] OR trans-adult* OR trans-individual*[tiab] OR trans-patient*[tiab] OR trans-men[tiab] OR trans-women[tiab] OR trans-participant* OR cross-gender[tiab] OR trans-child*[tiab] OR trans-youth*[tiab] OR cisgender[tiab] OR cissexual[tiab] OR non-binary[tiab] OR assigned-female[tiab] OR assigned-male[tiab] OR gay[tiab] OR gays[tiab] OR homosexual*[tiab] OR non-heterosexual*[tiab] OR lesbian*[tiab] OR lesbigay[tiab] OR bi-sexual*[tiab] OR bisexual*[tiab] OR heteronorm*[tiab] OR queer[tiab] OR plurisexual*[tiab] OR pansexual[tiab] OR asexual[tiab] OR transvestite[tiab] OR cross-dress*[tiab] OR gender-fluid[tiab] OR gender minorit*[tiab] OR sexual minorit*[tiab])