not typically associated with health, which makes efforts to integrate these sectors into promotion of healthy lifestyles more complex.

Finally, the magnitude of the effort that is necessary to eliminate health disparities should be acknowledged. Because the problem of health disparities is so intransigent, an effort of a magnitude appropriate to the scale of the problem should be made.


Brian Smedley is director of the Health Policy Institute at the Joint Center for Political and Economic Studies. His presentation focused on policy and programmatic trends that relate to health inequities and the progress that has been made in addressing these trends.

Challenges to Advancing the Health Equity Agenda

Advancing the health equity agenda has three major challenges, said Smedley. First, the effects of the current economic downturn cannot be underestimated. It is likely that over the next few years the data will show that health inequities have widened rather than narrowed.

Second, the perception among Americans that the United States is now in a postracial period is inaccurate, Smedley said. Because the country has an African American president and because many people of color are leading major corporations, some believe that U.S. society is now color-blind (e.g., Cho, 2009). The research shows, however, that structural inequalities and racial discrimination persist at significant levels.

One example of this line of research uses matched-pair testers. By this approach, two people—one white and one Latino or African American—are equally matched on levels of education, personality, clothing, and so on. The two people are then sent out into a community to apply for jobs, obtain rental housing, apply for a mortgage, or seek to purchase a home. Studies consistently show that the paired tester of color receives poorer treatment, on average (Turner et al., 2003).

In one study that was replicated in two different cities, Pager (2003) found that when the paired testers—one white member with a criminal background and one African American member with no criminal background—were sent out to seek employment, the white member of the pair had a better chance of being hired for a job than the African American member. These findings, Smedley explained, show the depth of the persistent discrimination experienced by people of color in the United States.

The third challenge is the value that American society places on the strong individual determinist ideal. Americans believe that their success is

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