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 Behavior Analysis and the Reduction of Health Disparities |
| Monday, May 27, 2024 |
| 11:00 AM–11:50 AM |
| Marriott Downtown, Level 3, Liberty Ballroom Salon A |
| Area: CSS/PCH; Domain: Service Delivery |
| Chair: Andrew C Bonner (Florida State University) |
| Discussant: Crystal M. Slanzi (Temple University) |
| CE Instructor: Andrew C Bonner, Ph.D. |
| Abstract: Health disparities undermine the wellbeing of Americans at every turn. Indeed, the life expectancy of Americans is shorter than almost any other developed nation. Very little progress has been made in reducing disparities such as premature death and the burden of disease. One reason for such lack of progress in closing the gap is a seemingly exclusive focus on proximate (as opposed to distal) influences of health disparities. Distal influences include poverty, economic inequality, and discrimination. The first paper in this symposium will discuss the historical development of health disparities in America, their root causes, and how behavior analysis can contribute to reducing disparities (including the comprehensive, community-driven initiatives required to do so). The second paper will describe a framework for large-scale comprehensive community interventions that can potentially alleviate and prevent health disparities. It will also describe how behavior analytic research tactics can pinpoint increasingly effective strategies for bringing about changes in health disparities. |
| Instruction Level: Intermediate |
| Keyword(s): community interventions, community organizing, experimental evaluations, health disparities |
| Target Audience: Target audience should be familiar with global health disparities and behavior-analytic methodology. |
| Learning Objectives: At the conclusion of the presentation, participants will be able to: (1) describe the historical root causes of health disparities; (2) describe a framework for large-scale interventions to reduce disparities; (3) describe how behavior-analytic methodology is relevant to the experimental evaluation of community interventions to reduce disparities. |
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| Health Disparities and Their Root Causes |
| ANTHONY BIGLAN (Oregon Research Institute) |
| Abstract: The longevity of Americans ranks 28th among 35 members of the Economic Cooperation and Development. The main reason is that we have stark disparities depending on race and social class. As of 2015, Black people under 65 had higher death rates than Whites for all-cause mortality. The rate of all-cause mortality among Native Americans is 30% higher than the rate for all races combined (Indian Health Services, 2019). Mortality rates also differ by socioeconomic status, with
the disparities for people with low socioeconomic status rising in recent years. Mortality rates for Non-Hispanic Whites in the USA have increased since 2000, while mortality rates declined significantly in France, Germany, the UK, Canada, Australia, and Sweden. Differences in health-related behavior, such as tobacco, alcohol use, and physical activity, account for much of the variance in these disparities. Still, these differences are, in turn, the result of differences in social conditions, including poverty, economic inequality, and discrimination. Thus, progress in reducing disparities will be limited if we do not change these distal influences on disparity. This paper will provide a brief overview of how behavior analysis can contribute to reducing disparities and the comprehensive community interventions needed to do so. |
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| How Behavior Analysts Can Contribute to Reducing Health Disparities |
| ANDREW C BONNER (Florida State University) |
| Abstract: Over the past fifty years, research in the behavioral sciences has identified numerous programs and policies that contribute to human health and wellbeing. Behavior analysis has been seminal in developing family, school, organizational, and community interventions that can prevent or alleviate the most common and costly psychological, behavioral, and health problems. Yet, for the most part, we have continued to target individual problems with interventions that focus narrowly on a single problem, such as aggressive social behavior. However, the fact that problems are interrelated and stem from the same set of social conditions (especially poverty, economic inequality, and discrimination) calls for developing and evaluating comprehensive interventions. This presentation will describe a framework for comprehensive community interventions that can potentially prevent the entire panoply of problems. It will describe a community organizing and Action Circle strategy for enabling communities to implement evidence-based programs and policies through a process that focuses on the community’s most important priorities. It will also describe how experimental methods mainly developed by behavior analysts can pinpoint increasingly effective strategies for bringing about change. |
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