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Health Equity Research Center (HERC) A WSU Grand Challenges Initiative

HERC Mission and Purpose

The Health Equity Research Center (HERC) focuses on research illuminating the social determinants of health disparities to understand and build resilience in vulnerable individuals and communities. A crucial problem at the intersection of 2 of the WSU Grand Challenges—Advancing Opportunity and Equity and Sustaining Health—is the elimination of health disparities among groups differing in economic and social resources.

At issue are basic principles of fairness and social justice and the need to address the impact and costs of high rates of chronic illness and mental disorders that disproportionately affect members of disadvantaged groups. Despite considerable attention to this problem in the U.S. population since the 1999 publication of Healthy People 2010, disadvantaged children and adults continue to experience persistent and serious health inequities.

For example, infant mortality rates are twice as high in African American and Native American populations as in the white majority population. Communities of color, low-income communities, and tribal communities suffer from greater exposure to violence, trauma, and environmental toxins, and they experience disproportionately higher rates of obesity, cardiovascular disease, cancer, depression, anxiety, and drug and alcohol abuse.

Additionally, rural populations disproportionately suffer from higher rates of obesity and, increasingly, substance abuse. They are less likely to report having a personal health-care provider, and they are more likely to report an inability to seek medical care because of cost. The Washington Department of Health identifies 77 percent of the state’s counties as rural, and many of those are also considered medically underserved.

Residents of these rural counties represent nearly a quarter of the total population of the state. Furthermore, the demographic profiles of rural populations (including those in Washington) reveal considerable heterogeneity in the social and economic makeup of populations, contributing, to a largely unknown degree, to unique health disparities. Thus, the greater Washington region is primed for a focused research effort addressing health inequities.

Not surprisingly, an overarching goal of Healthy People 2020, the current 10-year blueprint for addressing the health of the nation, is “to achieve health equity and eliminate health disparities.” The breadth and persistence of this challenge demands a bold vision in response.

Funded by a Grand Challenge Strategic Reallocation grant to an initial team from College of Arts and Sciences (CAS); Elson S. Floyd College of Medicine (ESFCoM); and College of Agricultural, Human, and Natural Resource Sciences (CAHNRS), we are a center of excellence that conducts cutting-edge research on the determinants of health disparities across biological, behavioral, family, and community levels, and will create partnerships with communities and health systems in the design and evaluation of interventions that address health disparities in a culturally sensitive and scalable manner.

Previously operating as a collaborative of engaged researchers, we have determined that an important element of our center strategy is creation of an intellectual environment that supports the investigation of resilience factors that allow some individuals and communities to achieve good health despite significant adversity. Consistent with the National Institute of Medicine’s roundtable reports on reducing health disparities, any such initiative must be interdisciplinary in nature.

We will not only conduct studies to identify determinants of risks to health in disadvantaged populations but also target sources of resilience that some individuals and groups display by having better than expected health outcomes despite significantly disadvantaged circumstances. Understanding of resilience can then be used to guide the design of interventions.

The affiliated researchers of the Center have extensive experience in health disparities research at the global, national, regional, or local level. To accommodate broader missions of the University, the center harnesses this experience to engage with large-scale health disparities issues and focus some research efforts here at home in Washington state.

In particular, many centers across the country focus on health equity in urban centers. Far fewer focus on rural areas. In many ways, the State of Washington presents the ideal setting in which to understand the implications of rural and urban spaces for health equity and resilience. Rural communities have worse health outcomes and less access to health care. As such, HERC will work with community partners to improve health equity in our region.