Examining Laboratory Medicine's Role in Eliminating Health Disparities.

In 2000 the United States Public Law 106-525 defined a health disparity population as a population with a disparity in the rate of disease incidence, prevalence, morbidity, mortality, or survival compared to the general population. Health disparities account for >$200 billion in direct medical expenses. Efforts focused on eliminating health disparities exist. The Healthy People initiative of the Department of Health and Human Services aims to combat health disparities by setting consecutive 10-year goals. For example, Healthy People 2020 focuses on achieving health equity, eliminating disparities, and improving overall care. The National Institutes of Health and the Centers for Disease Control employ multidisciplinary strategies for a healthier nation. Studies also show health disparities persist despite adjusting for confounders and may suggest biological or other unknown factors are responsible. Genetic variants may play a role in drug metabolism and disease risk. However, genetic variants alone are not responsible for health disparities. Health disparities continue, in part, due to systemic racism, mediated through the social determinates: economic instability, food deserts, educational gaps, and limited access to quality healthcare. Annually, in the United States, more than 7 billion clinical tests are performed by clinical laboratories and directly impact patient care and outcomes. The practice of laboratory medicine may be used to identify health disparities and develop interventions to eliminate them. We invited experts to share their views on the complexity of health disparities and the role that laboratory medicine can play in reducing health disparities.