New Horizons-Addressing Healthcare Disparities in Endocrine Disease: Bias, Science, and Patient Care

J Clin Endocrinol Metab. 2021 Nov 19;106(12):e4887-e4902. doi: 10.1210/clinem/dgab229.


Unacceptable healthcare disparities in endocrine disease have persisted for decades, and 2021 presents a difficult evolving environment. The COVID-19 pandemic has highlighted the gross structural inequities that drive health disparities, and antiracism demonstrations remind us that the struggle for human rights continues. Increased public awareness and discussion of disparities present an urgent opportunity to advance health equity. However, it is more complicated to change the behavior of individuals and reform systems because societies are polarized into different factions that increasingly believe, accept, and live different realities. To reduce health disparities, clinicians must (1) truly commit to advancing health equity and intentionally act to reduce health disparities; (2) create a culture of equity by looking inwards for personal bias and outwards for the systemic biases built into their everyday work processes; (3) implement practical individual, organizational, and community interventions that address the root causes of the disparities; and (4) consider their roles in addressing social determinants of health and influencing healthcare payment policy to advance health equity. To care for diverse populations in 2021, clinicians must have self-insight and true understanding of heterogeneous patients, knowledge of evidence-based interventions, ability to adapt messaging and approaches, and facility with systems change and advocacy. Advancing health equity requires both science and art; evidence-based roadmaps and stories that guide the journey to better outcomes, judgment that informs how to change the behavior of patients, providers, communities, organizations, and policymakers, and passion and a moral mission to serve humanity.

Keywords: Equity; disparities; endocrinology; outcomes; quality of care.

MeSH terms

  • Biomedical Research / ethics
  • Biomedical Research / legislation & jurisprudence
  • Biomedical Research / organization & administration
  • Biomedical Research / statistics & numerical data
  • COVID-19 / mortality*
  • COVID-19 / psychology
  • Endocrine System Diseases / epidemiology
  • Endocrine System Diseases / mortality
  • Endocrine System Diseases / therapy*
  • Health Equity / organization & administration
  • Health Equity / trends
  • Health Policy / legislation & jurisprudence
  • Health Policy / trends
  • Healthcare Disparities* / organization & administration
  • Healthcare Disparities* / trends
  • Humans
  • Pandemics
  • Patient Care* / ethics
  • Patient Care* / standards
  • Patient Care* / trends
  • Racism* / prevention & control
  • Racism* / trends
  • SARS-CoV-2