Session: Achieving Health and Scientific Equity: Perspectives from Epidemiologic, Intervention, and Implementation Research (Society for Prevention Research 27th Annual Meeting)

Health equity is “the state in which everyone has the opportunity to attain full health potential and no one is disadvantaged from achieving this potential because of social position or any other socially defined circumstance.” Drivers of health equity are largely social, economic and political. A similar concept, scientific equity, refers to applying evidence-based interventions inequitably across various settings and populations; skewing application of best available practices towards communities and organizations with high capacity and resources can further exacerbate health disparities between populations based on race/ethnicity, gender, sexual orientation, socioeconomic status, and other factors. Scientific inequity begins with the underrepresentation of historically disadvantaged populations in prevention research and persists into public health practice and implementation where new scientific and technological improvements can be slow in reaching or responding to the needs of populations who experience avoidable health disparities. This symposium includes three papers on this topic: The first paper examines “County-level mediators and moderators of Latino HIV prevalence disparities in the United States” and reports on a broad array of influences and associated key factors. This work is critical for informing prevention efforts for this underserved population, which has nearly 2.5 times higher prevalence of diagnosed HIV infection than that of non-Latino whites. The second paper explores the role of shared decision making (SDM) for HIV pre-exposure prophylaxis (PrEP) in African American transgender women. Qualitative analyses suggest the potential for SDM to reduce HIV-related healthcare disparities by improving bi-directional patient-provider communication and empowering engagement of African American transgender women through establishment of trust, trans-cultural competence by providers, and the understanding that deliberations about PrEP occur longitudinally. The third paper discusses “Implementation research methodologies for achieving scientific equity and health equity.” Three methodologic paradigms are explored: 1) making efficient use of existing data by applying epidemiologic and simulation modeling to understand what drives disparities and how they can be overcome; 2) designing new research studies that include, but do not focus exclusively on, populations experiencing disparities; and 3) implementation research that focuses exclusively on populations that have experienced disparities. The three papers point to the need to understand the causes of disparities, potential interventions for those that experience them, and implementation research done in a manner that achieves scientific equity to improve population health.