National Academy of Medicine

Building a Culture of Health Equity at the Federal Level

By David Zuckerman, Violeta Duncan, and Katie Parker
March 01, 2016 | Discussion Paper

The United States spends significantly more resources on health care than any other nation. Despite this fact and the remarkable improvements in the quality of health care over the past century, the nation’s relative standing in health outcomes and life expectancy continues to erode. “Americans die sooner and experience more illness than residents in many other countries,” a 2013 report from the National Research Council and Institute of Medicine bluntly noted.

In the United States, this burden of illness, premature death, and disability disproportionately affects racial and ethnic minority population groups and other underserved populations. These differences in health status, which are also known as “health disparities” or “health inequities,” persist and pose a significant economic burden to both affected individuals and all Americans. A 2009 analysis estimated that the U.S. economy loses $309 billion annually due to both the direct and indirect costs of disparities. The cost in both dollars and quality of life creates a compelling economic and moral imperative to address the causes of these inequities.



Suggested Citation

Zuckerman, D., V. Duncan, and K. Parker. 2016. Building a Culture of Health Equity at the Federal Level. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. doi: 10.31478/201603a


Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.