Modeling Health Disparities and Outcomes in Disenfranchised Populations.

Journal Article (Journal Article)

The Health Disparities and Outcomes (HDO) model originally created to explain the complexity of obtaining healthcare in rural settings has been revised and updated using emerging theoretical models of adversity and inequity and two decades of empirical work by the authors. With a strong orientation to explaining population-based health inequities, the HDO is applied to individuals with Serious Mental Illness (SMI), to explain their high rates of morbidity and mortality compared to the general population. Individual-, community-, and system-level factors that reflect an understanding of life-long risk, accrued hazards associated with multiple and intersecting disadvantages, and difficulty obtaining healthcare that meets accepted standards are described. The revised HDO can be applied to populations with disproportionate health challenges to identify multi-level factors that affect illness trajectory and overall health outcomes.

Full Text

Duke Authors

Cited Authors

  • Hauenstein, EJ; Clark, RS; Merwin, EI

Published Date

  • January 2019

Published In

Volume / Issue

  • 55 / 1

Start / End Page

  • 9 - 23

PubMed ID

  • 30136013

Pubmed Central ID

  • PMC8751484

Electronic International Standard Serial Number (EISSN)

  • 1573-2789

International Standard Serial Number (ISSN)

  • 0010-3853

Digital Object Identifier (DOI)

  • 10.1007/s10597-018-0326-9


  • eng