1

Health Disparities

Charles Odoka

Department of Nursing, Methodist College

N6306: Health Promotion & Communication w/Pt Pop in Gen Nursing Practice

Dr. Lori Wagner

Sept. 2, 2023
 2

Abstract

In "The Hate U Give," the character Starr Carter vividly illustrates the impact of social

determinants of health on individual well-being. This analysis focuses on five key determinants:

education, economic stability, social and community context, health and healthcare, and the

neighborhood and built environment. Starr's experiences reveal the intricate connections between

these factors, highlighting marginalized communities' challenges. Economic instability affects

healthcare access, education shapes her identity and resilience, community violence affects

mental health, and neighborhood conditions influence physical well-being. Her story is a call to

action, urging us to build a more just and equitable society where every individual has a fair

chance to lead a healthy life.

 3

Health Disparities

As depicted in "The Hate U Give," Starr Carter presents a compelling case study

highlighting the critical issue of limited access to healthcare services, a challenge that aligns with

the Healthy People 2030 objective of "Access to Health Services." Starr's situation exemplifies

the far-reaching consequences of inadequate healthcare access for individuals in underserved

communities. Her prolonged absence from healthcare services raises concerns about

undiagnosed health conditions, preventive care deficiencies, and overall well-being (Tillman jr,

2018). As a young woman exposed to traumatic events, including witnessing the fatal shooting

of her friend Khalil, Starr might be at risk of experiencing psychological distress and

trauma-related health issues, underscoring the urgency of addressing her healthcare needs.

Problem of Focus: Access to Health Services

Several factors contribute to Starr's need for more access to healthcare services.

Economic instability within her family might hinder their ability to afford health insurance and

medical expenses, perpetuating the cycle of health inequity. Limited access to quality education

in her community might also have resulted in inadequate health literacy, potentially leading to a

lack of awareness and poor health choices regarding the importance of regular medical

check-ups. Addressing Starr's healthcare access issues is vital for her well-being and embodies a

broader societal concern (HealthyPeople, 2022). To improve the health outcomes of individuals

like Starr, tackling the multifaceted barriers rooted in economic stability, education, social

context, and the availability of healthcare services within underserved communities is essential.

Economic Stability
 4

Economic stability refers to the financial well-being and security of individuals and

communities. In Starr Carter's life, economic instability is a central social determinant of health,

significantly impacting her access to healthcare and overall well-being. Starr's family faces

financial challenges, living in a neighborhood characterized by poverty and limited economic

opportunities. Her father, Maverick, runs a small grocery store that generates little income that is

insufficient to cater to all the family's needs. The financial constraints experienced by her family

make it difficult to afford health insurance or cover the costs of medical care. Preventive

screenings and regular check-ups might be deemed non-essential expenses, leading to delayed or

forgone healthcare visits.

Economic stability also restricts Starr's family's access to reliable transportation. Lack of

transportation is a huge barrier, especially for individuals with critical medical conditions. The

patients might fail to arrive at a health care facility on time due to poor selection of mode of

transport, or they might decide to completely avoid visiting the hospital due to the high cost of

transportation, which is not affordable. Starr's experiences of trauma in her community add an

extra layer of psychological distress (Finkelstein et al., 2022). It is evident that economic

stability directly affects Starr's ability to access necessary healthcare services, hence prompting

the need to address the issue while working towards reducing health disparities.

Education

Education is another critical social determinant of health. In Starr's case, it is a

double-edged sword where, while it offers opportunities for personal growth and development, it

also subjects her to unique challenges related to identity, stress, and mental health. Starr attends

Williamson Prep, a predominantly white private school far from her neighborhood, which offers
 5

her a quality education but exposes her to systemic racism and cultural challenges. Education

provides people with the knowledge and skills necessary to make informed decisions about their

health, hence providing access to education. In Starr's case, her education at Williamson Prep

likely provides her with better health literacy and awareness of the importance of healthcare

access.

Education can also lead to an awareness of health disparities. Due to the knowledge

acquired at school, Starr becomes aware of the disparities between her predominantly Black

neighborhood and the privileged environment at her school. The awareness might motivate her to

seek solutions to these disparities. Education can either alleviate or exacerbate mental health

challenges. Starr's experiences at school, including racial microaggressions and the pressure to

conform to certain norms, can impact her mental health, leading to mental health implications

(Zajcova& Lawrence, 2018). Starr's education also exposes her to different social and

community contexts. She must navigate the disparities between her neighborhood and school

environment, giving her a unique perspective on how education intersects with social

determinants of health.

Social and Community Context

Social and community context refers to the social and cultural factors that shape an

individual's life. In "The Hate U Give," Starr Carter's experiences are deeply influenced by the

context of her neighborhood, her family, and the larger society in which she lives. Starr resides in

a predominantly Black neighborhood marked by poverty and violence. The prevalence of

community violence, as depicted in the book, has profound implications for her mental and

physical health. Witnessing her friend Khalil's shooting at the hands of a police officer not only
 6

traumatizes Starr but also highlights the pervasive issue of police brutality and community

violence. Starr grapples with the challenge of code-switching, altering her behavior and speech

patterns depending on whether she's in her neighborhood or at her predominantly white school

(DeVyleder et al., 2020).. This cultural duality affects her self-identity and can contribute to

feelings of isolation and stress, impacting her overall mental health.

Social support and resilience in the community also play a vital role in Starr's life as her

family and neighborhood provide her with a strong sense of community support. Her parents,

Maverick and Lisa, provide her with guidance through the challenges she faces. This social

support acts as a protective factor against some of the negative social determinants of health she

encounters. Starr also became an active participant in advocating for justice in her community

following Khalil's death. Her actions exemplify the potential for positive change that can arise

within communities affected by social and health disparities.

Health and Health Care

Access to quality healthcare services and overall health are fundamental aspects of an

individual's well-being. In "The Hate U Give," Starr Carter's experiences shed light on the

disparities in health and healthcare access faced by marginalized communities. Her community

lacks easy access to quality healthcare facilities, which is not only due to economic factors but

also a result of healthcare deserts in underserved neighborhoods (Singu at al., 2020). As a result,

individuals like Starr often receive suboptimal healthcare or delay seeking treatment. Starr

witnesses the traumatic shooting of her friend Khalil, which has profound implications for her

mental and emotional health. Her trauma underscores the critical importance of mental

healthcare services in communities affected by violence and adversity.

 7

The issue of healthcare affordability significantly affects Starr and her family. The cost of

healthcare, including insurance premiums and out-of-pocket expenses, can be prohibitive for

those with limited economic stability, contributing to health disparities. The impact of trauma on

health is also evident as Starr witnesses the traumatic shooting of her friend Khalil (DeVyleder et

al., 2020). She faces profound implications for her mental and emotional health after the

incident. Her trauma underscores the critical importance of mental healthcare services in

communities affected by violence and adversity.

Neighborhood and Built Environment

The neighborhood and built environment in which individuals live play a substantial role

in determining their health outcomes and overall quality of life. In "The Hate U Give," Starr

Carter's experiences are deeply influenced by her neighborhood's physical and social

characteristics. Starr resides in a community marked by violence and crime, where safety is

constantly concerned. The prevalence of violence contributes to mental health challenges,

limiting outdoor physical activity and exercise opportunities, which are vital for every individual.

The availability of healthy food options can also impact dietary choices and health. Starr's

neighborhood lacks access to fresh and affordable produce, making it more challenging for

residents to maintain a healthy diet (Alvidrez et al., 2019). Based on the living standards of the

people living in Starr's neighborhood, the built environment might not be adequate due to the

lack of proper facilities and infrastructure.

In "The Hate U Give," Starr Carter's life reveals the challenges marginalized communities

face, where disparities in healthcare, the burden of trauma, and the limitations of their physical

and social surroundings intersect to create significant health inequities. As a character, Starr
 8

Carter emerges as a witness to these disparities and a catalyst for change, advocating for justice

and equity within her community (Tillman jr, 2018). Her story highlights the critical need for

structural changes to address social determinants of health, promote health equity, and establish

settings supporting people's well-being like Starr.

 9

References

Alvidrez, J., Castille, D., Laude-Sharp, M., Rosario, A., & Tabor, D. (2019). The

National Institute on minority health and health disparities research framework.

American Journal of Public Health, 109(S1), S16-S20.

https://doi.org/10.2105/ajph.2018.304883

DeVylder, J., Fedina, L., & Link, B. (2020). Impact of police violence on mental health:

A theoretical framework. American Journal of Public Health, 110(11),

1704-1710. https://doi.org/10.2105/ajph.2020.305874

Finkelstein, D. M., Harding, J. F., Paulsell, D., English, B., Hijjawi, G. R., & Ng’andu, J.

(2022). Economic well-being and health: The role of income support programs in

promoting health and advancing health equity. Health Affairs, 41(12),

1700-1706. https://doi.org/10.1377/hlthaff.2022.00846

HealthyPeople. (2022). Access to health services | Healthy people 2020. Archive-It

Wayback Machine.

https://wayback.archive-it.org/5774/20220413202227/https://www.healthypeople

.gov/2020/topics-objectives/topic/Access-to-Health-Services

Singu, S., Acharya, A., Challagundla, K., & Byrareddy, S. N. (2020). Impact of social

determinants of health on the emerging COVID-19 pandemic in the United

States. Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.00406

Tillman jr, G. (Director). (2018). The Hate U Give [Film]. State Street Pictures and

Temple Hill Entertainment.

Zajacova, A., & Lawrence, E. M. (2018). The relationship between education and

health: Reducing disparities through a contextual approach. Annual Review of

 1
0

Public Health, 39(1), 273-289.

https://doi.org/10.1146/annurev-publhealth-031816-044628