Introduction to the Second Special Section on Health Disparities

Here we present the second special section on health disparities in Annals of Behavioral Medicine. Papers in the first section, published in February 2012, examined potential explanations and risk factors for disparities, resilience factors that might narrow health disparities, and interventions to improve health outcomes in populations affected by health disparities. The articles spanned a range of health conditions and risk factors across the lifespan, focusing primarily on disparities among ethnic groups. In this second special section, the focus is just as broad, addressing topics such as potential explanations for disparities (discrimination, stress) in different health conditions (obesity, diabetes), among different racial/ethnic groups (Black/African Americans, Latinos, and Native Hawaiians and Pacific People). As a collection, the papers in this special section provide interesting insights on the determinants of health disparities, utilizing both betweenand within-group comparisons. Between-group comparisons allow the examination of the possibility of distinct psychosocial processes driving observed differences between groups. For example, the paper by Tomiyama et al. [1] shows how body mass index, one of the largest health disparities between Blacks and Whites, is moderated by stress. Between-group comparisons of majority to minority groups alone, however, have limitations to advancing our knowledge about health disparities [2, 3]. One criticism of traditional comparisons of minorities to majority samples is that Whites are often implicitly viewed as a standard from which the minority group is assumed to deviate if differences are found [4]. The paper by Earnshaw and colleagues [5] takes an alternative approach, comparing Black and Latina women to examine everyday discrimination as a source of health disparities. The study did not find a difference in perceived discrimination between the groups; instead, discrimination served as a central precipitating factor for the disparities in the two different ethnic groups. Another departure from between-group research is within-group examinations of health disparities. An example of this approach is provided by Sinclair et al. [6], in which the investigators worked with Native Hawaiians and Pacific Islanders to design and test a culturally tailored intervention that was shown to be successful in improving glycemic control among individuals with diabetes. Avoiding ethnic umbrellas is critical for designing research on health disparities that can be translated into practice [7]. Consistent with this notion, in the fourth paper in this special section, Molina and colleagues [8] examine how discrimination may influence self-rated health across subgroups of Latinos in the USA and demonstrate the importance of disaggregating these groups to fully appreciate how psychosocial factors intersect with health. Taken together, these papers provide a critical lens on how individual and social factors are interwoven to produce some of the key factors that drive disparities observed in the general K. E. Whitfield Department of Psychology and Neuroscience, Duke University, Durham, NC, USA