Health service disparities refer to differences in quality and access to healthcare among population groups, reflecting injustice and unfairness, resulting in systematic and plausibly avoidable health differences adversely affecting socially disadvantaged groups (Institute of Medicine, 2002). The central goal of my research as a health psychologist is to advance science that reduces health disparities in order to work towards health equity, especially for communities of color.
Organizational justice theory in health services
Organizational justice theory (Colquitt, 2001) in healthcare systems and services (e.g., Perez-Arechaederra et al., 2013) refers to fairness and fair treatment across encounters that patients have within a healthcare system. Four dimensions of justice exist based on facts, situations, other individuals, behaviors, and processes that contribute to patients’ judgments of whether or not they have been fairly treated.
First, distributive justice refers to the fair allocation of resources such as services and subsequent distribution of results such as health outcomes. In health care, fairness may be understood as allocation of procedures on the basis of need, equality, or other “deservingness” criteria. Second, procedural justice refers to fairness in the process by which decisions are made, such as which patients receive a referral to specialty services. Third, interactional (sometimes referred to as interpersonal) justice refers to fairness in treatment by those delivering resources, including patients’ perceptions of their providers’ demeanor during treatment delivery and whether they were treated with respect and absence of prejudice. Finally, informational justice, refers to the perception that information received along the care continuum was adequate, correct, and sufficient.
Informational justice provides an opportunity to examine fairness in information conveyed on what resources exist, how and why resources were distributed as they were, and provider communication. We situate our research questions within these domains of justice, as the REACH Lab is committed to pursuing health equity due to its implications for social justice.
Community-based participatory research principles
Community-based participatory research (CBPR) is an approach to scholarship that equitably involves relevant stakeholders throughout the research process, holding the core belief that all partners contribute expertise and therefore share in decision-making and ownership. Given that the research questions we pursue are about historically marginalized or underserved communities, as well as voices that have not been well represented in the literature, a CBPR framework is particularly valuable for power sharing in the pursuit of health equity. Indeed, we believe CBPR is critically necessary in the search for sustainable interventions and solutions that attend to the multiple determinants of health and wellness.
Our team focuses on understanding and addressing the mental health needs and unjust barriers to accessing healthcare experienced by communities of color. We utilize community-based participatory research (CBPR) methods to name and understand disparities, as well as develop and implement sustainable interventions to reach towards health equity.