Strategies to address health disparities in vulnerable populations
Health disparities, characterized by avoidable differences in health outcomes and access to healthcare services, disproportionately affect vulnerable populations, including racial and ethnic minorities, economically disadvantaged groups, and individuals in rural areas. Addressing health disparities is crucial for achieving health equity and enhancing the overall well-being of vulnerable populations. This article explores the contributing factors to health disparities, including socioeconomic, cultural, and environmental determinants, and examines the challenges faced by vulnerable populations in accessing healthcare services. It outlines strategies to address these disparities through health education, culturally competent care, policy initiatives, and community-based approaches. The review identifies socioeconomic status, education, geographic location, and race/ethnicity as significant factors contributing to health disparities. Promising interventions include improving cultural competence among healthcare providers, implementing community health worker programs, and advancing mobile health clinics. To mitigate health disparities, it is critical to address both the social determinants of health and systemic barriers that limit vulnerable populations from receiving equitable care. Effective interventions, along with policy and advocacy efforts, can significantly improve health outcomes. Ongoing research and data collection are necessary to monitor progress and ensure prioritized health equity in healthcare systems. This article is intended to inform both academic and practitioner audiences by providing theoretical insights for researchers and students, while also offering practical strategies for policymakers and health program implementers.
Alpert, J.S. (2024). Disparities in US healthcare-a national problem. American Journal of Cardiology, 216:100-101. https://doi.org/10.1016/j.amjcard.2024.02.005
Amboree, T.L., Parker, S.L., Bulsara, S., Anderson, M.L., Schmeler, K.M., Chiao, E.Y., et al. (2023). Cervical cancer screening among English- and Spanish-speaking Hispanic women in an urban safety-net health system, 2015-2020. BMC Women’s Health, 23(1):1-6. https://doi.org/10.1186/s12905-023-02448-3
Aragie, H., Negash, H.K., Getnet, M., Tesfaye, W., Gela, Y.Y., Asefa, T., et al. (2025). Barriers to healthcare access: A multilevel analysis of individual- and community-level factors affecting female youths’ access to healthcare services in Senegal. BMC Health Services Research, 25(1):607. https://doi.org/10.1186/S12913-025-12761-2/TABLES/3
Azzopardi-Muscat, N., & Sørensen, K. (2019). Towards an equitable digital public health era: Promoting equity through a health literacy perspective. The European Journal of Public Health, 29(Suppl 3):13-17. https://doi.org/10.1093/eurpub/ckz166
Babu, M.S., Kasting, M.L., & Rodriguez, N.M. (2025). Association between health insurance coverage and stage of diagnosis for cervical cancer among females in Indiana from 2011 -2019. Preventive Medicine Reports, 50:102975. https://doi.org/10.1016/j.pmedr.2025.102975
Balaj, M., York, H.W., Sripada, K., Besnier, E., Vonen, H.D., Aravkin, A., et al. (2021). Parental education and inequalities in child mortality: A global systematic review and meta-analysis. The Lancet, 398(10300):608-620. https://doi.org/10.1016/S0140-6736(21)00534-1
Bauer, G.R. (2014). Incorporating intersectionality theory into population health research methodology: Challenges and the potential to advance health equity. Social Science and Medicine, 110:10-17. https://doi.org/10.1016/J.SOCSCIMED.2014.03.022
Baquet, C.R., Carter-Pokras, O., & Bengen-Seltzer, B. (2004). Healthcare disparities and models for change. The American Journal of Managed Care, 10(Suppl):SP5-SP11.
Blanch, K. (2023). Housing, poverty, and health outcomes. Delaware Journal of Public Health, 9(2):104-109. https://doi.org/10.32481/djph.2023.06.020
Blonigen-Heinen, P., & Basol, R. (2015). Developing Cultural Competence. Nursing Posters. Available from: https:// digitalcommons.centracare.com/nursing_posters/37 [Last accessed on 2025 Oct 08].
Braveman, P. (2025). Health inequalities, disparities, equity: What’s in a name? American Journal of Public Health, 115(7):996-1002. https://doi.org/10.2105/AJPH.2025.308062
Bulatao, R.A., Anderson, N.B., & National Research Council (U.S.) Panel on Race, Ethnicity, and Health in Later Life. (2004). Understanding racial and ethnic differences in health in late life: A research Agenda. National Academies Press. Available from: https://www.ncbi.nlm.nih.gov/books/ nbk24693 [Last accessed on 2025 Oct 08].
Burton, D.C., Kelly, A., Cardo, D., Daskalakis, D., Huang, D.T., Penman-Aguilar, A., et al. (2023). Principles of health equity science for public health action. Public Health Reports, 139(3):277-285. https://doi.org/10.1177/00333549231213162
Burgard, S. A., Lin, K. Y. (2013). Bad jobs, bad health? How work and working conditions contribute to health disparities. Am Behav Sci, 57(8):1105-1127. https://doi.org/10.1177/0002764213487347
Chen, A.M. (2025). Barriers to health equity in the United States of America: Can they be overcome? International Journal for Equity in Health, 24(1):39. https://doi.org/10.1186/s12939-025-02401-w
Chunara, R., Gjonaj, J., Immaculate, E., Wanga, I., Alaro, J., Scott- Sheldon, L.A.J., et al. (2024). Social determinants of health: The need for data science methods and capacity. The Lancet Digital Health, 6(4):e235-e237. https://doi.org/10.1016/S2589-7500(24)00022-0
Clark, B., & Preto, N. (2018). Exploring the concept of vulnerability in health care. CMAJ. Canadian Medical Association Journal, 190(11):E308-E309. https://doi.org/10.1503/cmaj.180242
Collins, M.B., Munoz, I., & Jaja, J. (2016). Linking “toxic outliers” to environmental justice communities. Environmental Research Letters, 11(1):015004. https://doi.org/10.1088/1748-9326/11/1/015004
Coughlin, S.S., Vernon, M., Hatzigeorgiou, C., & George, V. (2020). Health literacy, social determinants of health, and disease prevention and control. Journal of Environment and Health Sciences, 6(1):3061.
Cushing, L., Faust, J., August, L.M., Cendak, R., Wieland, W., & Alexeeff, G. (2015). Racial/ethnic disparities in cumulative environmental health impacts in California: Evidence from a statewide environmental justice screening tool (CalEnviroScreen 1.1). American Journal of Public Health, 105(11):2341-2348. https://doi.org/10.2105/AJPH.2015.302643
Dagovetz, M., Momchilov, K., Blank, L., Khorsandi, J., Rizzo, A., Khabbache, H., et al. (2025). Global COVID-19 vaccination challenges: Inequity of access and vaccine hesitancy. Journal of Medicine Surgery and Public Health, 6:100197. https://doi.org/10.1016/j.glmedi.2025.100197
Do, D.P., Locklar, L.R.B., & Florsheim, P. (2019). Triple jeopardy: The joint impact of racial segregation and neighborhood poverty on the mental health of black Americans. Social Psychiatry and Psychiatric Epidemiology, 54(5):533-541. https://doi.org/10.1007/s00127-019-01654-5
Egwu, E. (2019). Mobile Health Clinic as a Medium for Reducing Health Disparities in Underserved Populations [Doctoral Dissertation, University of North Dakota]. ProQuest Dissertations Publishing. https://doi.org/10.57709/14488650
Epps, F., Wiley, Z., Teunis, L.J., Johnson, T.M., Patzer, R.E., Ofotokun, I., et al. (2021). A framework for mobilizing health care to respond to the community within the COVID-19 pandemic. Preventing Chronic Disease, 18:E33. https://doi.org/10.5888/pcd18.200572
Evans, T.S., Berkman, N., Brown, C., Gaynes, B., & Weber, R.P. (2016). Disparities within Serious Mental Illness. Agency for Healthcare Research and Quality. Available from: https:// www.ncbi.nlm.nih.gov/books/nbk368427 [Last accessed on 2025 Oct 08].
Faridi, B., Davies, S., Narendrula, R., Middleton, A., Atoui, R., McIsaac, S., et al. (2025). Rural-Urban disparities in mortality of patients with acute myocardial infarction and heart failure: A systematic review and meta-analysis. European Journal of Preventive Cardiology, 32(4):327-335. https://doi.org/10.1093/EURJPC/ZWAE351
Fitzpatrick, P.J. (2023). Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners. Frontiers in Digital Health, 5:1264780. https://doi.org/10.3389/FDGTH.2023.1264780
Flaskerud, J.H., & Winslow, B.J. (1998). Conceptualizing vulnerable populations in health-related research. Nursing Research, 47(2):69-78. https://doi.org/10.1097/00006199-199803000-00005
Gaffney, A., & McCormick, D. (2017). The affordable care act: Implications for health-care equity. The Lancet, 389(10077):1442-1452. https://doi.org/10.1016/S0140-6736(17)30786-9
Garzón-Orjuela, N., Samacá-Samacá, D.F., Luque Angulo, S.C., Mendes Abdala, C.V., Reveiz, L., & Eslava-Schmalbach, J. (2020). An overview of reviews on strategies to reduce health inequalities. International Journal for Equity in Health, 19(1):192. https://doi.org/10.1186/s12939-020-01299-w
Grey, K., Gonzales, G.B., Abera, M., Lelijveld, N., Thompson, D., Berhane, M., et al. (2021). Severe malnutrition or famine exposure in childhood and cardiometabolic non-communicable disease later in life: A systematic review. BMJ Global Health, 6(3):e003161. https://doi.org/10.1136/bmjgh-2020-003161
Guidry, J.J., Torrence, W., & Herbelin, S. (2005). Closing the divide: Diverse populations and cancer survivorship. Cancer, 104(S11):2577-2583. https://doi.org/10.1002/CNCR.21251
Häfliger, C., Diviani, N., & Rubinelli, S. (2023). Communication inequalities and health disparities among vulnerable groups during the COVID-19 pandemic: A scoping review of qualitative and quantitative evidence. BMC Public Health, 23(1):428. https://doi.org/10.1186/s12889-023-15295-6
Hasannejadasl, H., Roumen, C., Smit, Y., Dekker, A., Fijten, R., & Henri, P. (2022). Health literacy and eHealth: Challenges and strategies. JCO Clinical Cancer Informatics, 6:e2200005. https://doi.org/10.1200/CCI.22.00005
Health Resources and Services Administration. (n.d.). Health Workforce Shortage Areas. Available from: https://data.hrsa. gov/topics/health-workforce/shortage-areas [Last accessed on 2025 Aug 30].
Hill, C.F., Powers, B.W., Jain, S.H., Bennet, J., Vavasis, A., & Oriol, N.E. (2014). Mobile health clinics in the era of reform. The American Journal of Managed Care, 20(3):261-264. https://doi.org/10.37765/ajmc.2014.20.3.261
Hiratsuka, V., Delafield, R., Starks, H., Ambrose, A.J., & Mau, M.M. (2013). Patient and provider perspectives on using telemedicine for chronic disease management among Native Hawaiian and Alaska Native people. International Journal of Circumpolar Health, 72(Suppl. 1):21401. https://doi.org/10.3402/ijch.v72i0.21401
Holmes, D. (2019). Minority Healthcare Disparities. Integrated Studies. Available from: https://digitalcommons. murraystate.edu/bis437/190 [Last accessed on 2025 Oct 08].
Hudelson, P., Kolly, V., & Perneger, T. (2009). Patients’ perceptions of discrimination during hospitalization. Health Expectations, 13(1):24-34. https://doi.org/10.1111/j.1369-7625.2009.00577.x
Irimia, M., Kolke, T., Cyriac, A., Cepraga, C., Romani, G., Bieluczyk, A., et al. (2024). Exploring clinicians’ awareness of language line and barriers in accessing NHS interpreting services. Future Healthcare Journal, 11(1):100081. https://doi.org/10.1016/j.fhj.2024.100081
Joanna, K.D. (2010). Bridging the Gap: The Tribal Community Health Representative Program as a Model for Care: Lessons Learned and Implications for Replication with Sub-Saharan African Refugee Communities in Manchester, New Hampshire [Doctoral Dissertation, University of North Carolina at Chapel Hill]. University of North Carolina at Chapel Hill.
Johannes, B., Graaf, D., Blatt, B., George, D., & Gonzalo, J.D. (2019). A multi-site exploration of barriers faced by vulnerable patient populations: A qualitative analysis exploring the needs of patients for targeted interventions in new models of care delivery. Primary Health Care Research and Development, 20:e61. https://doi.org/10.1017/S1463423618000385
Johnston, J., & Cushing, L. (2020). Chemical exposures, health, and environmental justice in communities living on the fenceline of industry. Current Environmental Health Reports, 7(1):48-57. https://doi.org/10.1007/s40572-020-00263-8
Kirk, G.D., Himelhoch, S.S., Westergaard, R.P., & Beckwith, C.G. (2013). Using mobile health technology to improve HIV care for persons living with HIV and substance abuse. AIDS Research and Treatment, 2013:194613. https://doi.org/10.1155/2013/194613
Kolossváry, E., Farkas, K., Karahan, O., Golledge, J., Schernthaner, G.H., Karplus, T., et al. (2023). The importance of socio-economic determinants of health in the care of patients with peripheral artery disease: A narrative review from VAS. Vascular Medicine, 28(3):241-250. https://doi.org/10.1177/1358863x231169316
Kotoh, A.M., & Sjaak, V.D.G. (2016). Why are the poor less covered in Ghana’s national health insurance? A critical analysis of policy and practice. International Journal for Equity in Health, 15(1):34. https://doi.org/10.1186/s12939-016-0320-1
Lee, D. C., Liang, H., & Shi, L. (2021). The convergence of racial and income disparities in health insurance coverage in the United States. International Journal for Equity in Health, 20(1):107. https://doi.org/10.1186/s12939-021-01436-z
Leeshell, C., & Douglas, H. (2014). Building Advocacy in Healthcare: The Impact of Intergroup Dialogue on the Cultural Sensibility Outcomes of Health Profession Students using an Individual Diversity Development Framework [Master’s Thesis, Eastern Kentucky University]. Encompass. Available from: https://www.com/encompass.eku.edu/etd [Last accessed on 2025 Oct 08].
Leonard, C., Young, J., McKown, L., Klassen, C., Kaufman, G.E., & Abrahamson, D. (2024). Implementation of a mobile prosthetic and orthotic care program in the VA; A qualitative study of implementation challenges and associated strategies for improvement. Frontiers in Health Services, 4:1198191. https://doi.org/10.3389/FRHS.2024.1198191/BIBTEX
Macias-Konstantopoulos, W.L., Collins, K.A., Diaz, R., Duber, H.C., Edwards, C.D., Hsu, A.P., et al. (2023). Race, healthcare, and health disparities: A critical review and recommendations for advancing health equity. Western Journal of Emergency Medicine, 24(5):906-918. https://doi.org/10.5811/westjem.58408
Malik, S. (2018). The use of Community Health Workers in Chronic Disease Management [Doctoral Dissertation, University of North Carolina at Chapel Hill]. University of North Carolina at Chapel Hill.
Manuck, T.A. (2017). Racial and ethnic differences in preterm birth: A complex, multifactorial problem. Seminars in Perinatology, 41(8):511-514. https://doi.org/10.1053/j.semperi.2017.08.010
Martínez-Martínez, O.A., & Rodríguez-Brito, A. (2020). Vulnerability in health and social capital: A qualitative analysis by levels of marginalization in Mexico. International Journal for Equity in Health, 19(1):88. https://doi.org/10.1186/s12939-020-01138-4
McConnell, E.D. (2013). Who has housing affordability problems? Disparities in housing cost burden by race, nativity, and legal status in los Angeles. Race and Social Problems, 5(3):173-184. https://doi.org/10.1007/s12552-013-9086-x
Mheidly, N., Fares, N.Y., Fares, M.Y., & Fares, J. (2022). Emerging health disparities during the COVID-19 pandemic. Avicenna Journal of Medicine, 13(1):60-65. https://doi.org/10.1055/s-0042-1759842
Mokdad, A.H., Bisignano, C., Hsu, J.M., Ababneh, H.S., Abbasgholizadeh, R., Abdelkader, A., et al. (2024). The burden of diseases, injuries, and risk factors by State in the USA, 1990-2021: A systematic analysis for the global burden of disease study 2021. The Lancet, 404(10469):2314-2340. https://doi.org/10.1016/S0140-6736(24)01446-6
Nana-Sinkam, P., Kraschnewski, J., Sacco, R., Chavez, J., Fouad, M., Gal, T., et al. (2021). Health disparities and equity in the era of COVID-19. Journal of Clinical and Translational Science, 5(1):e99. https://doi.org/10.1017/cts.2021.23
National Center for Health Statistics. (2021). Healthy People 2020 Final Review. United States: National Center for Health Statistics; 2021. https://doi.org/10.15620/cdc:111173
Njoku, A. (2018). Teaching health disparities awareness in undergraduate public health courses. International Journal for the Scholarship of Teaching and Learning, 12(2):15. https://doi.org/10.20429/ijsotl.2018.120215
Oberg, C., Colianni, S., & King-Schultz, L. (2016). Child health disparities in the 21st century. Current Problems in Pediatric and Adolescent Health Care, 46(9):291-312. https://doi.org/10.1016/j.cppeds.2016.07.001
Oberg, C., Hodges, H.R., Gander, S., Nathawad, R., & Cutts, D. (2022). The impact of COVID-19 on children’s lives in the United States: Amplified inequities and a just path to recovery. Current Problems in Pediatric and Adolescent Health Care, 52(7):101181. https://doi.org/10.1016/j.cppeds.2022.101181
O’Brien, R., Neman, T., Seltzer, N., Evans, L., & Venkataramani, A. (2020). Structural racism, economic opportunity, and racial health disparities: Evidence from U.S. counties. SSM - Population Health, 11:100564. https://doi.org/10.1016/j.ssmph.2020.100564
Office of Minority Health and Health Disparities, Maryland Department of Health and Mental Hygiene. (2007). Best Practices in Capacity Building and Disease Management and Prevention to Address Minority Health Disparities. Baltimore, MD: Maryland Department of Health and Mental Hygiene.
Olowoyo, K.S., Esan, D.T., Adeyanju, B.T., Olawade, D.B., Oyinloye, B.E., & Olowoyo, P. (2024). Telemedicine as a tool to prevent multi-drug resistant tuberculosis in poor resource settings: Lessons from Nigeria. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 35:100423. https://doi.org/10.1016/j.jctube.2024.100423
Pandey, M., Maina, R.G., Amoyaw, J., Li, Y., Kamrul, R., Michaels, C.R. (2021). Impacts of English language proficiency on healthcare access, use, and outcomes among immigrants: A qualitative study. BMC Health Services Research, 21(1):1-13. https://doi.org/10.1186/s12913-021-06750-4
Patrick, K., Flegel, K., & Stanbrook, M.B. (2018). Vulnerable populations: An area CMAJ will continue to champion. CMAJ, 190(11):E307. https://doi.org/10.1503/cmaj.180288
Phan, J.M., Kim, S., Linh, Đ.T.T., Cosimi, L.A., & Pollack, T.M. (2022). Telehealth interventions for HIV in low- and middle-income countries. Current HIV/AIDS Reports, 19(6):600-610. https://doi.org/10.1007/s11904-022-00630-0
Pratte, M. (2016). Barriers to Care for Cardiovascular Risk Factor Management [Master’s Thesis, Yale University]. EliScholar. Available from: https://elischolar.library.yale. edu/ysphtdl/1234 [Last accessed on 2025 Oct 08].
Qoseem, I.O., Okesanya, O.J., Olaleke, N.O., Ukoaka, B.M., Amisu, B.O., Ogaya, J.B., et al. (2024). Digital health and health equity: How digital health can address healthcare disparities and improve access to quality care in Africa. Health Promotion Perspectives, 14(1):3-10. https://doi.org/10.34172/hpp.42822
Rad, J. (2025). Health inequities: A persistent global challenge from past to future. International Journal for Equity in Health, 24(1):5. https://doi.org/10.1186/s12939-025-02526-y
Rahemi, Z., Bacsu, J.D.R., Shalhout, S.Z., Sadafipoor, M.S., Smith, M.L., & Adams, S.A. (2024). Healthcare Disparities among Older Adults: Exploring Social Determinants of Health and Cognition Levels. medRxiv [Preprint]. https://doi.org/10.1101/2024.06.29.24309705
Rami, F., Thompson, L.S., & Solis-Cortes, L. (2023). Healthcare disparities: Vulnerable and marginalized populations. In: Chirico, F., editor. COVID-19: Health Disparities and Ethical Challenges Across the Globe. Berlin: Springer, p. 111-145. https://doi.org/10.1007/978-3-031-26200-5_6
Renzi, P., & Franci, A. (2023). Inequalities in health: Definitions, concepts and measurements-an application in the regional health authority in Italy. Social Indicators Research, 169(1-2):599-627. https://doi.org/10.1007/s11205-023-03170-1
Rivenbark, J.G., & Ichou, M. (2020). Discrimination in healthcare as a barrier to care: Experiences of socially disadvantaged populations in France from a nationally representative survey. BMC Public Health, 20(1):31. https://doi.org/10.1186/s12889-019-8124-z
Robinson, R.G. (2005). Community development model for public health applications: Overview of a model to eliminate population disparities. Health Promotion Practice, 6(3):338-346. https://doi.org/10.1177/1524839905276036
Rod, M.H., Rod, N.H., Russo, F., Klinker, C.D., Reis, R., & Stronks, K. (2023). Promoting the health of vulnerable populations: Three steps towards a systems-based re-orientation of public health intervention research. Health and Place, 80:102984. https://doi.org/10.1016/j.healthplace.2023.102984
Rolfe, S., Garnham, L., Godwin, J., Anderson, I., Seaman, P., & Donaldson, C. (2020). Housing as a social determinant of health and wellbeing: Developing an empirically informed realist theoretical framework. BMC Public Health, 20(1):1138. https://doi.org/10.1186/s12889-020-09224-0
Santangelo, O.E., Provenzano, S., Di Martino, G., & Ferrara, P. (2024). COVID-19 vaccination and public health: Addressing global, regional, and within-country inequalities. Vaccines (Basel), 12(8):885. https://doi.org/10.3390/vaccines12080885
Singh, S.P., Baig, F., & Singh, S. (2022). Mobile health clinics as a healthcare delivery model to address community disparities. Kansas Journal of Medicine, 15(2):259-263. https://doi.org/10.17161/kjm.vol15.16543
Smith, B.T., Warren, C.M., Rosella, L.C., & Smith, M.J. (2023). Bridging ethics and epidemiology: Modelling ethical standards of health equity. SSM Population Health, 24:101481. https://doi.org/10.1016/j.ssmph.2023.101481
Tan, S.Y., Foo, C.D., Verma, M., Hanvoravongchai, P., Cheh, P.L.J., Pholpark, A., et al. (2023). Mitigating the impacts of the COVID-19 pandemic on vulnerable populations: Lessons for improving health and social equity. Social Science and Medicine, 328:116007. https://doi.org/10.1016/j.socscimed.2023.116007
Steif, K. (2015). Toward school improvement districts: School quality and the equitable revitalization of neighborhoods [Doctoral dissertation, University of Pennsylvania]. ProQuest Dissertations & Theses Global. Available from: https://www.proquest.com/openview/ 2a32e6d8dbda5df38e1a46c2e2d7e6b9/1?pq-origsite=gscholar&cbl=18750 [Last accessed on 2014 Oct 22].
The Lancet Public Health. (2020). Education: A neglected social determinant of health. The Lancet Public Health, 5(7):e361. https://doi.org/10.1016/S2468-2667(20)30144-4
Thomas, B. (2014). Health and health care disparities: The effect of social and environmental factors on individual and population health. International Journal of Environmental Research and Public Health, 11(7):7492-7507. https://doi.org/10.3390/ijerph110707492
Thomas, S.B., & Gilbert, K.L. (2006). Overview of minority health and health disparities in the U.S. Maryland Journal of Health Care Policy, 9(2):123-136. https://doi.org/10.13016/8ukc-qh7p
Touger, R., & Wood, B.R. (2019). A review of telehealth innovations for HIV pre-exposure prophylaxis (PrEP). Current HIV/AIDS Reports, 16(1):113-119. https://doi.org/10.1007/s11904-019-00430-z
United States National Committee on Vital and Health Statistics & National Center for Health Statistics (US). (2005). Eliminating Health Disparities: Strengthening Data on Race, Ethnicity, and Primary Language in the United States. Available from: https://www.com/stacks.cdc.gov/view/cdc/52283 [Last accessed on 2025 Oct 08].
Vanden Bossche, D., Zhao, Q.J., Ares-Blanco, S., Peña, M.P.A., Decat, P., Kondo, N., et al. (2023). Addressing health inequity during the COVID-19 pandemic through primary health care and public health collaboration: A multiple case study analysis in eight high-income countries. International Journal for Equity in Health, 22(1):171. https://doi.org/10.1186/s12939-023-01968-6
Vart, P. (2022). Understanding the social determinants of health. The Lancet, 399(10334):1467. https://doi.org/10.1016/S0140-6736(21)02660-x
Vergunst, R., Swartz, L., Mji, G., Kritzinger, J., & Braathen, S.H. (2016). Beyond the checklist: Understanding rural health vulnerability in a South African context. Global Health Action, 9(1):33272. https://doi.org/10.3402/gha.v9.33272
Walter, J.R., Xu, S., & Rogers, J.A. (2024). From lab to life: How wearable devices can improve health equity. Nature Communications, 15(1):123. https://doi.org/10.1038/s41467-023-44634-9
Watson, J., Crawley, J., & Kane, D. (2016). Social exclusion, health and hidden homelessness. Public Health, 139:96-102. https://doi.org/10.1016/j.puhe.2016.05.017
Weeks, W.B., Chang, J.E., Pagán, J.A., Lumpkin, J., Michael, D., Salcido, S., et al. (2023). Rural-Urban disparities in health outcomes, clinical care, health behaviors, and social determinants of health and an action-oriented, dynamic tool for visualizing them. PLOS Global Public Health, 3(10):e0002420. https://doi.org/10.1371/journal.pgph.0002420
Wehby, G.L., & Lyu, W. (2018). The impact of the ACA Medicaid expansions on health insurance coverage through 2015 and coverage disparities by age, race/ethnicity, and gender. Health Services Research, 53(2):1248-1271. https://doi.org/10.1111/1475-6773.12711
Williams, A.M., Clayton, H.B., & Singleton, J.A. (2021). Racial and ethnic disparities in COVID-19 vaccination coverage: The contribution of socioeconomic and demographic factors. American Journal of Preventive Medicine, 62(4):473-481. https://doi.org/10.1016/j.amepre.2021.10.008
Williams, D.R., & Cooper, L.A. (2019). Reducing racial inequities in health: Using what we already know to take action. International Journal of Environmental Research and Public Health, 16(4):606. https://doi.org/10.3390/ijerph16040606
World Health Organization. (2024). Determinants of Health. Available from: https://www.who.int/news-room/questions-and-answers/item/determinants-of-health [Last accessed on 2025 Aug 29].
World Health Organization. (n.d.a). Digital Health. Available from: https://www.who.int/health-topics/digital-health [Last accessed on 2025 Aug 29].
World Health Organization. (n.d.b). Health Equity. Available from: https://www.who.int/health-topics/health-equity [Last accessed on 2025 Aug 29].
Wynia M., & Matiasek J. (2006). Promising Practices for Patient- Centered Communication with Vulnerable Populations: Examples from Eight Hospitals. The Commonwealth Fund. Available from: https://www.commonwealthfund.org/publications/fund/reports/2006/aug/ promising-practices-patient-centered-communication-vulnerable [Last accessed on 2025 Oct 08].
Xu, S., Kim, J., Walter, J.R., Ghaffari, R., & Rogers, J.A. (2022). Translational gaps and opportunities for medical wearables in digital health. Science Translational Medicine, 14(666):eabn6036. https://doi.org/10.1126/scitranslmed.abn6036
Ye, H., & Kim, H. (2014). Measuring spatial health disparity using a network-based accessibility index method in a GIS environment: A case study of Hillsborough County, Florida. International Journal of Geospatial and Environmental Research, 1(1):2.
Yedjou, C.G., Sims, J.N., Miele, L., Noubissi, F., Lowe, L., Fonseca, D.D., et al. (2019). Health and racial disparity in breast cancer. In: Tchounwou, P.B. editor. Advances in Experimental Medicine and Biology. Vol. 1152. Berlin: Springer, p. 31-49. https://doi.org/10.1007/978-3-030-20301-6_3
Yu, S.W.Y., Hill, C., Ricks, M.L., Bennet, J., & Oriol, N.E. (2017). The scope and impact of mobile health clinics in the United States: A literature review. International Journal for Equity in Health, 16(1):178. https://doi.org/10.1186/s12939-017-0671-2
Zambrana, R.E., Molnar, C., Munoz, H.B., & Lopez, D.S. (2004). Cultural competency as it intersects with racial/ethnic, linguistic, and class disparities in managed healthcare organizations. American Journal of Managed Care, 10(1):SP37-44.
Zhen, Z., Tang, D., Wang, X., & Feng, Q. (2024). The impact of digital technology on health inequality: Evidence from China. BMC Health Services Research, 24(1):512. https://doi.org/10.1186/s12913-024-12022-8