Effects of race, ethnicity, gender, culture, literacy, and social marketing on public health.

Societies globally have a long road ahead in eliminating health risks and discrepancies due to race and ethnicity, gender, culture, and illiteracy. In terms of race, for example, females and African-Americans are less likely to be referred for cardiac catheterization, and Caucasians are more likely than minorities to receive pain management in the emergency room. Regarding gender, physiologic differences certainly account for some divergent health outcomes, but they do not explain how women and men have different prevalences of diseases that are not obviously gender-specific. Cultural beliefs play a vital role in determining health choices, and health care professionals need a deeper understanding of these beliefs prior to promoting certain health interventions. Illiteracy may also prevent a person from following health instructions, and the strong association between illiteracy and poverty may exert powerful, negative influences on health outcomes. Employing the characteristics of social marketing (synchronous messages, reinforcement, and actionability) may help society to overcome some of the obstacles.