Report on Health Disparities and Challenges in the United States: Emphasizing Sustainable Development Goals (SDGs)

The High Cost of Healthy Foods and Its Impact on American Diets and Health

Rising grocery prices, particularly for healthy foods, are significantly influencing American dietary choices, pushing many towards cheaper, ultraprocessed alternatives. This trend exacerbates health disparities and diet-related chronic conditions, aligning with concerns under SDG 2: Zero Hunger and SDG 3: Good Health and Well-being.

1. Nearly 70% of adults report that food costs affect their diets, with disproportionate effects on lower-income and minority communities.
2. Fruits and vegetables remain significantly overpriced, creating barriers to healthy eating including:

• Lack of access
• Limited time
• Insufficient knowledge

• Updating Supplemental Nutrition Assistance Program (SNAP) benefits
• Improving food availability in underserved areas
• Integrating food insecurity screening in healthcare settings

Financial Burden and Food Insecurity Among Patients with Obesity

Adults with obesity in the United States face nearly double the financial hardship compared to those with normal weight, highlighting issues relevant to SDG 1: No Poverty and SDG 3: Good Health and Well-being.

1. A study analyzing data from over 143,000 adults (2019-2023) found:

• Higher rates of medical debt
• Increased food insecurity
• Cost-related medication nonadherence

Protecting Progress in LGBTQ+ Health Care a Decade After Obergefell

The 10th anniversary of the Supreme Court’s Obergefell v. Hodges decision marks significant progress in LGBTQ+ rights and health care access, reflecting goals under SDG 3: Good Health and Well-being and SDG 10: Reduced Inequalities.

• Advancements over the past decade include:
• Expanded gender-affirming care
• Improved insurance coverage
• Updated clinical guidelines
• Progress in HIV prevention, including long-acting injectable pre-exposure prophylaxis
• Recent political changes threaten these gains through:
• Executive actions targeting diversity, equity, and inclusion initiatives
• Dismantling health equity programs
• Potential rollback of protections established by Obergefell
• Advocates warn of risks to marriage equality and broader civil rights amid funding cuts and regulatory rollbacks.

Disparities in Multiple Myeloma Outcomes and the Impact of Comorbidities

Despite advances in multiple myeloma treatment, disparities persist due to socioeconomic and geographic factors, aligning with SDG 3: Good Health and Well-being and SDG 10: Reduced Inequalities.

1. National cancer data analysis reveals:

• Higher myeloma mortality rates among individuals with lower household incomes or living in rural areas
• Limited access to specialized care, clinical trials, and advanced treatments in these populations

• Higher rates of advanced disease at diagnosis
• Increased mortality

Gaps in Patient Materials for Rheumatoid Arthritis

Research indicates that patient-facing materials for rheumatoid arthritis often lack crucial information, impacting informed decision-making and care quality, relevant to SDG 3: Good Health and Well-being.

• Key health outcomes such as pain, joint damage, physical function, and remission are inconsistently described or omitted in materials like decision aids and preference studies.
• The study recommends:
• Development of standardized health outcome descriptors
• Implementation of a structured framework organizing outcome information into clear domains: symptoms, testing and treatment, time horizon, and consequences
• Improved communication and shared decision-making will enhance patient understanding and treatment outcomes in rheumatoid arthritis care.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 2: Zero Hunger – The article discusses food insecurity, access to affordable and nutritious food, and the impact of rising grocery prices on diets, which directly relate to ending hunger and ensuring food security.
2. SDG 3: Good Health and Well-being – The article highlights health disparities, chronic diseases linked to diet (obesity, cardiovascular disease, cancer), access to healthcare, and health outcomes for various populations.
3. SDG 10: Reduced Inequalities – The article emphasizes disparities based on income, race, geography, and minority status affecting health and food access.
4. SDG 5: Gender Equality (implied) – The section on LGBTQ+ health care and rights relates to promoting equality and reducing discrimination.
5. SDG 1: No Poverty (implied) – Financial burdens related to medical debt, food insecurity, and treatment affordability connect to poverty reduction.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 2 Targets:
   • 2.1 – End hunger and ensure access to safe, nutritious, and sufficient food all year round.
   • 2.2 – End all forms of malnutrition, including achieving targets on stunted and wasted children and addressing nutritional needs of vulnerable populations.
2. SDG 3 Targets:
   • 3.4 – Reduce premature mortality from non-communicable diseases through prevention and treatment.
   • 3.8 – Achieve universal health coverage, including financial risk protection and access to quality essential health-care services and medicines.
   • 3.b – Support research and development of vaccines and medicines for communicable and non-communicable diseases.
3. SDG 10 Targets:
   • 10.2 – Empower and promote social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
4. SDG 5 Targets:
   • 5.1 – End all forms of discrimination against all women and girls everywhere (extended to LGBTQ+ inclusion).
5. SDG 1 Targets:
   • 1.2 – Reduce at least by half the proportion of men, women and children living in poverty in all its dimensions.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicators related to SDG 2:
   • Proportion of population experiencing food insecurity or unable to afford healthy foods (implied by data on grocery prices and food cost impact).
   • Availability and affordability of fruits and vegetables in households.
2. Indicators related to SDG 3:
   • Prevalence and mortality rates of diet-related chronic diseases such as obesity, cardiovascular disease, cancer, and myeloma.
   • Rates of medical debt, food insecurity, and medication nonadherence among adults with obesity.
   • Access to health services including gender-affirming care, HIV prevention, and availability of antiobesity medications.
   • Health outcome measures in rheumatoid arthritis patients such as pain, joint damage, physical function, and remission rates.
3. Indicators related to SDG 10:
   • Disparities in health outcomes and mortality rates by income, race, geography, and minority status.
   • Access to specialized care and clinical trials in rural versus urban areas.
4. Indicators related to SDG 5:
   • Insurance coverage and access to LGBTQ+ inclusive health services.
   • Funding levels and regulatory support for LGBTQ+ health programs.
5. Indicators related to SDG 1:
   • Rates of financial hardship, medical debt, and poverty-related barriers to healthcare and medication adherence.

4. Table: SDGs, Targets and Indicators

Source: ajmc.com