Guest Column
Improving disparate health outcomes is a global imperative that must start here at home | Column
The work to understand and eradicate health disparities begins long before a patient needs a doctor.
This essay was written by an author who will participate in the St. Petersburg Conference on World Affairs, which runs from Feb. 15-18, 2022.
This essay was written by an author who will participate in the St. Petersburg Conference on World Affairs, which runs from Feb. 15-18, 2022. [ Photo illustration by Don Brown ]
Published Feb. 11

Editor’s note: For years, the St. Petersburg Conference on World Affairs has brought together diplomats, journalists and academic experts to discuss key international issues. This year’s edition is planned as an in-person and live-stream “hybrid” event. It will be held from Tuesday through Friday. It is free, but sign-up is required at This column was written by a conference participant.

The impact of COVID-19 shines a bright light on the disparity-darkened corners of our world. Inequities in health care access and efficacy are laid bare by the virus’ ravaging hold on unvaccinated populations. Whether stymied by the post-traumatic hesitancy of African-Americans who recall historic transgressions that targeted minorities, or physical challenges such as the NPR reported 20-hour mountainous journey across front lines that stands between inoculation and willing people in Yemen, COVID persists, in part, because disparities in prevention and care do.

Kanika Tomalin
Kanika Tomalin [ Provided ]

The World Health Organization’s 2021 goal to vaccinate 40% of every country fell short against the realities of the nearly 40 countries that couldn’t break 10%. An extended effort to vaccinate 70% of each nation’s people by the end of 2022 hangs in the balance. The agency’s comprehensive Strategy to Achieve Global COVID-19 Vaccination underscores our inextricable connectivity across borders and boundaries; illustrating the pressing need for planet-wide equilibrium that puts an end to wasted vials in wealthy nations, while other countries wait with little promise for limited supply.

It’s no surprise that nearly all of the 36 countries that hover at vaccination rates of 10% or less share geography in the world’s waistline — middle Africa, a region where historically our geopolitical resource belt tightens when faced with scarcity of critical supply. At a global health conference last June, Dr. Matshidiso Moeti, WHO’s regional director for Africa, shared the startling statistic that the United States administered 11 times as many COVID-19 tests as the entire WHO African region, which spans 47 countries.

And, while the supply challenges that drive disparate outcomes in the world’s underserved areas are being increasingly conquered, disparities of every kind, across every diagnosis, continue to mount. Race, ethnicity, age, geography, disability, sexual identity, socioeconomic status and other demographics have long informed health outcomes across the world, America and our community.

According to America’s Health Ranking’s 2021 Health Disparities Report, the nation celebrated progress in several key measures prior to the pandemic, but not all Americans share equally in these improvements. Black infants and their mothers continue to have the highest birth-related mortality rates. Disparities in the prevalence of chronic diseases, such as asthma, cancer and diabetes persist by race and ethnicity. Mental health challenges are more prevalent among some racial and ethnic groups. And, food insecurity among underserved populations increased almost everywhere. That same report shows some progress for Florida’s outcomes, but high disparity between subpopulations.

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The work to understand and eradicate health disparities begins long before a patient needs a doctor. The healthiest communities engineer equity and opportunity for the social conditions that define quality of life: housing, education, economic stability, neighborhood safety, access to nutritious food and dependable transportation. All of these factors play a critical role in the health outcomes that can be expected and experienced. Systemic racism, implicit bias and historic disenfranchisement in these areas compound negative outcomes for some in ways that cannot be out earned, out educated, or outperformed. The crushing weight of bias-driven disparity requires the bias to be changed, not the people who suffer as a result.

St. Petersburg, home to the upcoming Conference on World Affairs, is a community that has made significant commitment and impressive strides in this regard. A vision-driven, values-fueled partnership between the private and public sectors acts as a catalyst for systems change that is making a difference.

Years of service to provide quality health care for all, regardless of ability to pay, taught me that access to care is at the core of so many of the issues we faced in City Hall. Poverty, homelessness, inclusive economic prosperity, and education all have roots in residents receiving the right care, from the right provider at the right time. In 2015, I initiated Healthy St. Pete — a community engagement and empowerment initiative to build a culture of health. Today, it thrives as a great amplifier of life changing-efforts that unfold throughout our community. From the American Heart Association to the Foundation for a Healthy St. Pete, many local organizations work effectively to end health disparities, formally accepting this charge as central to their missions.

This critical work must remain a principal priority for the world’s leaders and everyone who calls our community home. Whether crossing a sweltering desert in the Sahara in search of a vaccine, or a food desert in St. Pete in search of fresh vegetables, the delta that divides the Earth’s people by access and outcomes is a pervasive determinant of overall quality of life. It needn’t be permanent. Change starts here.

Kanika Tomalin is the Chief Operating Officer and vice president for Eckerd College in St. Petersburg. There she leads the Eckerd College St. Pete Center for Engaged Citizenship and Social Impact. She is a former health care executive who holds a doctorate in Law and Policy and served eight years as the deputy mayor and city administrator of St. Petersburg. She is a featured speaker on the upcoming St. Petersburg Conference on World Affairs Health Equity vs. Health Equality panel.


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