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This Article Extract Full Text (PDF) All Versions of this Article: AJPH.2005.063396v1 95/7/1089    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Freimuth, V. S. Articles by Quinn, S. C. Search for Related Content PubMed Articles by Freimuth, V. S. Articles by Quinn, S. C. Related Collections Health Education Other Race/Ethnicity

Vicki S. Freimuth, PhD and Sandra Crouse Quinn, PhD

Vicki S. Freimuth is with the Department of Speech Communication and the Grady School of Journalism, University of Georgia, Athens. Sandra Crouse Quinn is with the Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pa.

Correspondence: Requests for reprints should be sent to Sandra Crouse Quinn, PhD, Graduate School of Public Health, 230 Parran Hall, 130 Desoto St, Pittsburgh, Pa, 15261 (e-mail: squinn{at}pitt.edu).

Eliminating racial and ethnic health disparities requires a multidisciplinary approach, including scholarship on the contribution of intelligence (IQ) to health outcomes as described by Batty and Deary. We agree with his conclusion that "proactive involvement of health care providers in the provider–client interaction . . . might reduce health differentials." However, his reliance on IQ to make his claim places limits on our comprehensive health communication focus and minimizes important social determinants of health.

Batty and Deary present evidence that IQ and health status are strongly correlated. While correlation is not causation, a potential relationship in some individuals is no surprise, given that both IQ measures and health status are dependent on social and cultural determinants. In fact, Neisser and colleagues state, "All social outcomes result from complex causal webs in which psychometric skills are only one factor." ^1(p96) This statement is consistent with a conclusion from Taylor et al.’s study on smoking cessation, also cited by Batty and Deary: "[O]ur data suggest that once variance in social class and deprivation was taken into account the effect of childhood IQ on smoking cessation was no longer significant."^2(p465)

Populations suffering from disparities have been blamed for the lack of success of many interventions and labeled pejoratively as "hard to reach," "obstinate," "recalcitrant," and "chronically uninformed."³ The practice of negatively labeling groups with health disparities is counterproductive. If we focus on strengths rather than weaknesses and shift the responsibility for eliminating disparities from the individuals affected to the professionals with the responsibility of reaching them, we may make a greater contribution toward closing the gap. Over the years, we have raised awareness about the problem of low health literacy, and progress is being made in adapting health communication materials to populations with lower literacy levels. Information must be functional in people’s lives before we can expect them to value and use it. Furthermore, social determinants of health disparities extend beyond the individual level to include exposure to environmental hazards; socioeconomic factors, including education, income, and employment opportunities; discrimination; neighborhood conditions; access to health services; and lifestyle choices.⁴ These factors constitute the web of causation in which IQ may be but one thin thread. Therefore, health communication strategies must address multiple determinants in order to be effective in eliminating disparities.

Acknowledgments

Sandra Crouse Quinn is supported by the EXPORT Health Project at the Center for Minority Health, University of Pittsburgh (NIH/NCMHD grant P60 MD-000-207-02).

References

1. Neisser U, Boodoo G, Bouchard TJ Jr, et al. Intelligence: knowns and unknowns. Am Psychol. 1996;51: 77–101.[CrossRef]

2. Taylor MD, Hart CL, Davey Smith G, et al. Childhood mental ability and smoking cessation in adulthood: prospective observational study linking the Scottish Mental Survey 1932 and the Midspan studies. J Epidemiol Community Health. 2003;57: 464–465.[Free Full Text]

3. Freimuth VS, Mettger W. Is there a hard-to-reach audience? Public Health Rep. 1990;105: 232–238.[ISI][Medline]

4. Control Centers for Disease and Prevention. Health disparities experienced by black or African Americans—United States. MMWR Morb Mortal wkly Rep. 2005;54:1–3.[Medline]

This Article Extract Full Text (PDF) All Versions of this Article: AJPH.2005.063396v1 95/7/1089    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Freimuth, V. S. Articles by Quinn, S. C. Search for Related Content PubMed Articles by Freimuth, V. S. Articles by Quinn, S. C. Related Collections Health Education Other Race/Ethnicity