Over the last three decades a variety of approaches have been proposed to identify, evaluate and intervene in factors or conditions which affect the well-being of underserved populations, especially youth. Longitudinal assessments, individual-based theoretical models and health related features of the environment provide insight and suggestions on how to remedy conditions associated with health disparity in the US. These evidence-based evaluations can identify specific health indicators that are amenable to improvement if the appropriate interventions are initiated. This article broadly reviews several approaches that address health indicators for youth. In addition, using geocoding technology, several local neighborhoods are identified as having conditions that marginalize good health. Local initiatives in these two communities are described and outcomes for these efforts are compared and discussed. This article also presents possible reasons for why documented disparities among underserved populations are not addressed and known solutions to those disparities do not occur.

Key Take Away Points

. Health is not an isolated variable

. The context in which we live impacts our well-being

. Improvements in the social determinants of health can be cost effective in reducing morbidity and mortality among vulnerable populations.

Author Biography

For 44 years, Dr. Peggy B. Smith has directed the Baylor College of Medicine Teen Health Clinics, a county-wide system of 10 reproductive health clinics for inner city youth, and has demonstrated leadership in focusing community resources on this issue. As a Professor in the Department of Obstetrics and Gynecology, Pediatrics, and Psychiatry, she has participated in a variety of research and academic projects adolescent pregnancy, reproduction, and male sexual health. In these domain, She has successfully collaborated with a variety of public and private entities including the Texas Legislature to craft and implement health policies to reduce health disparities in this targeted population. The Teen Health Clinics have also played a significant role in integrating health care research in clinical settings. Initiatives, such as expedited partner treatment for STIs, outreach for male involvement, group maternity care and family planning, and broad-based utilization of rapid testing for HIV are included in state of the art care. Such initiatives have allowed these clinical services to be the model for quality programs among youth in our state. This leadership has generated broad-based support for innovative approaches to reduce STIs, pregnancy, and infant mortality. The clinics also operate school-based programs, conduct outreach to at-risk populations, and use an electronic messaging program, teenhealthclinic.org, to reduce risky sexual behavior among teens.


This work was made possible in part by the Madison Foundation, the Spirit Golf Association and the O'Neill Foundation.