What is health equity?
By Dr. Nancy Yoon of the Springfield-Greene County Health Department
Health equity exists when everyone has a fair and just opportunity to reach their full potential for health and well-being. Unfortunately, there can be multiple systemic barriers that people face to achieving health equity, which includes lack of access to quality education and housing, safe environments, healthcare, and good jobs with fair pay. Additional obstacles include poverty, racism and discrimination. These can all lead to health disparities, which are differences in population health status and mortality rates that are systemic, patterned, unjust, and actionable, as opposed to random or caused by those who become ill.
Here are a few questions that are often asked when it comes to health equity, answered.
What are some groups that can experience health inequities?
Historically marginalized or excluded groups include groups of similar races, ethnicity, gender, sexual orientation, age, class, disability status, and/or neighborhood of residence. Inequities often result from structural racism or the historical disenfranchisement of particular marginalized groups. These groups have been withheld from obtaining resources needed to be healthy. It’s important to note when discussing health inequities that historical and current experiences of racism and discrimination contribute to mistrust of the healthcare system. This mistrust may extend to medical treatments, healthcare providers and institutions.
What are some examples of health inequities?
Well, let’s take one of the most recent and the one that has been on nearly everyone’s mind the past two years: the COVID-19 pandemic. The COVID-19 pandemic has had a disproportionate impact on Black/African American, Hispanic/Latino, American Indian and Alaska Native persons, who have experienced higher rates of COVID-19-related hospitalization and death compared with non-Hispanic White populations. These disparities persist even when accounting for other demographic and socioeconomic factors.
For many years, there have been gaps in life expectancy between Black and white Americans. Many may not realize that Black, Hispanic and American Indians/Alaska Natives have higher rates of diabetes than white Americans. Also, Black women are three times more likely to die from a pregnancy-related cause than White women. Communities of color have been disproportionally affected by the effects of climate change such as air pollution and extreme weather events.
Why should we be concerned about health equity?
The goal of health equity is that everyone has the opportunity to achieve optimal health. Health disparities contribute to avoidable medical costs related to preventable diseases and the overutilization of health care resources. Health disparities also result in negative economic impacts due to decreased employment potential and loss of productivity. Efforts to improve health equity will ultimately benefit all of society in a sustainable manner.
How can we achieve health equity?
Equity recognizes that each person has different circumstances, and allocates resources and opportunities needed so that everyone can reach an equal outcome. We need the collaboration of health systems and providers, employers, public health agencies, policy makers, community organizations and others to all work toward this common goal of improving the health of everyone in our communities.
Services should be provided in a culturally and linguistically appropriate way for all people. Accessibility factors should always be considered, including location and time of services offered, transportation, broadband access, language services, accommodation for disabilities, and reduction in stigma. Historically marginalized groups should be included as part of the planning and implementation of activities to achieve greater health equity.
Access to the conditions and resources that influence health also needs to be addressed. These social determinants of health include good jobs with fair pay, high quality education, safe housing and physical environments, high-quality healthcare, and freedom from discrimination.
Progress should be assessed over time to measure changes in health disparities experienced by the marginalized groups, and the size of gaps between disadvantaged and advantaged groups.
There are a few more specific ways we can achieve health equity, including encouraging representatives in Congress to support health equity legislation and to increase funding for public health investments, and supporting access to comprehensive and affordable health coverage.
A positive example of increasing funding for public health investments would be the recent grant awarded to the Health Department by the Missouri Department of Health and Senior Services which will help us address health disparities caused by COVID-19 in Greene County. With the help of this grant, we will be able to expand testing and vaccination opportunities to underserved communities in Greene County and continue toward the goal of health equity here in our community.
This is all to say that collaborative, community-led, multi-sector approaches will pave the way to the goal of having thriving, resilient communities with improved health outcomes and greater social cohesion for people of all identities.
Sources:
American Public Health Association. (2022, March). Health Equity. https://www.apha.org/topics-and-issues/health-equity
National Center for Chronic Disease Prevention and Health Promotion. (2022, March). Health Equity. Centers for Disease Control and Prevention. https://www.cdc.gov/chronicdisease/healthequity/index.htm
Robert Wood Johnson Foundation. (2022, March). Achieving Health Equity. https://www.rwjf.org/en/library/features/achieving-health-equity.html
