Health Equity means Social Justice for health (i.e., nobody is denied their opportunity to be healthy because they are part of a group who has been historically economically/socially disadvantaged). For the purposes of measurement, health equity means the reduction and eventual elimination of disparities in health and its determinants that negatively impact excluded or marginalized groups. How access equity is measured in health care is typically linked to social determinants of health.
Considering health care through the lens of equity means taking the social determinants of health, like systemic racism and sexism, seriously. Achieving health equity generally means eliminating or reducing barriers to the social and economic resources that impact individual health. Achieving health care equality requires treating all people the same, through a concentrated, sustained social effort that addresses avoiding disparities, historic and present-day injustices, and eliminating disparities in health care and care.
IHI seeks to achieve health equity through working collaboratively with organizations, communities, and individuals to accelerate the elimination of health and health care access, treatment, and outcomes disparities throughout our country. Over the years, efforts to address inequities and achieve health equity have focused predominantly on diseases or illnesses and on the delivery of health care services. Consistent with that focus, Healthy People 2030 provides tools for action that can help individuals, organizations, and communities committed to improving health and wellbeing promote health equity.
To equip public health practitioners with tools to tackle these disparities in their communities, the report describes multiple ways that equity-based changes to housing justice can be advanced by leveraging policies and advocacy, cross-sector partnerships, and engagement and education of communities. The fact sheet provides recommendations to combat existing inequities that exacerbate these health impacts for children of color and those living in underserved communities.
Research also suggests that disparities occur throughout the lifespan, from birth, to middle age, and in older adults. Federal efforts to reduce disparities have focused on designated priority populations, including people of color, lower-income populations, women, children/adolescents, older adults, individuals with special health care needs, and individuals living in rural and urban areas. For instance, differences in health and medical care are present among Latinos by duration in our country, major languages, and immigration status. In addition, data for Asians frequently disguise the potential for differences between subgroups within the Asian population.
Inequalities are different than health inequalities, which are differences in peoples health outcomes that are related to social or demographic factors, such as race, sex, income, or geographic area. Health care disparities generally refer to differences among groups in health insurance coverage, access and utilization of care, and quality of care. The terms health inequity and health disparity are also used to denote disparities.
Prior to the publication of Healthy People 2020 in 2010, federal agencies had formally defined health disparities in very general terms, referring to differences in health between various groups in a population, with no additional specifics. Healthy People 2020 defines health disparities as a specific type of health disparity closely related to social, economic, and/or environmental disadvantage. Although the term disparity is commonly interpreted to mean a racial or ethnic difference, there are multiple dimensions to disparities, especially health differences, across the U.S.
These factors that affect the health of individuals or populations are known as health determinants. When factors like social location restrict a persons health, this may result in health disparities. Social determinants include education, housing, and the surrounding neighborhood environment (e.g., sidewalks, parks), access to transportation, job opportunities, laws and justice systems, and the healthcare and public health systems. We partner with other sectors to address factors affecting health, including employment, housing, education, health care, public safety, and access to food.1 We identify racism as one of the forces determining how factors that affect health are distributed.
Resolving disparities in health and in healthcare is important, not just in terms of social justice and equity, but in improving the overall health of our country and the economic prosperity. Those institutions and physicians who fail to acknowledge the importance of attaining health equity within their communities, as well as the reduction of costs associated with health disparities, will be challenged increasingly in future years as this nation moves to a healthcare system that is more affordable, equitable, affordable, and person-centered. Gradually realizing the right to health means systematically identifying and eliminating disparities resulting from differences in health and in general conditions of life.
Pursuing health equality means striving to achieve the highest health standard possible for all individuals, while paying particular attention to the needs of individuals who are at greater risk for poor health, as determined by their social conditions. The definition of health equity presented above will be discussed as one resource to guide solutions and measure progress, and other participants will share examples of how their communities are working toward making sure that all can have the best health. Reflection means education, housing, transportation, community development, business, finance, and other sectors must participate in efforts for health equity, and our definition must clearly recognize that health equity requires efforts that go beyond the healthcare sector. The Fact Sheet teaches us how to promote health equity in education, with efforts like offering group therapy, providing students with access to washrooms and dryers, and making sure that school personnel have consistent opportunities for culturally competent professional development.
The legislation also strengthens opportunities for engaging community health workers across our nations health care systems, creates grant programs to address health care inequities, and requires providers of tax-exempt hospitals to conduct meaningful assessments of communities health needs. In fact, 30 years ago, during the Reagan Administration, the federal government began efforts to make laws and policies prioritize issues affecting health outcomes for underserved populations, as well as disparities experienced by those groups.
For instance, if health seemed to get worse for a whole group over time, or there was a major outbreak of disease in affluent communities not seen in the least-affluent communities, those differences in health merited attention, but for reasons other than their correlation with health differences or fairness. Some groups are disproportionately exposed to combinations of health risks, such as poverty, violence, unsafe housing, and environmental health hazards, which may increase the need for health interventions.