What is health equity?
When it comes to health care, it might seem—with medical advancements and state-of-the-art technology in today’s world—that everyone should have a human right to health. When you’re sick, make a doctor’s appointment. When you’re experiencing a major medical issue, call 911. When you’re ready to adopt a healthier lifestyle, you know the drill: Eat more nutritious foods, start exercising and make sure to get at least eight hours of sleep every night. It sounds easy enough.
In actuality, the solution is not that simple.
The role of social determinants of health
Your health doesn’t start in a clinic or hospital. And it’s so much more complex than personal choice or genetics.
Non-clinical factors like housing, education, air quality and access to food all affect our health and well-being. The personal, social, economic and environmental factors influencing health outside of exam rooms and hospitals are determinants of health.
According to the U.S. Department of Health and Human Services, social determinants are “the social conditions in the environments where people are born, live, learn, work, play and worship.”
Social determinants are circumstances that impact a person’s health—circumstances that can be powerful predictors of risk and outcomes.
What are health disparities? Why do they matter?
Differences in the health status of groups are called health inequalities. An inequality is the unequal treatment between people because of social differences.
If there is a difference, then a disparity exists.
Disparities aren’t just influenced by race, poverty or ethnicity. Gender can play a role. So can geography, age, religion or sexual identity.
The National Institutes of Health defines health disparities as “the metric we use to measure progress toward achieving health equity.” They help tell the complete story.
What are health inequities?
Inequities imply an unfairness. Community-level policies that affect public health—including where funding goes—have created unfair systems and structures that prevent people from accessing basic health services (and reaching their full potential). In turn, those systems have negatively affected certain groups more than others.
“Health inequities are rooted in social injustices that make some population groups more vulnerable to poor health than other groups.”1
What causes health inequities? According to Communities in Action, they stem from the “unequal allocation of power and resources, including goods, services and societal attention, which manifests into social determinants of health.”
Health inequities are preventable socially-produced (human-invented vs. biological) barriers to opportunities. Poverty and discrimination, for example, are health inequities that can stand in the way of a long, healthy life.
What’s the difference between a disparity and an inequity?
According to data from the Centers for Disease Control and Prevention (CDC), in July of 2021, American Indian/Alaska Native people had died from Covid-19 at a rate 2.8 times higher than white people, when taking age into account. That statement illustrates a disparity.
The why behind health disparities can uncover not-so-measurable unfair and avoidable injustices, or health inequities. Why is life expectancy lower in certain demographics than others? Why is the prevalence of diabetes higher among certain populations? Why did the pandemic hit certain groups harder than others? What social determinants played a role?
Non-medical factors affecting health outcomes:
- Childhood experiences
- Race (racism)
- Sexual orientation
- Education/literacy
- Living conditions (clean water, public safety, pollution)
- Access to health services
- Job opportunities
- Social support
- Income/social status
What is health equity?
Health equity isn’t just a shift in health outcomes. It’s the concept of dismantling the systems and public health infrastructure that contribute to disparities. It’s social justice in health.
For example, according to the National Institutes of Health, it’s when “no one is denied the possibility to be healthy for belonging to a group that has historically been economically/socially disadvantaged.”
The CDC defines health equity as “when every person has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances.”
Health equity is not about treating everyone equally, because not all circumstances are equal (case in point: social determinants). It’s about identifying the needs of certain populations and creating strategies to support them. It’s about meeting people where they are, wherever they might be. It’s about the distribution of resources, of creating a fair playing field.
One size doesn’t fit all: Think differently
We don’t have the same resources or opportunities to achieve our full health potential. In order to achieve health equity, we have to identify and address health disparities by asking tough questions. We have to find creative ways to implement system-level changes. It starts with recognizing the deeper issues at play and changing our thinking.
When you’re sick, you make a doctor’s appointment.
I don’t have the income for an unexpected expense. I need this job and can’t take time off work for an appointment. I don’t have a car to get to the doctor.
When you’re experiencing a major medical issue, call 911.
I live in a community with limited broadband/cell phone service and don’t have a cell phone—or even a landline—to place a call. I didn’t know the jaw pain and shortness of breath I was experiencing were signs of a heart attack. I didn’t call 911 because I didn’t think it was that serious.
When you’re ready to adopt a healthier lifestyle, you know the drill: Eat more nutritious foods, start exercising and make sure to get at least eight hours of sleep every night.
The nearest full-service grocery store is nowhere near where I live, but we do have plenty of fast-food restaurants.
I would love to go for a run in my neighborhood, but I really don’t feel safe doing that.
I can’t get eight hours of sleep at night, I work two jobs to make ends meet.
How do you promote health equity?
Not only do people have to think differently, the system needs to change.
A health equity agenda might include:
- Access to affordable, healthy food
- Safe places to exercise
- Education reform
- Job opportunities
- Healthy neighborhood communities
Leveraging data
A completely revamped health plan like Surest can help drive change on a larger scale. One way to do this is through data, data, data. Data can paint a clear picture of how people are affected by social determinants and inequities.
At Surest, data is used to price and design subsidization. For service categories that are prevalent within high-risk, underserved populations, we can apply a price discount to those services—regardless of race or ethnicity. This can decrease the financial burden and increase access to care for populations who have faced systemic discrimination in health care. Employers with employees more likely to be dealing with specific conditions, like renal failure or diabetes, can now offer a plan that lowers the cost of these conditions, making it more affordable across their population.
Ready to learn how Surest is closing health equity gaps and building a better future? Contact us
1 Boston Public Health Commission. “Health disparities vs. health inequities.”