Health equity is the attainment of the highest level of health for all people. It involves valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of disparities in health and health care.
Often, these inequities arise from access to the social determinants of health, including income, education, and neighborhood characteristics. Understanding how specific adverse SDOH lead to health disparities helps healthcare professionals improve the health of populations.
Health equity refers to a state of health where everyone can be as healthy as possible without limiting the opportunities for them. It includes a variety of nonmedical factors that can influence health, including education, income, social status, neighborhoods, and medical care.
To achieve health equity, communities need to identify and address avoidable inequalities, historical and contemporary injustices, and the social determinants of health. By valuing everyone equally, they can create policies, laws, systems, environments, and practices that reduce and eliminate inequities, improve access to services, and build community strength and resilience.
Developing a common definition of health equity can help bridge divides and promote productive dialogue across diverse stakeholder groups. It also can help ensure that efforts are focused on core values and are consistent with current scientific knowledge.
Social determinants of health
The social determinants of health are conditions in the environments where people live, learn, work, play and age that affect their physical, mental, and socioeconomic health. They can be influenced by economic policies and systems, development agendas, and social norms.
These factors can make a difference in how people access health care and quality of care, and in how well they are able to maintain good health over time. A clear understanding of the role of social determinants in health is important for all stakeholders-including physicians, researchers, policymakers, and patients.
The social determinants of health are complex and inextricably linked, often involving multiple factors that can impact individuals independently or in combination. The effects of these factors persist into generations. They can lead to health inequities that result in different outcomes for racial and ethnic groups, including a higher incidence of certain diseases and lower life expectancy for some populations. The Centers for Disease Control and Prevention (CDC) emphasizes that the underlying social determinants of health must be addressed to achieve health equity.
Throughout the country, people of color and other underserved populations experience health disparities. This includes differences in access to and use of healthcare, insurance, and quality of care.
Disparities in health affect the quality of life of individuals, families and communities. They also lead to significant economic costs and premature deaths in the United States.
Federal agencies have generally defined health disparities in very general terms, and they lack clear criteria for identifying them. In addition, many differences in health between groups are not related to specific social positions but rather are part of the domain of epidemiology (the study of the distribution of diseases and other risk factors).
The best method of measuring a difference in the rates of a health indicator among disadvantaged groups is to compare their rate with the average population rate of the same indicator. However, this practice has been discouraged because it is not informative about the extent of inequalities in health, particularly when the disadvantaged group is relatively small and its rate is not very different from the overall rate.
Health equity is about looking at all the factors that influence health and addressing the disparities in those factors. This requires engagement from many sectors, including healthcare.
One way that healthcare systems can address health equity is by making it a systemwide strategic priority and investing in the right resources, infrastructure, and programs. Some systems, such as Allina Health, have done this and have achieved impressive results.
Solutions to health equity include addressing racial and ethnic disparities in insurance coverage, access, and quality of care. These inequities are costly to the economy, as well as to individuals and their communities, resulting in lost productivity and increased disability costs.
Other solutions include focusing on the social determinants of health and building community connections that protect from toxic stress and help people cope with adversity. Investing in these solutions will increase overall health outcomes and improve community well-being. It will also promote economic mobility and strengthen the social safety net, ensuring that everyone has access to the services they need to thrive.