John VorhausHealth equity is a concept that values everyone’s health equally. This includes removing or reducing barriers and biases that may prevent people from accessing healthcare.
Achieving health equity requires efforts at the individual, community, and national levels. These include advocacy, training, and research.
Social determinants of health
The social determinants of health (SDOH) are the conditions that shape people’s lives, including their employment security, income levels, housing stability, food availability and access to quality education. These factors influence health outcomes, and they are often influenced by public policy decisions that are made by governing authorities.
As a result, countries with higher levels of income and wealth tend to have better health outcomes than those with lower incomes and wealth. These differences are called health inequities.
To address health inequities, physicians, public policymakers, communities, and individuals need to understand the role that these factors play in individual and community health. They must strive to implement policies that reach the largest number of people while targeting the day-to-day needs of individuals in their communities. This will help reduce health disparities and promote health equity across the population.
Health inequities
Health inequities are systematic differences in health status between groups of people due to unfair systems that negatively impact their living conditions and access to healthcare. They have significant social and economic costs both to individuals and society.
Inequities impact everyone – privileged and disadvantaged alike. As Pierre Theodore, MD, vice president health disparities at Johnson & Johnson Global Public Health, notes, “When you address inequities for one group, you raise the level of health for all.”
Disparities stem from a broad range of factors and are often linked to socioeconomic disadvantage. These include racial or ethnic origin, religion, gender, age, disability, mental illness, cognitive, sensory, or physical impairment, and geographic location.
Access to health care
Access to healthcare services is a crucial determinant of health equity. Inequalities in access can lead to higher rates of illness, mortality and premature death among racial and ethnic minorities and low-income populations.
Health insurance, a critical component of access, facilitates entry into the health care system and helps people afford needed medical treatments without having to pay out-of-pocket. Uninsured Americans live longer and have more serious health problems than those with insurance (Healthy People 2020).
Inequalities in healthcare access are also influenced by other factors that are outside an individual’s control, such as socioeconomic status, race, poverty and the availability of medical education, technology and infrastructure. Policy makers must be aware of these factors and take action to address them.
Prevention
Investing in prevention is the best way to address many health issues. It can help to stop things like disease, mental illness or suicide in their tracks before they begin.
People have long known that certain behaviors and lifestyle choices can decrease the risk of a variety of conditions including diabetes, heart disease and cancer. Yet, all too often, preventive care isn’t accessed.
This is often due to factors such as income, education level and access to transportation. But it also occurs because of social determinants, such as housing insecurity or poor nutrition.
The National Institutes of Health recently surveyed experts to determine why these gaps exist and how to better promote health equity in preventive care. The researchers concluded that social determinants are a major driver of disparities in health care. They said, “It is critical that we better understand the ways in which social determinants impact preventive care access and take steps to address them.”