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public health has two main goals The first is to promote the health of the population, and the second is to reduce health inequities. Those are moral aims or ethical endeavors that public health is concerned with and I’m just going to focus for a minute on the second one, Which is around health equity
What is health equity?
promoting health equity as a primary public health goal Health equity is really about ensuring that everyone in the population has the resources for health.
And so when we’re addressing health equity, we need to be concerned about unfair or unjust conditions that create a situation in which some members of the population Are disadvantaged in terms of gaining access to their full optimal level of health
so when we think about health equity as a moral endeavor, that means that there’s a set of ethical issues that we have to be concerned about and it’s not your usual set of ethical issues that we might think about, such as in public health ethics we do think about things like emergency
So when we think about health equity as a moral endeavor, that means that there’s a set of ethical issues that we have to be concerned about and it’s not your usual set of ethical issues that we might think about, such as in public health ethics we do think about things like emergency preparedness We think about uh dealing with health
and when we should communicate to the public, what’s the right information at the right time? When we’re talking about health equity issues, we’re concerned with issues that are very much of concern across society because they disadvantage individuals From gaining access to resources to help
So as examples we can think about the fact that sometimes people are not able to achieve health because of issues related to stigma racism gender bias to sexual discrimination Those are examples of equity issues because not everyone has the same opportunity for health because those kinds of social conditions create disadvantage and people can’t always access the same kind of resources
Another example would be if you think of living in a poor neighborhood, you don’t have the same access to nutritional food to safe and adequate housing Those are other things we often call the determinants of health and those determinants influence whether people Can be healthy or not so we kind of have a whole additional set of ethical issues that arise when we take very seriously this aim to promote health and to reduce health inequities
Let’s understand more about health equity with this example.
Hi, I’m an expert with the American Public Health Association and today we’re going to talk about health equity.
Let’s imagine that you’re a baseball fan on your way to a game but when you reach the stadium, there’s a wooden fence blocking the view Some people are standing on milk crates to catch a glimpse; some are tall enough to not even need a crate but they’re standing on a whole stack of them anyway; And some are standing in a ditch where even a crate couldn’t help them so some get to see the game and some don’t
We face a similar situation in public health: some people can easily access whatever resources and services they need and others who struggle to get the basics like health care clean water safe housing education and a livable wage. This means that certain groups of people are more at risk for disease but have less ability to get treatment, so They may be more likely to get severely sick or die from treatable and even preventable diseases
Let’s go back to our baseball example to explain more Just like a difference in height helped some people see the game, many health outcomes are a result of things we can’t change, like age or genetics bones become more brittle as we age so we’d expect 80-year-olds as a group to suffer more hip fractures than 30 somethings
On the other hand, back at the game, some people Weren’t naturally tall enough to see and didn’t have any crates, and others were forced to stand in a ditch Likewise many gaps in health trends are caused by a lack of access to various resources and are rooted in unfairness
A person’s education income employment status and housing all have an impact on their health These are what we call the social determinants of health, and when non-medical factors like these contribute to a difference in health, we call that difference a health disparity.
Like black mothers, black mothers are almost three times more likely to die in childbirth than white mothers and are less likely to have access to quality prenatal care there’s no biological reason for this but there is a strong history of medical racism toward black women so this is an example of racial inequity or the unfair and unequal distribution of resources along racial lines when addressing health disparities
Some focus on Equality which would mean giving the same assistance to all but this doesn’t often work in practice because some people need more support or a different kind of support
For others, an online portal that lets you quickly sign up for vaccinations is a great idea but for people who don’t have internet access or a car to get to the vaccine clinic, it’s still a one size doesn’t fit all solution
5 Reasons Why Health Equity Matters
Health equity is the fair and just distribution of health resources and opportunities, regardless of race, ethnicity, gender, socioeconomic status, or other factors. It means that everyone has the opportunity to live a healthy life, regardless of their circumstances.
There are many reasons why health equity matters. Here are five:
- It is the right thing to do. Everyone deserves to have the opportunity to live a healthy life, regardless of their background or circumstances. Health equity is about ensuring that everyone has the same chance to be healthy, regardless of their race, ethnicity, gender, socioeconomic status, or other factors.
- It is good for the economy. When people are healthy, they are more productive workers and taxpayers. They are also less likely to need costly medical care. Achieving health equity can boost the economy and create a more equitable society.
- It is essential for public health. When there are health disparities, it means that some people are more likely to get sick and die than others. This can lead to outbreaks of disease and other public health problems. Achieving health equity can help to improve the overall health of the population.
- It is a moral imperative. We live in a society where everyone should have the opportunity to reach their full potential. Health equity is essential for creating a just and equitable society.
- It is possible to achieve. There are many things that can be done to achieve health equity, such as addressing the social determinants of health, expanding access to healthcare, and eliminating discrimination. By working together, we can create a healthier and more equitable society for all.
Here are some specific examples of how health equity can be achieved:
- Expanding access to healthcare: This includes making sure that everyone has health insurance, regardless of their income or employment status. It also includes making sure that healthcare is affordable and accessible to everyone.
- Addressing the social determinants of health: These are the factors that influence our health, such as our housing, education, employment, and income. Addressing these factors can help to improve the health of everyone, regardless of their race, ethnicity, or socioeconomic status.
- Eliminating discrimination: This includes discrimination in healthcare, housing, employment, and other areas. Eliminating discrimination can help to ensure that everyone has the same opportunity to be healthy.
Health equity is a complex issue, but it is one that is worth fighting for. By working together, we can create a healthier and more equitable society for all.
In addition to the above, here are some other things that can be done to achieve health equity:
- Invest in public health programs that promote healthy behaviors and environments.
- Support research on the social determinants of health and how to address them.
- Raise awareness of health equity issues and the need for action.
- Advocate for policies that promote health equity.
We all have a role to play in achieving health equity. By working together, we can create a healthier and more just society for everyone.
How Can Health Care Promote Health Equity?
Let’s go back to the four-year gap between yes the racial gap in life expectancy that remains yes and is unconscionable Can we close that with health care or is it as worn out That’s a good question so health care clearly has a part to play and you know ensuring that every patient gets high-quality care would be a step in that direction because their racial-ethnic disparities not only in the onset of
Disease and the prevalence of disease but in the course of the disease the severity in courses worse and part of the poorer prognosis and the more difficult severity of disease for many minorities it reflects the fact that they don’t get as high-quality care so quality care is important most estimates suggest though that medical care alone will not solve the problem we have to look at all of the factors that drive health the fact that medical care
Is important in terms of restoring us to good health once we get sick but what drives health what makes us healthy in the first place has a lot to do with the opportunities to be healthy in the places where most Americans spend time in our homes you know workplaces in our schools in our neighborhoods and so where we live learn work play and worship and opportunities to be healthy in those places have a lot to do with health so
Health strategies would include things like ensuring that every child has a life where they can grow up and thrive and be not only ready for school but a life free of early childhood adversity and stress which could include things like chronic poverty for example stress sores that have a long term like negative health consequences there is a very strong relationship in the United States and elsewhere in the world between education and health so ensuring
Good quality academic success ensures better socioeconomic success which is powerfully linked to health Looking at the opportunities to be healthy in neighborhoods in some neighborhoods it’s not easy to find a safe place to exercise, and there isn’t access to fresh fruits and vegetables so again creating a culture of good health where the healthy choice becomes the easy choice where people work and where people live are all factors that can play a role in
Improving the quality of health and racism has played a role in creating neighborhoods that are unequal in access to resources and so on so that’s another distal mechanism in which racism affects health