What is health equity? October 13, 2022
Equality and equity are not the same thing, although many people do tend to use the terms interchangeably. As a direct primary care (DPC) provider, you are focused on providing quality care to your patients and should be concerned with the equity of that care. What exactly is health equity and what does it mean for your DPC team in practical terms?
The Centers for Disease Control & Prevention (CDC) explains that health equity “is achieved 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.’” The organization points out that health inequities are reflected in the differences patients experience in their:
- Length of life
- Quality of life
- Rates of disease, disability, and death
- Severity of disease
- Access to treatment.
The World Health Organization defines equity as “the absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically.” While lack of access to healthcare is a major factor, inequities can also “infringe on fairness and human rights norms.”
Health equity, then, is essentially ensuring that all individuals have the opportunity to be healthy. That involves a process designed to provide care in a way that reduces the health disparities gap. The DPC practice is in a unique position to help address the underlying needs of the underserved and vulnerable populations.
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Often, social determinants of health, including income level, education, underemployment and unemployment, geographic neighborhood location, ethnicity, and race, contribute to the availability of access to healthcare that can affect a patient’s equity status. For example, these determinants have been found to impact the occurrence or heart disease, stroke, and other health-promoting behaviors.
Experts at the Robert Wood Johnson Foundation state that health equity “means increasing opportunities for everyone to live the healthiest life possible, no matter who we are, where we live, or how much money we make.” In a published report, they outlined four key steps to achieve health equity that your DPC practice can assist with in regard to improving opportunities for your patient population:
- Identify important health disparities. Many disparities in health are rooted in inequities in the opportunities and resources needed to be as healthy as possible. The determinants of health include living and working conditions, education, income, neighborhood characteristic, social inclusion, and medical care. An increase in opportunities to be healthier will benefit everyone but more focus should be placed on groups that have been excluded or marginalized in the past.
- Change and implement policies, laws, systems, environments, and practices to reduce inequities in the opportunities and resources needed to be as healthy as possible. Eliminate the unfair individual and institutional social conditions that give rise to the inequities.
- Evaluate and monitor efforts using short- and long-term measures as it may take decades or generations to reduce some health disparities. In order not to underestimate the size of the gap between advantaged and disadvantaged, disadvantaged groups should not be compared to the general population but to advantaged groups.
- Reassess strategies in light of process and outcomes and plan next steps. Actively engage those most affected by disparities in the identification, design, implementation, and evaluation of promising solutions.