Health Equity

What is health equity?

The World Health Organization describes equity as "the absence of avoidable or

remediable differences among groups of people, whether those groups are
defined socially, economically, demographically, or geographically."

“Health equity means that everyone has a fair and just opportunity to be as
healthy as possible. This requires removing obstacles to health such as poverty,
discrimination, and their consequences, including powerlessness and lack of
access to good jobs with fair pay, quality education and housing, safe
environments, and health care.”

Across the nation, gaps in health are large, persistent and increasing—many of
them caused by barriers set up at all levels of our society. After all, it's hard to be
healthy without access to good jobs and schools and, safe, affordable homes.
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.

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”

Many governments and leaders are working towards fulfilling health equity and
the right to health is confronted with false choices between worthy health
interventions, and how advocacy to increase investment in the health sector is
critical for helping to remedy this situation. There is need of supporting leaders in
those advocacy efforts and lays out complementary arguments for community
health workers that leaders can employ that go beyond human rights and clinical
outcomes. These arguments reinforce many of the themes highlighted by the case
study countries and include:

1. generating return on investment,

2. delivering public goods for public health, and
 3. promoting health security.

While working towards health equity is critical, being successful in achieving that
goal requires us to be practical about how we design, deliver, and advocate for
community health worker programs as part of a comprehensive approach to
primary health care.

How to achieve equity in health care

1. Adopt new vital signs to screen for the nonmedical factors influencing
health.
2. Commit to helping low-income and non-English/Kiswahili -speaking patients
get the care they need.
3. Guard against the potential for bias to influence medical care.
4. Make sure the elderly, women, and racial/ethnic minorities are adequately
represented in clinical trials.
5. Understand the effects of adverse childhood experiences and use trauma-
informed care.

Four key steps to achieve health equity:

1. 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.

2. 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.
3. 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.

4. 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.