The Office of Health Equity

What is Health Equity?

Health equity is the goal of achieving the highest level of health for all people regardless of differences in social, economic or environmental conditions.

Whereas equality focuses on trying to ensure everyone gets the exact same thing, equity is about fairness, and making sure people get access to the same opportunities. Health Equity focuses on looking at the different determinants that can affect an individual's health overall, and finding ways to help put them back on a level playing field with those around them.





What are the Determinants of Health?

According to the World Health OrganizationExternal site disclaimer (WHO):

"The social determinants of health are the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics."

The reality is that, according to the CDCExternal site disclaimer, only 25% of your overall health is likely affected by an individual's gentics/biology, and their personal behaviors, such as alcohol and tobacco use, or exercise. That means that 75% of a person's overal determinants of health are beyond their personal involvement, and instead are part of the society they live in.

More specifically, according to Healthy People 2020External site disclaimer, these determinants usually fall into 5 areas: Economic Stability, Education, Social & Community Context, Health & Healthcare, and Neighborhood & Built Environment.

Click any of the images below for more information on each area


Economic Stability

Money is one of the key social determinants in an individual's health. Beyond just the idea that you need money to pay for healthcare, there are factors such as stress and anxiety that can come from loss of income, or the dangers that poverty and sudden lifestyle changes can bring. A loss of job can be devastating on the physical and mental well-being of a person, whereas a promotion or raise could have beneficial effects on the same bodily systems.

Some of the various areas where economic stability can affect health are:

      • Poverty
      • Employment
      • Food Security
      • Housing Stability

Education

Some may argue that education levels should not affect health in the way other determinants might, but education is a vital part of a healthy person's world. Without proper and higher education, individuals are more likely to avoid going to the doctor or seeking help for issues. Sometimes this is because they feel ignorant to the bigger words and technical terms many medical professionals may use, and in some cases, they may not fully understand even the simplest of treatment methods. Someone without a proper education may also underestimate the severity of an issue or injury they have, because they have not had examples and lessons to give them context.

Some of the areas affected most by education include:

      • High School Graduation
      • Enrollment in Higher Education
      • Language and Literacy
      • Early Childhood Education and Development

Social and Community Context

Social and community areas can also have enormous effects on an individual's health. If a person doesn't feel like they belong to the community they live in, perhaps through isolation of a rural town, it can cause a number of health related issues such as fatigue and depression. Likewise, if an person doesn't feel they can properly engage in their community in some way, like PTA meetings, or a lack of religious structure, they can feel isolated and alone, which can also cause their health to suffer. Discrimination and even the idea of discrimination can be devastating to an individual, and as such, it is often the minority populations in an area that can have the worst health outcomes.

A few of the social/community areas that can have real negative impacts on health are:

      • Social Cohesion
      • Civic Participation
      • Perceptions of Discrimination and Equity
      • Incarceration/Institutionalization

Health and Health Care

Most would think that the healthcare aspect of social determinants was the primary cause for imbalances in health outcomes in an area, but it is only one piece of the puzzle. That being said, there are still a number of social factors that affect an individual's health in this area. Access to hospital and medical services, such as emergency transport or express care can be vitally important to anyone, but just as important is access to regular primary care. Is there an adequate number of primary care physicians in the area? Can they see new patients? How accessible are they for those with no car of their own? What about a good pharmacy? Will there be someone at any of these locations that can properly translate directions for care and explain dosage amounts? These are all the lesser thought of issues that can affect an individual's health, but just as important to consider.

These are just a few of the areas health and health care can affect a person's health in a social setting:

      • Access to Health Care
      • Access to Primary Care
      • Health Literacy

Neighborhood and Built Environment

It is doubtful that anyone could argue that a neighborhood can be seen as a big determinant of health in a populous. From air quality to water quality, to crime rates and drug proliferation, there are any number of factors that could affect someone's health in the neighborhood they live in. But most would forget factors such as availability of public transit, or how far someone has to travel for good, quality foods, and how they can get there. Even in the nicest neighborhoods, if the building a person lives in has a problem with mold, or asbestos, or perhaps criminals living a few doors down, it can create some major detrimental effects in an individual's health.

This is just a small list of some of the factors that can affect a neighborhood or built environment:

      • Access to Healthy Foods
      • Quality of Housing
      • Crime and Violence
      • Environmental Conditions

If you would like more information on how to define health equity and social determinants of health, we recommend the following websites: