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While recent healthcare innovations have made it possible for populations to live longer and achieve optimal levels of well-being, access to these benefits isn’t evenly distributed across communities. There are several socio-economic and geographic barriers that contribute to this inequity, leading to differences in the quality of care.
To combat this, public health professionals are trying to find ways to make healthcare equitable on a national and global scale. In response, more than 80 percent of C-suite executives from healthcare and life sciences organizations have created goals around improving health equity according to a Deloitte report.
But what is health equity, and why does it matter?
According to the Centers for Disease Control and Prevention (CDC), health equity is the fair and just opportunity for populations to attain the highest level of health. This isn’t the reality for several underserved communities though, causing a significant gap between those who have ready access to quality healthcare and those who do not.
This is often caused by social determinants of health—the social, environmental, and economic conditions that influence the health outcomes of populations.
Some of the most common determinants of health are:
These factors cause systematic disparities in underserved communities that don’t just compromise individual health but also cause deep-rooted insecurity within communities about the value of proactive health maintenance.
Effective public health advocates can’t address these challenges without understanding the nuances of health equity though.
“If you never walk in their shoes or understand where they are coming from, you’ll never find the right solution to the problem,” says Dr. Linda Kilby, a registered dietician and Executive Director of Philadelphia County’s Special Supplemental Nutrition Program for Women, Infants and Children (WIC).
Here are the most common factors that impact equity in healthcare that all public health professionals should know about.
Socioeconomic status refers to the social capital and material wealth individuals have available to them. People of high socioeconomic status typically have a high quality of life due to individuals’ access to healthcare.
These communities are more likely to have an abundance of healthcare facilities staffed with top specialists. They also often have consistent access to health coverage and preventative care, which lowers the rate of chronic diseases.
In contrast, people of lower economic status often live in environments with fewer health resources, such as understaffed facilities and lower-quality food.
To achieve equity in these communities, public health professionals have to understand what prevents people from adopting healthier practices. For example, the Philadelphia WIC program has individuals who are in the 175 percentile of the poverty level. Since this community doesn’t have access to quality nutrition, it’s up to public health professionals to provide food and educational resources.
“We provide them with certain foods high in protein, as well as vitamins and minerals, that we know will be helpful to them,” Kilby says. “We also work very hard to talk about the importance of whole grains and fiber in their diet.”
Marginalized populations, such as racial and ethnic minorities, may face bias that has a negative impact on their ability to access timely or appropriate care. This can result in discriminatory practices such as racial profiling and language barriers which often lead to unequal distribution of resources and quality care.
“Most people realize that we all have some bias,” Kilby notes. “But if we can learn how to work through it, then it's to the benefit of everybody.”
Public health professionals need to recognize these cultural insensitivities and discriminatory practices within healthcare settings. This means they need to engage in continuous education on cultural competence and inclusivity to better serve these diverse populations. By implementing policies that promote equity and respect for all individuals, it can create a far more inclusive healthcare environment.
Living in underserved areas, such as rural towns, can create lasting obstacles for individuals who need immediate health services. This is because many of these locations have limited providers and resources at their disposal.
In areas with few hospitals and clinics, communities need to travel far distances to get assistance, and specialists may not be available to manage more serious conditions. All of these factors lead to healthcare facilities that are overwhelmed and large groups of people who don’t receive the care they need.
This doesn’t mean, however, that communities with an abundance of resources don't face accessibility challenges. While rural communities need to travel far distances for care, urban environments struggle with language, cultural, and income barriers that can tip the scale.
Education also plays a major role in health equity. This is largely because communities with more individuals with a higher level of education often have jobs with high-quality health coverage. This can better equip individuals to navigate various health challenges.
On the other hand, communities with less education may have more difficulty finding affordable plans and effectively advocating for themselves.
“People often say, ‘Everybody has access to healthcare,” Kilby says. “We have Obamacare, Medicaid, and Medicare.’ But if the person who's in need does not understand how to access this, it's not an easy process. So I think that it's important that students understand what is needed and have empathy for the people that they're providing this information to.”
Employment status is a major factor in healthcare access, and the quality of benefits largely depends on which plans and providers an employer chooses.
Being employed full-time or married to an employed person is the primary method of obtaining insurance in the United States. While people who are unemployed or disabled are often eligible for state-funded assistance, they may have stricter limitations on where they can receive care and what treatments are available. In addition, people who are employed part-time might not be eligible for employer-sponsored or state-funded health insurance, leaving them with fewer affordable options and reduced coverage.
Health equity is a core building block of resilient, healthy communities. It gives everyone the opportunity to obtain the care they need.
Health equity also has far-reaching implications for economic efficiency. For one, healthier populations lead to more productive workers, even during a health crisis like a pandemic, which ultimately boosts the economy in a few ways.
By investing in preventive care, early intervention, and community-based initiatives, societies can also reduce healthcare costs. When people have access to regular check-ups, screenings, vaccinations, and early treatment for health conditions, it can prevent the progression of diseases and reduce the need for expensive medical interventions down the line.
Disparities in healthcare access also result in low-income populations relying on emergency rooms for non-emergency care. This can drive up healthcare costs significantly as emergency room visits are typically more expensive than primary care visits.
Beyond the economic benefits, embracing health equity is necessary for fostering inclusive communities. For example, dismantling systemic barriers can result in better social cohesion and compassion between different populations.
Public health advocates can lead the way in addressing gaps in healthcare access, but only if they’re well-informed of the challenges and priorities of the populations they want to help.
One of the best ways to do this is by enrolling in a reputable master of public health degree program. Regis College’s online Master of Public Health (MPH) program can prepare you for these systemic challenges in healthcare. With expert faculty and real-world experience opportunities, this degree can take your public health advocacy to the next level.