Attaining Health Equity

What is meant by Health Disparities and Health Equity?

“A basic principle of public health is that all people have a right to health. Differences in the incidence and prevalence of health conditions and health status between groups are commonly referred to as health disparities. Most health disparities affect groups marginalized because of socioeconomic status, race/ethnicity, sexual orientation, gender, disability status, geographic location, or some combination of these. People in such groups not only experience worse health but also tend to have less access to the social determinants or conditions (e.g., healthy food, good housing, good education, safe neighborhoods, freedom from racism and other forms of discrimination) that support health. Health disparities are referred to as health inequities when they are the result of the systematic and unjust distribution of these critical conditions. Health equity, as understood in public health literature and practice, is when everyone has the opportunity to ‘attain their full health potential’ and no one is ‘disadvantaged from achieving this potential because of their social position or other socially determined circumstance.’”

—Excerpt from Promoting Health Equity: A Resource to Help Communities Address Social Determinants of Health.  Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2008; page 6.

 

How is CDC's Healthy Communities Program addressing health disparities in communities?

Eliminating health disparities is an overarching goal of the Healthy People 2010 national public health agenda and is a top priority for the Centers for Disease Control and Prevention. CDC's Healthy Communities Program supports eliminating socioeconomic and racial/ethnic health disparities as an integral part of its chronic disease prevention and health promotion efforts. In their local health improvement activities, the Healthy Communities Program's funded communities are encouraged to identify and address social determinants of health (i.e., the social, economic, and environmental conditions under which people are born, grow up, live, work, and age, which influence their health). These activities include raising awareness or increasing knowledge of social determinants of health inequities and their influence on health; building skills and capacities to change inequitable social, economic, or environmental conditions or their influence on health; and improving these conditions through policies, systems, and environmental changes. Equally important to the goal of assuring equal access to high quality health care is the goal of reducing other conditions that contribute to the emergence of chronic diseases and conditions in the first place. Intervening on social determinants of health requires the Healthy Communities Program's funded communities to expand the scope of traditional public health efforts. These communities work with partners in education, housing, transportation, work sites, and other sectors to reduce the effects of poverty and racism and create healthy communities.

Racial and Ethnic Approaches to Community Health Across the United States (REACH U.S.) communities serve as the cornerstone of CDC’s efforts to eliminate racial and ethnic health disparities among the following groups: African Americans, American Indians, Hispanics/Latinos, Asian Americans, Alaska Natives, and Pacific Islanders. REACH U.S. mobilizes and equips communities and institutions to plan, implement, and evaluate programs and strategies that eliminate health disparities. REACH U.S. communities have identified numerous individual, community, societal, cultural, and environmental factors that must be changed to eliminate racial and ethnic disparities. Using a broad social-ecological perspective, each community develops appropriate programs and strategies that address the complex root causes of racial and ethnic health disparities. By sharing their best practices, REACH U.S. communities give other communities and public health programs valuable tools to eliminate health disparities among racial and ethnic minority populations.

Resources on health disparities and related interventions for communities

Promoting Health Equity: A Resource to Help Communities Address Social Determinants of Health (2008)
This workbook is for public health practitioners and partners interested in developing initiatives to increase health equity in their communities. It reflects the views of experts from multiple arenas, including the local community, public health, medicine, social work, sociology, psychology, urban planning, community economic development, environmental sciences, and housing. The workbook builds on existing resources and highlights lessons learned by communities. Readers are provided with information and tools to develop, implement, and evaluate interventions in their communities that address social determinants of health equity.
(Note: Additional health disparities resources are also listed on the above Web page, including the Data Set Directory of Social Determinants of Health at the Local Level which is an extensive list of existing data sets that can be used to address social determinants of health.)

Racial and Ethnic Approaches to Community Health — Resource Library
CDC's REACH U.S. Web site provides a variety of resources, including The Power to Reduce Health Disparities: Voices from REACH Communities (PDF–6.7M) and REACHing Across the Divide: Finding Solutions to Health Disparities (PDF–1.9M).

CDC's Office of Minority Health & Health Disparities
The "Eliminating Racial & Ethnic Health Disparities" Web page, from the Office of Minority Health & Health Disparities, provides fact sheets on six health-related areas in which racial and ethnic minority groups experience serious health disparities in access and outcomes: Infant Mortality, Cancer Screening and Management, Cardiovascular Disease, Diabetes, HIV Infection/AIDS, and Immunizations. These six areas were selected for emphasis by the U.S. Department of Health and Human Services because they reflect areas of disparity that are known to affect multiple racial and ethnic minority groups at all life stages. Additional resources related to health disparities are also available at this link.

Unnatural Causes...Is Inequality Making Us Sick? (2008)
This 4-hour (7-part) documentary series, aired on PBS and available on DVD, explores racial and socioeconomic inequalities in health. The UNNATURAL CAUSES series and accompanying impact campaign aim to enlarge public discourse about health. The opening 1-hour episode presents the series' overarching themes. Each of the six supporting 25-minute episodes, set in a different ethnic/racial community, provides a deeper exploration of the ways in which social conditions affect population health and how some communities are extending lives by improving them.

National Partnership for Action to End Health Disparities
U.S. Department of Health and Human Services Office of Minority Health (OMH) has developed the National Partnership for Action to mobilize and connect individuals and organizations across the country to create a nation free of health disparities, with quality health outcomes for all people. Also included on this Web site is OMH's new Strategic Framework for Improving Minority Health and Eliminating Health Disparities which aims to promote systems approaches to understanding and eliminating racial and ethnic health disparities through program, policy, and research activities.

Tackling Health Inequities Through Public Health Practice: A Handbook for Action (2006)
The National Association of County and City Health Officials (NACCHO) offers ideas, insight, and examples for local health departments to strengthen their capacity for influencing the root causes of health inequities through a social justice perspective. This publication 1) provides a conceptual framework, raises questions, and spurs thought for exploring the nature and causes of health inequity and what to do about them, and 2) provides a knowledge base, resources, case studies, and suggestions for transforming everyday public health practice, departmental structure, and organizational culture in ways that may advance the attack on health inequities.

Reaching for a Healthier Life: Facts on Socioeconomic Status and Health in the U.S. (2007)
This publication is the result of a decade of work by the MacArthur Foundation Research Network on Socioeconomic Status and Health. This multidisciplinary group of scientists has examined the pathways by which socioeconomic status “gets into the body” to affect health and longevity. There is no single pathway by which this occurs. Resources associated with where people stand on the social ladder shape multiple aspects of their lives in ways that affect their health and well-being.

Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health (2008)
The Commission on Social Determinants of Health (CSDH) had a 3-year directive to gather and review evidence on what must be done to reduce health inequalities within and between countries and to report its recommendations for action to the Director-General of the World Health Organization (WHO); this publication is the result of those efforts. The CSDH is a global network of policy makers, researchers, and civil society organizations brought together by WHO to give support in tackling the social causes of poor health and avoidable health inequalities.

Health Disparities: A Selected Bibliography (2005)
This bibliography cites publications written by CDC staff and partners during January 2000–January 2005. Included are peer-reviewed journal articles, book chapters, and monographs focusing on the United States.

 

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