LibGuides: Health Equity: Understanding Health Equity

Understanding Health Equity: Past, Present, and Future

The History of Health Equity: Concept and Vision
This 2017 article traces the history of the idea of health equity and raises questions about the translation of the concept into practice.
Can be viewed and download as a PDF.
Health Equity Timeline
Published by U.S. Department of Health & Human Services, this timeline highlights numerous milestones and activities related to health equity since 1985.
CDC Health Disparities & Inequalities Report (CHDIR)
This 2013 report from the CDC "provides analysis and reporting of recent trends and ongoing variations in health disparities and inequalities for selected social and health indicators". It examines "disparities in deaths and illness, use of health care, behavioral risk factors for disease, environmental hazards, and social determinants of health at the national level."
America's Health Disparities Report 2021: America's Health Rankings
Latest report of current health equity progress in the States.

What does the future hold?

Anti-DEI legislation targeting colleges and universities: Its potential impacts on nursing education and the pursuit of health equity | Nursing Outlook, 2023 Sociopolitical movements can revolutionize cultures and aim to redirect society toward more equitable outcomes for everyone (Jenkins, 1981). These movements, often manifested through protests, attempt to usher in social change and are often nestled within politics, creating political tensions. However, these movements can reshape public discourse and influence public policy (Woodly, 2021). In recent years, these movements have proliferated across the United States, as seen with the protests associated with the Black Lives Matter Movement, the separation of migrant children at the border, antisemitism, and the anti-Asian sentiment resulting from the Covid-19 pandemic. These national protests highlighted the many social injustices experienced by minoritized populations and, consequently, enabled the public to become more aware of, conscious of, or ‘woke’ to the social and racial injustices embedded within the history of the U.S. (Merriam-Webster, n.d.). The heightened awareness of societal injustices came to be known as woke. To be woke means that individuals are informed, educated, aware, and conscious of the social and racial injustices present within the U.S. etc.
Back to the Future: Achieving Health Equity Through Health Informatics and Digital Health | JMIR mhealth and uHealth, 2020 The rapid proliferation of health informatics and digital health innovations has revolutionized clinical and research practices. There is no doubt that these fields will continue to have accelerated growth and a substantial impact on population health. However, there are legitimate concerns about how these promising technological advances can lead to unintended consequences such as perpetuating health and health care disparities for underresourced populations. To mitigate this potential pitfall, it is imperative for the health informatics and digital health scientific communities to understand the challenges faced by disadvantaged groups, including racial and ethnic minorities, which hinder their achievement of ideal health. This paper presents illustrative exemplars as case studies of contextually tailored, sociotechnical mobile health interventions designed with community members to address health inequities using community-engaged research approaches. We strongly encourage researchers and innovators to integrate community engagement into the development of data-driven, modernized solutions for every sector of society to truly achieve health equity for all.
Building health equity through housing policies: critical reflections and future directions for research | Journal of Epidemiology and Community Health, 2022 Housing may be at once the most powerful and underused tool at our disposal to improve population health. Using examples from the USA, we argue that current levels of housing insecurity are the result of clear and inequitable policy choices, leading to the entrenchment of health inequities—particularly, across race and class. Solutions to housing insecurity must, therefore, be structural. The COVID-19 pandemic has opened a window of opportunity for these structural housing policy reforms. Through justice- and action-oriented research, health researchers can inform the development and implementation of housing policies that advance health equity. We offer a series of recommendations to better position our field to achieve this goal.
Cooperate! A Paradigm Shift for Health Equity | International Journal of Equity in Health, 2017 The role of competition and cooperation in relation to the goal of health equity is examined in this paper. The authors explain why the win-lose mentality associated with avoidable competition is ethically questionable and less effective than cooperation in achieving positive outcomes, particularly as it relates to health and health equity. Competition, which differentiates winners from losers, often with the winner-takes-all reward system, inevitably leads to a few winners and many losers, resulting in social inequality, which, in turn, engenders and perpetuates health inequity. Competitive market-driven approaches to healthcare—brought about by capitalism, neo-liberalization, and globalization, based primarily on a competitive framework—are shown to have contributed to growing inequities with respect to the social determinants of health, and have undermined equal opportunity to access health care and achieve health equity. It is possible to redistribute income and wealth to reduce social inequality, but globalization poses increasing challenges to policy makers. John Stuart Mill provided a passionate, philosophical defense of cooperatives, followed by Karl Polanyi who offered an insightful critique of both state socialism and especially the self-regulating market, thereby opening up the cooperative way of shaping the future. We cite Hannah Arendt’s “the banality of evil” to characterize the tragic concept of “ethical fading” witnessed in business and everyday life all over the world, often committed (without thinking and reflecting) by ordinary people under competitive pressures. To promote equity in health for all, we recommend the adoption of a radically new cooperation paradigm, applied whenever possible, to everything in our daily lives.
The Future of Health Equity in America | Ethnicity & Disease Even though health equity is a key component of the transforming journey of health that our nation is embarking on, little has been done to trans-disciplinarily coordinate health policy research and collaboratively address issues driving health inequities. This article examines the past and present health policy issues affecting health equity in the United States and discusses the need to address the multiple, intersecting determinants of health in order to fully realize health equity and eliminate health disparities in the future.
Health Care for All: A Framework for Moving to a Primary Care-Based Health Care System in the United States
This American Academy of Family Physicians policy supports and advocates for the right to "universal access to timely, acceptable and affordable health care or appropriate quality."
Peterson-Milbank Program for Sustainable Health Care Costs: Messaging Fact Sheet
More and more states are now focusing on addressing the heath inequity caused by the rising cost of health care.
Promoting health equity with HBCUs: Breaking away from structural racism | Nursing Outlook, 2023 Background: The United States continues to be plagued with pervasive health disparities. Leading health and professional organizations acknowledge structural racism as a contributing factor for the lack of a racially diverse nursing workforce particularly those serving in leadership roles which could help to mitigate health disparities among historically stigmatized populations. Purpose: Purpose Lack of funding for Historically Black Colleges and Universities (HBCUs) and lack of meaningful partnerships, stymie efforts that can be made by nursing programs at HBCUs. Discussion: Discussion This position paper examines collaborative actions that can address upstream factors that perpetuate healthcare disparities through deep engagement between the policymakers, professional associations, industry, and educational institutions. Methods: Faculty representing HBCU's and predominately White institutions, professional organizations, and staff met via videoconference to refine the focus of the paper, determine topic areas for writing teams, and refine details which occurred during weekly meetings. Conclusion: To disengage from structural racism, three critical recommendations are amplified with associated examples.
Public Health, Embodied History, and Social Justice: Looking Forward | International Journal of Health Services, 2015 This essay was delivered as a commencement address at the University of California-Berkeley School of Public Health on May 17, 2015. Reflecting on events spanning from 1990 to 1999 to 2015, when I gave my first, second, and third commencement talks at the school, I discuss four notable features of our present era and offer five insights for ensuring that health equity be the guiding star to orient us all. The four notable features are: (1) growing recognition of the planetary emergency of global climate change; (2) almost daily headlines about armed conflicts and atrocities; (3) growing public awareness of and debate about epic levels of income and wealth inequalities; and (4) growing activism about police killings and, more broadly, "Black Lives Matter." The five insights are: (1) public health is a public good, not a commodity; (2) the "tragedy of the commons" is a canard; the lack of a common good is what ails us; (3) good science is not enough, and bad science is harmful; (4) good evidence--however vital--is not enough to change the world; and (5) history is vital, because we live our history, embodied. Our goal: a just and sustainable world in which we and every being on this planet may truly thrive.
Recommendations for improving national clinical datasets for health equity research | Journal of the American Medical Informatics Association, 2020 Health and healthcare disparities continue despite clinical, research, and policy efforts. Large clinical datasets may not contain data relevant to healthcare disparities and leveraging these for research may be crucial to improve health equity. The Health Disparities Collaborative Research Group was commissioned by the Patient-Centered Outcomes Research Institute to examine the data science needs for quality and complete data and provide recommendations for improving data science around health disparities. The group convened content experts, researchers, clinicians, and patients to produce these recommendations and suggestions for implementation. Our desire was to produce recommendations to improve the usability of healthcare datasets for health equity research. The recommendations are summarized in 3 primary domains: patient voice, accurate variables, and data linkage. The implementation of these recommendations in national datasets has the potential to accelerate health disparities research and promote efforts to reduce health inequities.

Current Health Equity Projects

Austin Health Equity Unit
The Austin Health Equity Unit provides various "community-based programs and services to ensure all our residents have the opportunity to reach their full health potential no matter their race, ethnicity, gender, age, sexual orientation, immigration status, or income level."
Johns Hopkins Center for Health Equity
This center is currently conducting research from the perspective of inequities in people experiencing hypertension.
UCLA Kaiser Permanente Center for Health Equity
The Center's projects are concentrated in Los Angeles and surrounding counties, but also include some projects across the state, nation, and the world.
UCSF Center for Health Equity
Committed to a world with health equity, UCSF's projects focus to eliminate the disparities brought on through the effects of social determinants of health.
UMass Amherst Center for Community Health Equity Research
UMass seeks to promote health equity through community-based research and capacity building.