Get to root causes: Address poor health outcomes through a health equity lens
Understanding health equity can help educators and practitioners address root causes of negative health outcomes.
January 24, 2014 - Author: Karen Pace, Michigan State University Extension
For many years, health educators and public health practitioners have worked to understand health disparities based on race, class and other differences. Health disparities are the differences in health outcomes between two populations. For example, according to a recent Michigan Department of Community Health (MDCH) report, an African American baby born in Michigan is 2.6 times more likely to die by age 1, compared to a White infant. While this type of data about health disparities is helpful to describe the disturbing reality of what’s happening within families and communities, it doesn’t explain the reasons why these differences in health outcomes exist.
In order to address underlying root causes of disparities in infant mortality and other health issues, such as diabetes and obesity, it’s important to understand the concept of health equity. According to Doak Bloss, health equity and social justice coordinator of the Ingham County Health Department (ICHD), health equity is the fair, just distribution of the opportunities and resources needed to obtain wellbeing. Sometimes called the social determinants of health, these include access to safe and affordable housing, quality education, a living wage, healthy and affordable food, transportation, social connection, safe communities and other factors.
On the other hand, health inequity is the pattern of systematic, unjust differences in the distribution of illness and disease based on race, gender, class and other differences. Research shows that social injustices such as community decay, exposure to environmental hazards, job insecurity, lack of affordable housing, low wages and food insecurity impact disease and mortality rates. In other words, inequity makes us sick and impacts the distribution of disease, illness and wellbeing based on differences. In addition to the institutional and systemic examples of inequity already mentioned, human interactions grounded in prejudice and racism can also impact health. For example, several studies link racism experienced by women of color to maternal and child health outcomes including very low birth weight babies and preterm infants.
Health inequities refer to disparities that are avoidable and unjust. Exploring issues through a health equity lens includes moving away from simple approaches such as only focusing on “stress” or individual behavior change – toward examining historic and current realities impacting groups of people based on race, ethnicity, gender, class and other differences. A health equity lens also invites us to work in partnership within and across communities to create more opportunities and greater access to the social, economic and environmental factors that contribute to the overall health of individuals and communities.
Health educators, practitioners and others who care about the health and wellbeing of children, adults, families and communities can learn more about how to apply a health equity lens to their work through a number of resources. One is the Unnatural Causes initiative which includes documentaries, case studies, policy guides, community toolkits and other resources that examine root causes of racial and socioeconomic inequities in health. Another resource is the ICHD, which includes an initiative that provides ongoing dialogue sessions and other resources focused on social justice and health equity issues. You can also learn more about health equity issues related to infant mortality through a MDCH initiative called PRIME: Practices to Reduce Infant Mortality Through Equity.
Michigan State University Extension also provides education and training focused on issues of diversity, cultural competency, equity and social justice. For more information, visit MSU Extension’s Diversity and Multiculturalism web page.