INSIDE EQUITY: Bridging Health Gaps
By: Vedika Kumar
What is Health Equity?
To understand health equity it is important that we distinguish between the general definitions of equity vs equality. Equality is when everyone all gets the same resources, equity is when people get different resources to get them to the same end result. Health equity applies this concept to the healthcare field and can be broadly defined as everyone getting the same opportunity to be as healthy as possible despite their social or economic circumstances.
However, right now Health Equity is more of an ideal than a reality because of the many historical and present day socioeconomic barriers that prevent people from receiving the care that they need. The Kaiser Family Foundation places different factors that affect health equity into 6 categories: Economic Stability, Neighborhood and Physical Environment, Education, Food, Community Safety and Social Context, and the Healthcare System. We will be breaking down each of these factors below.
Economic Stability
One of the biggest contributors to health inequities is differences in economic stability. Things that fall under the umbrella of economic stability include: employment, income, expenses, debt, and medical bills. When you are employed and have a steady and strong source of income it is easier to pay for the medical treatment you need.
When people aren’t able to pay for medical care they are less likely to get their symptoms checked out and more likely to face greater health issues in the future which are more expensive, creating an endless cycle of financial distress. Economic Stability ties into every other social determinant that affects health equity.
Neighborhood and Physical Environment
Different aspects of your physical environment can drastically affect one's health such as, housing, transportation, parks, playgrounds, and walkability. If you have access to higher quality grocery stores and parks in your neighborhood, it is much easier to live a healthy lifestyle.
Access to reliable transportation can also affect your health and economic standing because it can limit or expand your ability to make it to appointments as well as to your job which can affect career prospects. Additionally, neighborhoods with better schools set up kids for a better future in terms of colleges and job prospects which affect their economic standing in the future.
Education
Higher education can open a lot of doors in terms of job opportunities which in turn increase a person’s economic standing and ability to take care of themselves. Additionally, going to school helps increase literacy rates and reasoning skills which can help someone process and understand information. This is important in the context of health because a person who has those skills will be better equipped to handle medical diagnoses. These skills can also help a person discuss their symptoms with their doctors and advocate for themselves in a medical setting. However, it is also the responsibility of medical professionals to work past any barriers that arise from a lack of these skills and reach an accurate diagnosis and create treatment plans that work for their patients.
Food
It is no secret that what you eat affects your health, but it isn’t always easy to find healthy options or afford food in general. Food insecurity can lead to a myriad of health issues such as Type 2 diabetes, high blood pressure, heart disease, and obesity. Healthy foods are generally more expensive than fast food and they aren’t always easily accessible.
Oftentimes, in lower income neighborhoods, it is harder to find grocery stores that stock healthy fresh foods, leaving individuals with less options which create negative health outcomes.
Community Safety & Social Context
The safety of a community depends on access to support systems, community engagement, exposure to; stress, violence, and trauma, along with the communities policing and justice policy. When an individual is placed in an unsafe environment without a support system, they are more likely to experience a large amount of stress which negatively affects their health leading to not just mental health issues but also physical health issues as well.
Research from the Neighborhood Data for Social Change states that, “Feelings of fear, anxiety, anger, etc. produce cardiovascular, neurological and other bodily responses that put strain on body organs, negatively affecting health and increasing mortality.” The study also found that inappropriate police stops and racial profiling occur more in certain areas of Los Angeles than others which touches on the point of how justice policies can affect health. Individuals in different neighborhoods could have different experiences with the justice system that contribute to their stress and confidence in social systems in general.
Healthcare System
There are many factors that contribute to a healthcare system’s ability to provide for its patients such as health insurance, provider and pharmacy availability, language and cultural barriers, and general quality of care. The type of health insurance that an individual has determines how much they will have to pay out of pocket for the medicines and treatment they need and often times the out of pocket cost is too much for a person to afford causing them to go without treatment or begin rationing medicines to prolong the time before they have to buy new ones. These delays can cause health issues to get worse and create bigger and more expensive problems in the long run. On top of that, it can be hard to access a provider or pharmacy to get the care that you need. Hospitals sometimes have more patients than providers leading to increased wait times. This means that patients will sometimes have to wait months before getting seen by their provider which once again means an issue can get worse over time.
Additionally, contrary to popular belief, a hospital doesn’t necessarily cover all aspects of medicine. Certain hospitals specialize in certain things such as strokes, traumas, cardiovascular issues, children’s health and more. This means that if you have a specialized health issue you might have to travel to a different hospital to get it addressed which can create more stress for the patient due to transport concerns, insurance coverage issues, and much more.
Another big issue that the health care system can face comes from cultural and language differences. A language barrier can prevent providers and the patient from understanding the extent of the issue and can make it much harder to administer treatment. Cultural differences can play into how patients interact with their providers as well as what treatments they are willing to accept. If a doctor seems dismissive of a patient’s cultural practices, the patient might be less likely to trust them and come forward about issues that they are facing. Conversely, patients are more likely to feel comfortable with providers who come from the same backgrounds as them and are empathetic to their struggles.
Conclusion
All in all health equity is an incredibly complex issue with many moving parts and no real easy fix. However, if we are mindful of the various contributing factors and empathetic to the struggles that people face then we are already moving in a better direction. Hopefully this article was able to provide some clarity and new information that you can begin to observe in your everyday life.
