Western society has often placed the onus of achieving health on the individual. And while the public discourse on the topic has been slow to change, healthcare professionals, both administrators and caregivers, have understood for decades now that the factors determining health are complex. In the United States and globally, it takes concerted effort from healthcare providers, administrators, and governments to move the needle toward health for all, what is known as health equity. As an organization whose mission holds people at the center, Edgility shares many of the same values as the healthcare and life sciences sectors. We know many healthcare providers, administrators, and whole healthcare systems are actively working to find solutions that drive equitable health outcomes for all. This blog starts a series highlighting a subset of challenges faced by healthcare providers and systems in the U.S. and the role that equitable services can play in helping them reach their equity goals. 

What is equity in terms of health, and why does it matter? 

If the term “health equity” is new to you, allow us to give a brief synopsis (and if this is beginner knowledge to you, jump here). Health equity is defined in several ways across the globe. The World Health Organization (WHO) states, “Health equity is achieved when everyone can attain their full potential for health and well-being.” The U.S. Department of Health and Human Services adds, “Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and healthcare disparities.” Ultimately, health equity is about patient-centered care and recognizing that different populations and individual patients need different resources to receive optimal care and achieve optimal health.

Social Determinants of Health (SDOH) 

A wide variety of factors contribute to an individual’s health and the overall health of populations. These factors are frequently referred to as the social determinants of health (shortened to SDOH), which the Department of Health and Human Services divides into five broad categories: economic stability, education access, and quality, health care access and quality, neighborhood and built environment, and social and community context. Individuals and populations may deal with adverse conditions in these categories in various ways. Let’s look at how individuals may be affected by each, as well as their interconnectedness. 

Economic stability is the ability of individuals and families to earn steady incomes that meet their health needs. This includes making enough money to have stable housing, purchase healthy foods, and to afford copays and prescription medications. 

Education access might seem unrelated at first glance. Research shows, however, that people with higher levels of education are more likely to score well on key health metrics and live longer. Yet not all people have access to the same educational opportunities, and for those living in poverty, the stress of being poor can make obtaining an education difficult. 

Neighborhood and built environment profoundly impact the other four categories on this list. For starters, neighborhoods or rural areas that are in food deserts have less access to healthy food. Few economically advantageous job opportunities and few educational choices may make it hard for those living in these neighborhoods or areas to achieve health. Furthermore, these neighborhoods could lack public green spaces, be disproportionately policed, or see extreme amounts of violence, all of which can negatively impact stress and thus overall health.  

Healthcare access and quality. Individuals and families may live somewhere that lacks easily accessed, quality medical care. The nearest health system might be unavailable through walking or public transportation. This can be particularly true in rural areas, but can occur in cities as well. Black and Latino neighborhoods in particular are significantly more likely to live in areas with few or no primary care doctors. Additionally, Black patients and other patients of color are more likely to suffer from implicit bias in their medical care that negatively affects their health outcomes. 

Lastly, social and community context can have a big impact on health. For example, the Surgeon General of the United States has declared a loneliness epidemic. When people are socially disconnected, they are more likely to experience a range of health problems, including depression, heart disease, and stroke. Healthy, supportive relationships are key to our health, and unsafe neighborhoods, discrimination, or needing to work multiple jobs to make ends meet  can drastically impede our ability to form these bonds