Glossary

2.4 Strategies for promoting health equity

10 min read•august 20, 2024

is about giving everyone a fair shot at optimal health, regardless of their circumstances. It involves tackling disparities in health outcomes and access to care among different groups. Achieving health equity means addressing like economic stability, education, and neighborhood environment.

Strategies to promote health equity include , , addressing social factors, , and . Nurses play a key role through , , , and . Ongoing challenges remain in overcoming systemic barriers and biases.

Defining health equity

  • Health equity refers to the principle that everyone should have a fair opportunity to attain their full health potential, regardless of their social, economic, or environmental circumstances
  • Achieving health equity involves addressing and eliminating disparities in health outcomes and access to healthcare services among different population groups
  • Health equity is a fundamental human right and a key component of social justice, recognizing that health is influenced by a wide range of factors beyond individual behavior and genetics

Social determinants of health

  • Social determinants of health (SDOH) are the conditions in which people are born, grow, live, work, and age that shape their health outcomes and well-being
  • SDOH encompass a wide range of factors, including economic stability, education, healthcare access, neighborhood environment, and social context
  • Addressing SDOH is crucial for promoting health equity, as these factors often contribute to and inequities among different population groups

Economic stability factors

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  • include employment, income, expenses, debt, and medical bills, which can significantly impact an individual's health and well-being
  • Poverty and financial instability can limit access to healthy food, safe housing, and healthcare services, leading to poor health outcomes
  • Policies and programs that promote economic stability, such as living wage laws, affordable housing initiatives, and financial assistance programs, can help improve health equity

Education access and quality

  • Education is a key determinant of health, with higher levels of education associated with better health outcomes and longer life expectancy
  • Access to quality education can provide individuals with the knowledge, skills, and resources needed to make informed health decisions and navigate the healthcare system
  • Disparities in , such as underfunded schools and limited educational opportunities in disadvantaged communities, can contribute to

Health care access and quality

  • Access to comprehensive, affordable, and culturally competent healthcare services is essential for promoting health equity
  • Barriers to healthcare access, such as lack of insurance coverage, high out-of-pocket costs, and limited availability of providers in underserved areas, can exacerbate health disparities
  • Improving healthcare access and quality through policies like , increasing the diversity of the healthcare workforce, and investing in community health centers can help reduce health inequities

Neighborhood and built environment

  • The physical and social characteristics of neighborhoods, such as access to healthy food, safe green spaces, and transportation, can significantly impact health outcomes
  • Exposure to environmental hazards, such as air pollution, lead contamination, and poor housing conditions, can contribute to health disparities in disadvantaged communities
  • Creating healthy built environments through urban planning, zoning regulations, and community development initiatives can promote health equity

Social and community context

  • Social and community factors, such as social support networks, community engagement, and exposure to discrimination and violence, can influence health and well-being
  • Social isolation, discrimination, and chronic stress can negatively impact mental and physical health, particularly among marginalized populations
  • Strengthening social connections, promoting community resilience, and addressing discrimination and violence can help promote health equity

Health disparities vs health inequities

  • Health disparities refer to differences in health outcomes and access to healthcare services among different population groups, such as racial/ethnic minorities, low-income individuals, and rural residents
  • Health inequities are a subset of health disparities that are considered unfair, unjust, and avoidable, arising from systemic and structural factors rather than individual choices or behaviors
  • While health disparities can be caused by a variety of factors, health inequities specifically result from social, economic, and environmental disadvantages that are rooted in historical and contemporary injustices

Strategies to promote health equity

  • Promoting health equity requires a multi-faceted approach that addresses the root causes of health disparities and inequities, such as poverty, discrimination, and unequal access to resources and opportunities
  • Effective strategies for promoting health equity involve community engagement, culturally competent care delivery, addressing social determinants of health, advocating for policy changes, interprofessional collaboration, and utilizing community health workers
  • Implementing these strategies requires a commitment to health equity at all levels of the healthcare system, from individual providers to healthcare organizations and policymakers

Community engagement and empowerment

  • Community engagement involves actively involving community members in the planning, implementation, and evaluation of health equity initiatives
  • Empowering communities to identify their own health priorities, assets, and solutions can lead to more effective and sustainable interventions
  • , , and are examples of community engagement strategies

Culturally competent care delivery

  • Culturally competent care involves providing healthcare services that are responsive to the cultural, linguistic, and social needs of diverse patient populations
  • Providing culturally competent care can help reduce health disparities by improving patient-provider communication, trust, and adherence to treatment plans
  • Strategies for promoting cultural competence include training healthcare providers in cultural humility, hiring a diverse workforce, and providing language interpretation services

Addressing social determinants of health

  • Addressing social determinants of health involves implementing interventions that target the upstream factors that influence health outcomes, such as poverty, education, and housing
  • Examples of interventions include providing housing assistance, improving access to healthy food, and investing in early childhood education programs
  • Collaborating with community organizations and non-healthcare sectors, such as social services and education, can help address social determinants of health in a comprehensive manner

Advocating for policy changes

  • Advocating for policy changes at the local, state, and federal levels can help create systemic solutions to health inequities
  • Examples of policy changes include expanding Medicaid coverage, implementing paid family leave policies, and increasing funding for community health centers
  • Nurses can advocate for policy changes by engaging in grassroots activism, writing op-eds and letters to policymakers, and participating in professional organizations that lobby for health equity

Interprofessional collaboration strategies

  • Interprofessional collaboration involves healthcare providers from different disciplines working together to provide coordinated, patient-centered care
  • Collaboration among healthcare providers, social workers, community health workers, and other professionals can help address the complex social and medical needs of vulnerable populations
  • Strategies for promoting interprofessional collaboration include establishing interdisciplinary care teams, conducting joint training and education programs, and developing shared communication and documentation systems

Utilizing community health workers

  • are frontline public health professionals who are trusted members of the communities they serve
  • CHWs can help bridge the gap between healthcare systems and underserved communities by providing culturally appropriate health education, navigation services, and social support
  • Integrating CHWs into healthcare teams and providing them with adequate training, supervision, and compensation can help promote health equity and improve health outcomes

Challenges in achieving health equity

  • Achieving health equity is a complex and long-term process that requires addressing deeply rooted social, economic, and political inequalities
  • Challenges in achieving health equity include systemic and institutional barriers, in healthcare, lack of diversity in the healthcare workforce, and inadequate funding for equity initiatives
  • Overcoming these challenges requires sustained commitment, collaboration, and advocacy from healthcare providers, policymakers, and communities

Systemic and institutional barriers

  • Systemic and institutional barriers, such as racism, discrimination, and unequal distribution of resources, can perpetuate health inequities
  • Examples of systemic barriers include residential segregation, unequal school funding, and discriminatory hiring practices
  • Dismantling systemic and institutional barriers requires long-term, multi-sectoral efforts to address the root causes of inequality and promote social justice

Implicit bias in healthcare

  • Implicit bias refers to unconscious attitudes and stereotypes that can influence healthcare providers' perceptions, judgments, and behaviors towards patients
  • Implicit bias can lead to disparities in healthcare quality and outcomes, such as underdiagnosis and undertreatment of pain in racial/ethnic minority patients
  • Strategies for addressing implicit bias include providing implicit bias training for healthcare providers, implementing standardized treatment protocols, and promoting diversity and inclusion in healthcare organizations

Lack of diversity in healthcare workforce

  • The healthcare workforce often does not reflect the diversity of the patient populations it serves, which can contribute to cultural and linguistic barriers and perpetuate health disparities
  • Increasing diversity in the healthcare workforce can help improve cultural competence, patient-provider communication, and trust among underserved communities
  • Strategies for promoting diversity in the healthcare workforce include implementing diversity and inclusion initiatives, providing mentorship and pipeline programs for underrepresented students, and addressing barriers to entry and advancement for diverse candidates

Inadequate funding for equity initiatives

  • Achieving health equity requires significant investments in public health, social services, and community development programs
  • However, funding for health equity initiatives is often limited and subject to political and economic pressures
  • Advocating for increased and sustained funding for health equity initiatives, such as community health centers, social determinants of health interventions, and health disparities research, is crucial for promoting long-term progress towards health equity

Measuring progress towards health equity

  • Measuring progress towards health equity involves tracking changes in health disparities and inequities over time, evaluating the effectiveness of interventions, and identifying areas for improvement
  • Effective measurement requires the use of health equity indicators and metrics, ongoing monitoring and assessment, and the involvement of communities in the evaluation process
  • Measuring progress towards health equity is essential for accountability, learning, and continuous quality improvement in health equity initiatives

Health equity indicators and metrics

  • Health equity indicators are measurable characteristics that can be used to track progress towards health equity goals
  • Examples of health equity indicators include rates of preventable hospitalizations, life expectancy, and access to primary care services among different population groups
  • Selecting appropriate health equity indicators and metrics requires considering the specific context, priorities, and data availability of the communities and healthcare systems involved

Evaluating effectiveness of interventions

  • Evaluating the effectiveness of health equity interventions involves assessing their impact on health disparities and inequities, as well as their unintended consequences and sustainability
  • Evaluation methods can include quantitative analyses of health outcomes data, qualitative assessments of patient and provider experiences, and economic evaluations of intervention costs and benefits
  • Involving communities in the evaluation process can help ensure that interventions are responsive to their needs and priorities, and can promote trust and ownership of the results

Ongoing monitoring and assessment

  • Achieving health equity is a continuous process that requires ongoing monitoring and assessment of progress and challenges
  • Establishing systems for regular data collection, analysis, and reporting can help identify trends, gaps, and opportunities for improvement in health equity initiatives
  • Sharing monitoring and assessment results with communities, healthcare providers, and policymakers can help promote transparency, accountability, and collective action towards health equity goals

Nurse's role in promoting health equity

  • Nurses play a crucial role in promoting health equity through their direct patient care, advocacy, and leadership in healthcare organizations and communities
  • Nurses can promote health equity by providing patient-centered care, addressing social determinants of health, participating in community outreach and research, and advocating for policy changes
  • Integrating health equity principles and practices into nursing education, practice, and research can help prepare nurses to be effective agents of change in promoting health equity

Patient advocacy and empowerment

  • Nurses can advocate for their patients by identifying and addressing their unique health needs, preferences, and barriers to care
  • Empowering patients to be active participants in their own health and healthcare decisions can help promote health equity and improve health outcomes
  • Strategies for patient advocacy and empowerment include providing patient education, supporting shared decision-making, and connecting patients to community resources and support services

Providing equitable care to all

  • Providing equitable care involves delivering high-quality, culturally competent, and patient-centered care to all patients, regardless of their social, economic, or cultural background
  • Nurses can promote equitable care by recognizing and addressing their own biases, using inclusive language and communication strategies, and tailoring care plans to patients' individual needs and preferences
  • Implementing standardized protocols and decision support tools can help reduce disparities in care quality and outcomes

Participating in community outreach efforts

  • Nurses can participate in community outreach efforts to promote health equity by providing health education, screenings, and referrals to underserved populations
  • Collaborating with community organizations, faith-based institutions, and schools can help reach populations that may face barriers to accessing healthcare services
  • Engaging in community-based participatory research can help identify community health needs and assets, and develop interventions that are responsive to community priorities

Engaging in health equity research

  • Nurses can contribute to the evidence base for health equity interventions by engaging in research that addresses health disparities and inequities
  • Examples of health equity research topics include evaluating the effectiveness of culturally tailored interventions, examining the impact of social determinants of health on health outcomes, and developing and testing new models of care delivery for underserved populations
  • Disseminating research findings to healthcare providers, policymakers, and communities can help inform the development and implementation of evidence-based health equity initiatives

Key Terms to Review (32)

Affordable Care Act: The Affordable Care Act (ACA) is a comprehensive healthcare reform law enacted in March 2010 aimed at expanding access to health insurance, reducing healthcare costs, and improving the quality of care. It has significant implications for various populations, promoting health equity and addressing disparities in access to quality healthcare.
Centers for Disease Control and Prevention (CDC): The Centers for Disease Control and Prevention (CDC) is a national public health institute in the United States that focuses on protecting public health and safety through the control and prevention of disease, injury, and disability. The CDC plays a crucial role in promoting health equity by addressing health disparities and working to ensure that all communities have access to the resources needed to achieve optimal health.
Community Advisory Boards: Community advisory boards are groups composed of local stakeholders who provide input and guidance on health-related issues and initiatives within their community. These boards play a crucial role in promoting health equity by ensuring that diverse voices are heard and that programs are tailored to meet the specific needs of vulnerable populations. Their involvement fosters trust between communities and health organizations, ultimately leading to more effective health interventions.
Community Engagement: Community engagement is the process of actively involving individuals and groups in the decision-making and activities that affect their lives and well-being. This collaborative approach empowers communities, fosters trust, and enhances social connections, leading to improved health outcomes and greater equity in health access. Through community engagement, diverse voices are heard, ensuring that interventions and policies reflect the actual needs and experiences of the community.
Community Health Needs Assessments: Community health needs assessments (CHNAs) are systematic processes that identify and prioritize the health needs of a community by collecting and analyzing data on health status, access to care, and social determinants of health. These assessments provide valuable insights into the specific health challenges faced by different populations, guiding the development of strategies to promote health equity and improve overall community health outcomes.
Community Health Workers (CHWs): Community Health Workers (CHWs) are frontline public health workers who are trusted members of the communities they serve, bridging the gap between healthcare systems and vulnerable populations. They play a crucial role in promoting health equity by providing education, resources, and support tailored to the specific needs of their communities. Their work is essential in improving access to care for at-risk groups, especially mothers and children, by addressing barriers such as cultural differences, language barriers, and lack of awareness of available services.
Community outreach: Community outreach refers to the process of engaging with community members and organizations to promote health awareness, provide resources, and improve access to services. This proactive approach aims to address the needs of vulnerable populations by building trust, fostering relationships, and creating tailored programs that effectively reach those who may face barriers to healthcare.
Community-based participatory research: Community-based participatory research (CBPR) is a collaborative approach to research that involves community members in the design, implementation, and analysis of studies affecting their lives. This method empowers communities by ensuring their voices and experiences shape the research process, promoting mutual learning and social change.
Culturally competent care: Culturally competent care is a framework for healthcare providers that emphasizes understanding and respecting diverse cultural beliefs, practices, and values in order to improve patient outcomes. It involves adapting healthcare delivery to meet the specific cultural needs of individuals and communities, which enhances communication, trust, and overall effectiveness of care.
Diversity in Healthcare Workforce: Diversity in the healthcare workforce refers to the inclusion of individuals from various backgrounds, including race, ethnicity, gender, sexual orientation, socioeconomic status, and cultural perspectives within healthcare settings. This diversity is crucial for addressing the varying needs of a diverse patient population and promoting health equity by ensuring that care delivery is respectful, culturally competent, and tailored to the unique experiences of all individuals.
Economic Stability Factors: Economic stability factors refer to the various elements that contribute to a stable and predictable economic environment, which is crucial for individuals and communities to thrive. These factors include income levels, employment rates, access to financial resources, and economic policies that support growth and equity. Understanding these factors helps identify disparities in wealth and resources, influencing health outcomes and access to healthcare services.
Education Access and Quality: Education access and quality refer to the ability of individuals to obtain an education that is both available to them and meets certain standards of excellence. This concept encompasses various factors, including physical access to educational institutions, the availability of qualified teachers, and the overall learning environment that enables students to achieve their full potential. Ensuring equitable access and high-quality education is crucial for addressing health disparities and promoting health equity across communities.
Equitable care delivery: Equitable care delivery refers to the provision of healthcare services that are fair and just, ensuring that all individuals receive appropriate and effective medical treatment regardless of their background or circumstances. This concept emphasizes the importance of reducing disparities in health outcomes by addressing barriers that vulnerable populations face in accessing care. It connects deeply with strategies for promoting health equity and the cultural knowledge needed to understand and meet diverse patient needs.
Health Advocacy: Health advocacy involves supporting and promoting the health and well-being of individuals and communities, aiming to ensure that everyone has access to the resources necessary for a healthy life. This concept is essential in addressing health disparities and promoting health equity, as it empowers individuals to speak up for their rights and needs within the healthcare system. Effective health advocacy can lead to policy changes, improved healthcare access, and greater awareness of health issues affecting vulnerable populations.
Health Care Access and Quality: Health care access and quality refer to the degree to which individuals can obtain necessary medical services and the standard of those services. Access includes factors like availability, affordability, and geographical proximity to health care facilities, while quality encompasses the effectiveness, safety, and patient-centeredness of care received. Improving both access and quality is essential for promoting health equity, ensuring that all populations can achieve optimal health outcomes regardless of their socioeconomic status or geographic location.
Health disparities: Health disparities refer to the differences in health outcomes and access to healthcare that are often experienced by specific population groups, particularly those who are disadvantaged due to social, economic, or environmental factors. These disparities can arise from a range of factors including socioeconomic status, geographic location, race, ethnicity, and disability status, leading to unequal opportunities for achieving optimal health.
Health Equity: Health equity refers to the principle of fairness in health care and the idea that everyone should have the opportunity to attain their highest level of health. It emphasizes reducing and eliminating disparities in health and its determinants, such as social and economic factors, and aims to ensure that vulnerable populations receive appropriate resources and care.
Health Equity Research: Health equity research refers to the systematic investigation aimed at understanding and addressing the disparities in health status and access to healthcare services among different population groups. This field seeks to identify the social, economic, and environmental factors that contribute to these inequities, facilitating targeted interventions to promote equal health opportunities for all individuals, regardless of their background. It emphasizes the importance of integrating diverse perspectives to create a comprehensive approach towards eliminating health disparities.
Health Inequities: Health inequities refer to the systematic differences in health outcomes and access to healthcare that are unfair and avoidable, often linked to social determinants like socioeconomic status, race, ethnicity, and geographic location. These inequities highlight the gap between different population groups, emphasizing that not all individuals have the same opportunities for achieving optimal health.
Healthy People 2030: Healthy People 2030 is a national initiative led by the U.S. Department of Health and Human Services that aims to improve the health and well-being of people in the United States over the next decade. It focuses on promoting health equity, reducing health disparities, and improving social determinants of health, guiding public health actions through specific, measurable objectives.
Implicit Bias: Implicit bias refers to the unconscious attitudes or stereotypes that affect our understanding, actions, and decisions in an automatic manner. These biases can influence how individuals perceive and interact with others, especially in healthcare settings where they may impact patient care, access to services, and treatment outcomes.
Interprofessional collaboration: Interprofessional collaboration refers to the cooperative approach taken by professionals from different disciplines to work together towards a common goal in healthcare, particularly in improving patient outcomes. This teamwork enhances communication, breaks down silos, and integrates diverse perspectives, leading to more effective care delivery. It’s especially vital in addressing complex health issues that require input from various healthcare specialties and community resources.
Medicaid Expansion: Medicaid expansion refers to the provision of the Affordable Care Act that allows states to extend Medicaid eligibility to more low-income individuals and families. This expansion aims to improve access to healthcare for vulnerable populations, reduce the number of uninsured, and promote overall health equity across diverse communities.
Mobile Clinics: Mobile clinics are healthcare units that are equipped to provide medical services and care directly to individuals in various communities, especially underserved areas. They play a critical role in addressing health disparities by bringing essential services to those who may face barriers to accessing traditional healthcare facilities, such as transportation issues, financial constraints, or lack of awareness.
Neighborhood and Built Environment: Neighborhood and built environment refer to the physical and social aspects of the spaces where people live, work, and interact. This encompasses the design of buildings, public spaces, transportation systems, and the availability of services and amenities that can impact the health and well-being of individuals and communities. Understanding this concept is crucial for identifying how various elements within a neighborhood can either promote or hinder health equity among different populations.
Patient advocacy: Patient advocacy involves supporting and promoting the interests and rights of patients to ensure they receive appropriate care and services. This concept is crucial in healthcare, as it emphasizes the importance of listening to patients, understanding their needs, and empowering them to make informed decisions about their health. Patient advocacy also highlights the role of healthcare providers in addressing barriers to care and fostering health equity through culturally competent practices.
Policy advocacy: Policy advocacy refers to the active efforts made to influence decisions within political, economic, and social systems and institutions. It aims to promote policies that improve the welfare of individuals and communities, particularly vulnerable populations, by addressing inequities and health disparities. This approach is crucial for driving systemic change and ensuring that the needs of marginalized groups are recognized and met in policy-making processes.
Policy Change: Policy change refers to the process of altering existing regulations, laws, or guidelines to address emerging issues or improve public welfare. This process is essential in promoting health equity, as it can influence access to healthcare, resource allocation, and the implementation of health programs that target vulnerable populations.
Social and Community Context: Social and community context refers to the environments, relationships, and social structures that influence individual behaviors and health outcomes. This term encompasses factors like socioeconomic status, cultural norms, and social networks that can significantly affect access to resources, healthcare services, and overall well-being, particularly in promoting health equity.
Social determinants of health: Social determinants of health are the conditions in which people are born, grow, live, work, and age that impact their health outcomes. These factors include economic stability, education, social and community context, health care access, and the neighborhood environment, all of which contribute to health disparities and overall well-being.
Telehealth Services: Telehealth services refer to the delivery of healthcare-related services and information through digital communication technologies, allowing patients to access care remotely. This approach includes video consultations, remote patient monitoring, and mobile health applications, which can help bridge the gap between healthcare providers and patients, especially in underserved areas. By utilizing telehealth, healthcare systems can enhance access to care, promote continuity of treatment, and improve health outcomes for vulnerable populations.
World Health Organization (WHO): The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. It aims to promote health, keep the world safe, and serve vulnerable populations by addressing global health issues, ensuring equitable access to healthcare, and advocating for health policies that enhance health equity across all countries.
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