Public Health's Role in the Pursuit of Health Equity
Danielle Broussard, PhD | Research Manager, Resiliency & Post-Disaster Mental Health Team Lead
The charge to address health disparities, which are differences in health outcomes between different groups within a population, began in earnest just over two decades ago. For much of this time, efforts to reduce and even eliminate health disparities have largely relied on disease prevention and health promotion efforts undertaken by or funded by public health agencies such as the Centers for Disease Control and Prevention (CDC) and state and local health departments. Over the years, there has been progress towards reducing some health inequalities; however, disparities in health outcomes continue to exist in many critical areas such as preterm births and infant mortality, chronic health conditions, HIV infection and homicides. Disease prevention and health promotion efforts such as health education and disease screening programs are still very necessary to reduce the burden of many of these adverse health outcomes. However, the impacts of these efforts will continue to be limited as long as there are barriers in place that hinder equity in access to the means, services, environments, and other resources that support achieving good health.
Many public health organizations and agencies around the country endorse social justice and equal access to basic needs and services, as well as the conditions and supports needed to thrive as the pathway to health equity. As part of a larger national project, Building the Capacity of Public Health to Advance Equity, and in partnership locally with faculty from the Mary Amelia Douglas-Whited Community Women’s Health Education Center at Tulane University, the Institute of Women & Ethnic Studies (IWES) recently concluded an environmental scan of existing policies and practices within the governmental public health system related to equity, community engagement, and addressing the social, economic and environmental factors into which people are born, grow, live, work and age, also referred to as the social determinants of health. Findings from the study are being used to support recommendations and strategies that health departments can use to advance racial, social and health equity. One finding from the assessment was that advancing health equity in the community will require health departments to build their internal awareness and understanding about the root causes of health disparities including the roles that racism, discrimination, and bias play in poor health. Additionally, the study highlighted the importance of meaningful community engagement including partnerships with the community that are built on respect and trust.
What is clear from this work is that public health alone cannot solve equity issues; doing so will require participation from other sectors and systems that affect peoples’ lives such as housing, public safety, law enforcement, education, and transportation. But, as there is a movement toward recognizing “health in all policies,” public health can play an important role in partnering with and bringing together the various sectors and systems that impact health and make certain that the health impacts of proposed policies are considered as a part of decision-making.
Ultimately, achieving health equity relies on buy-in from and engagement with all segments of the community. It is only when all community members are able to earn a living wage, receive a quality education, reside in quality, affordable housing in safe neighborhoods, access reliable public transportation, obtain culturally competent health care services and purchase nutritious, affordable foods that we can truly begin to claim victory over health disparities.