Defining Health Equity

Governments and researchers define health equity as the state in which everyone has a fair and just opportunity to attain their highest level of health.  

Achieving health equity would mean the absence or removal of avoidable, unfair or remediable differences among groups of people, whether the groups are defined socially, economically, demographically, geographically or by other means of stratification.

Health Disparities

Governments and researchers define a health disparity as a particular type of health difference that is closely linked with one or more of social, economic or environmental disadvantage.

Health disparities adversely affect groups of people who systematically have experienced greater challenges to health based on their:

  • Socioeconomic status

  • Cognitive, sensory or physical disability

  • Other characteristics historically linked to discrimination or exclusion

  • Geographic location

  • Age

Social Determinants Of Health

Social determinants of health, also known as social drivers of health, (SDOH) are the non-medical factors that influence health outcomes – the conditions in which people are born, grow, work, live and age.  SDOH also include the wider set of forces and systems shaping the conditions of daily life, including social norms and policies and economic and political policies and systems.

Examples of SDOH that can influence health equity in positive and negative ways include:

  • Income and social protection
  • Education
  • Unemployment and job insecurity

  • Working conditions

  • Food security

  • Housing, basic amenities and the environment
  • Early childhood development

  • Social inclusion

  • Access to affordable health services of decent quality

SDOH Influence On Health Equity

At all levels of income, health and illness follow a social gradient – the lower the socioeconomic position, the worse the health outcomes.

SDOH can be more important than health care or lifestyle choices in influencing health outcomes.

SDOH can account for 30% – 55% of health outcomes.

Healthcare outcomes are influenced more by sectors outside of health than from the health sector.

Healthcare Expenditures

Health inequities and SDOH impact healthcare expenditures.

– Health Inequities And SDOH Impact Healthcare Expenditures –

Socioeconomic
Factors — 40%

  • Education

  • Job status

  • Family/social support

  • Income

  • Community safety

Physical
Environment — 10%

  • Building

  • Transportation

  • Climate

Health
Behaviors — 30%

  • Tobacco use

  • Diet and exercise

  • Alcohol use

  • Sexual activity

Health
Care — 20%

  • Access to care

  • Quality of care

Health-Related Social Needs

Some populations and individuals may have related social needs (HRSN) arising from socially-determined factors.  While SDOH are broad social conditions, HRSN are more immediate individual or family needs that are impacted by such conditions.  HRSN include housing insecurity, food insecurity and lack of reliable transportation that can lead to declining health and a lower quality of life.

SDOH And HRSN

Understanding SDOH and addressing HRSN are critical to reducing health disparities and promoting health equity.

Unmet Medical Needs:

  • Disease management programs that target SDOH and reduce health disparities and inequities

  • A wide array of services and supports for complex high-need people whose health outcomes are driven in part by unmet social needs

  • Value-based initiatives that improve the quality of health based on outcome measures

  • Funding for providers to acquire advanced technologies required to deliver SDOH-informed outcomes through value-based care