The authors note that equity is not the same as equality. To equalize opportunities, those with worse health and fewer resources need more efforts expended to improve their health.
Defining Health Equity and Key Steps to Achieving Greater Health Equity
Although the term health equity is used widely, a common understanding of what it means is lacking. This RWJF report defines health equity and identifies crucial elements to guide effective action to reduce disparities in health status.
Simply put, “health equity means that everyone has a fair and just opportunity to be healthier. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”
Health equity surrounds and underpins all of the Robert Wood Johnson Foundation’s Culture of Health Action Areas and the goal of a society in which everyone has an equal opportunity to live the healthiest life possible.
Also included in the report are alternative definitions of health equity for different audiences that may have varying backgrounds and perspectives, and examples of specific terms that often arise in discussions around the concept.
The authors, including RWJF staff members, put forth these four key steps to achieve health equity:
Identify important health disparities. Many disparities in health are rooted in inequities in the opportunities and resources needed to be healthier. The determinants of health include living and working conditions, education, income, neighborhood characteristic, social inclusion, and medical care. An increase in opportunities to be healthier will benefit everyone but more focus should be placed on groups that have been excluded or marginalized in the past.
Change and implement policies, laws, systems, environments, and practices to reduce inequities in the opportunities and resources needed to be healthier. Eliminate the unfair individual and institutional social conditions that give rise to the inequities.
Evaluate and monitor efforts using short- and long-term measures as it may take decades or generations to reduce some health disparities. In order not to underestimate the size of the gap between advantaged and disadvantaged, disadvantaged groups should not be compared to the general population but to advantaged groups.
Reassess strategies in light of process and outcomes and plan next steps. Actively engage those most affected by disparities in the identification, design, implementation, and evaluation of promising solutions.