INTRODUCTION TO HEALTH EQUITY: Dr.Arya Flashcards
health Equity
This refers to the goal of ensuring everyone has the opportunity to attain their highest level of health. It emphasizes that no one should be disadvantaged due to social or other circumstances that are beyond their control.
Health Inequity:
This signifies the existence of differences in health outcomes that stem from avoidable, unfair, and unjust social and structural disparities. Inequities highlight disparities that could and should be mitigated or eliminated.
Health disparities
These are the measurable differences in health outcomes among different populations. They serve as the indicators or metrics used to assess progress toward achieving health equity.
Genes and biology
Refers to the inherited characteristics that influence our health, such as our sex, race, and family history.
Physical environment
refers to the places where we live, work, and play, and the factors in those places that can affect our health, such as air and water quality, access to healthy food, and opportunities for physical activity.
10% of environment
Social and economic factors
include our income, education level, social status, and access to healthcare. These factors can have a significant impact on our health, as they can influence our ability to afford healthy food, live in a safe and healthy neighborhood, and get the medical care we need
40% of determinants of health
Clinical care
refers to the healthcare services that we receive from doctors, nurses, and other healthcare professionals. This includes preventive care, such as immunizations and screenings, as well as treatment for acute and chronic illnesses.
Health behaviors
Include our choices about what we eat and drink, how much physical activity we get, and whether or not we smoke or use drugs. These behaviors can have a major impact on our health and well-being.
Highest deaths due to attributable factors?
Low education
Racial Segregation
Low social support
individual poverty & income inequality
The Social Determinants of Health
(SDOH) are the conditions and factors in the environments where people are born, live, learn, work, play, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
Economic Stability:
Employment: Job insecurity or unemployment can lead to financial stress, affecting access to healthcare, nutritious food, and stable housing.
Income Inequality:
Disparities in income can result in unequal access to resources like healthy food, safe neighborhoods, and quality education.
Neighborhood and Physical Environment:
Housing Conditions: Living in substandard or overcrowded housing can increase the risk of health issues such as respiratory problems or infections.
Access to Green Spaces: Communities lacking parks or recreational areas may experience higher levels of stress and lower physical activity.
Education
Educational Attainment: Lower levels of education can lead to limited job opportunities and lower income, impacting access to healthcare and other resources.
Health Literacy: Education levels can affect understanding and utilization of health information and services.
Food
Food Insecurity: Limited access to nutritious and affordable food can lead to malnutrition or diet-related diseases, affecting overall health and well-being.
Food Deserts: Areas lacking access to fresh, healthy foods due to limited grocery stores or markets can contribute to poor dietary choices.
Community and Social Context:
Social Support Networks: Strong social connections and support systems contribute to better mental health and overall well-being.
Discrimination and Marginalization: Discrimination based on race, ethnicity, gender, or other factors can negatively impact mental and physical health outcomes.
Healthcare System:
Access to Care: Limited access to healthcare services due to financial barriers or geographic distance can result in delayed care and poorer health outcomes.
Quality of Care: Disparities in healthcare quality, cultural competence, and availability of services can impact health outcomes among different populations.
What cause health disparities?
Health disparities arise from
social factors like education,
taxes, jobs, housing, city
planning, laws, and healthcare
systems. People can’t directly
change these but need social
and economic policies to fix
unfair health differences.
Health Impact Pyramid
is a visual representation used to illustrate the varying levels of impact that different types of interventions can have on public health outcomes. The pyramid categorizes interventions based on their effectiveness in improving population health and preventing diseases. It typically consists of layers, each representing different types of interventions and their relative effectiveness in producing widespread health improvements.
Socioeconomic Factors and Social Determinants:
At the base of the pyramid are the social determinants of health, such as education, income, housing, and social environment. These factors have the broadest and most significant impact on population health but often require substantial societal changes to address.
Changing the Context to Make Individuals’ Decisions Healthy:
This layer involves modifying the environment or setting default options to encourage healthy behaviors. Examples include making healthy foods more accessible or designing cities to promote physical activity.
Long-Lasting Protective Interventions:
These are interventions that provide long-term protection, such as vaccinations or counseling on healthy habits, aiming to reduce risks and prevent diseases.
Clinical Interventions:
: This layer includes healthcare services provided by clinicians, like medical treatments, surgeries, or medication. While critical for individuals, these interventions have less impact on the health of entire populations compared to broader social and environmental changes.
Clinical Interventions
: This layer includes healthcare services provided by clinicians, like medical treatments, surgeries, or medication. While critical for individuals, these interventions have less impact on the health of entire populations compared to broader social and environmental changes.
Counseling and Education:
Targeted at changing individual behavior through education and counseling, this layer focuses on imparting knowledge and skills to promote healthier choices.
Increasing Population Impact:
This line or axis represents the scale of impact an intervention has on a population level. As you move down the pyramid towards the base, the interventions have a greater effect on the health of larger populations. Strategies or interventions at the bottom of the pyramid, addressing social determinants like education, income, or living conditions, have a more widespread impact on a larger number of people within a community or society.
Increasing Individual Effort Needed:
This line represents the level of personal effort or individual action required to benefit from a particular intervention. At the top of the pyramid, interventions often demand more individual effort or engagement, such as changing personal behaviors, adhering to medical treatments, or seeking healthcare services. These interventions might require more active participation or compliance from individuals to achieve health benefits.
Inequality
Inequality refers to disparities or uneven distributions of resources, opportunities, or privileges among individuals or groups. It can encompass various forms, such as economic inequality (unequal distribution of wealth or income), social inequality (unequal treatment based on factors like race, gender, or socioeconomic status), or educational inequality (unequal access to quality education).
Equity
Equity involves ensuring fairness and justice in providing resources, opportunities, and treatment to all individuals or groups, accounting for their specific needs and circumstances. It aims to address underlying disparities or barriers by giving everyone what they need to achieve similar outcomes, even if it requires different supports or approaches for different individuals or groups.
Equality
Equality focuses on treating everyone in the same way without accounting for individual differences or varying needs. It implies providing the same resources, opportunities, or treatment to everyone regardless of their starting point or circumstances. However, this approach might not address existing disparities as it doesn’t consider the differing needs or challenges faced by individuals or groups.
Justice
Justice encompasses the concept of fairness, moral rightness, and the application of ethical principles in the treatment of individuals or groups. It involves ensuring that all individuals have access to their rights and are treated fairly within society. Justice seeks to address systemic issues that lead to inequalities and promote a society where everyone has equal opportunities and treatment.
Addiction” vs. “Substance Use Disorder”:
Historically, “addiction” often carried a stigma, implying a moral failing or lack of willpower. It placed blame on individuals for their struggles with substance use.
Substance Use Disorder (SUD):
: “Substance Use Disorder” is a more modern term used in clinical and public health contexts. It emphasizes that substance use issues are a medical condition requiring treatment rather than a moral failing.
Moral Character Flaw
This older narrative framed addiction as a weakness or personal flaw, often stigmatizing those affected.
Families Affected by the Opioid Epidemic:
: Shifting the narrative to focus on families affected by the opioid crisis humanizes the issue, emphasizing compassion and support rather than judgment and blame.
Institutional Racism:
This occurs within institutions when their policies, practices, or systems lead to unequal or unjust outcomes based on race. These outcomes can persist due to deliberate or unintentional actions within the institution.
Racial Equity:
It’s both an end goal and a process. Achieving racial equity means that race doesn’t dictate or predict outcomes. The process of achieving racial equity involves ensuring that those most affected by racism have a say in decisions that impact their lives, thus addressing systemic biases and disparities.
Intersectionality
This concept recognizes that various forms of inequality, such as race, gender, sexuality, class, etc., intersect and compound each other’s effects. For instance, an individual may face unique challenges resulting from the combined impact of different types of discrimination or disadvantages based on various aspects of their identity.
Lived Experiences
Structural racism influences how individuals experience the world. It can impact where people live, the quality of their housing, the availability of resources and opportunities, and the interactions they have with institutions like schools, law enforcement, and healthcare. These experiences are often shaped by systemic biases and inequalities.
Comparative Analysis:
Among 11 highly industrialized, high-income countries, the United States reports the highest rates of maternal mortality. This ranking is troubling, especially considering the resources and advancements in healthcare available in the country.
maternal mortality rate
Disturbingly, the maternal mortality rate in the US is on an upward trajectory. This trend highlights a persistent and worsening problem that demands immediate attention and comprehensive solutions.
Preventability of maternal mortality
y: A significant revelation is that a substantial majority—ranging from 66% to 80%—of pregnancy-related deaths in the US could have been prevented. This staggering statistic underscores the urgent need for better healthcare practices, improved access to quality care, and the implementation of appropriate interventions
Pregnancy-associated mortality
Deaths during pregnancy and up to 1 year after, regardless of cause
Pregnancy-related mortality
Deaths during pregnancy and up to 1 year after, related to pregnancy and its effects
Maternal mortality
Death during or within the last 42 days of pregnancy, from any cause related to pregnancy or its management
Black mothers mortality
Higher than any group
Black women experience significantly higher maternal mortality rates compared to white women. Studies consistently show that Black mothers are two to three times more likely to die from pregnancy-related complications than their white counterparts.
Trend of Maternal Mortality Rates: race
Maternal mortality rates have been on the rise across all racial groups in the United States. This pattern signals a systemic problem demanding immediate attention and comprehensive solutions.
Disproportionate Impact on Non-Hispanic Black Individuals:
Among these rising rates, non-Hispanic Black individuals consistently experience the highest rates of maternal mortality. This disparity highlights a persistent and deeply concerning issue within healthcare systems that disproportionately affects this demographic.
Maternal Mortality rates with age
Teens face risks due to physical immaturity.
- Women ≥35 have higher complications.
- Women ≥40 often have highest risks.
Factors like health, care access, and risks impact rates.
Maternal mortality rate for Black women:
55.3 deaths per 100,000 live births
Maternal Immortality rate for women aged ≥ 40
107.9 deaths per 100,000 live births
About 7.8 times higher than the rate for women under age 25
Common causes of maternal death for Black Women
Cardiomyopathy, thrombotic pulmonary embolism, hypertensive disorders
Statistics for Maternal Death
Postpartum cardiomyopathy, preeclampsia & eclampsia were 5 times higher…
Obstetric embolism were 2.3 times higher…
Obstetric hemorrhage were 2.6 times higher…
Structural Racism:
Legalized systems in society reinforcing racist agendas.
Implicit Bias:
Unintentional associations impacting judgments, decisions & behaviors.
Underlying Chronic Conditions:
Higher likelihood of hypertension, diabetes, cardiovascular disease.
Variations in Healthcare Quality:
Smaller representation of Black OB-GYNs and specialized nurses.
Personal Responsibility:
Blaming individuals for their health without considering systemic barriers.
Unfortunate but not Unjust
Viewing disparities as natural, not acknowledging underlying injustices.
Nothing can be done:
Assuming helplessness in addressing health inequities.
