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3 Things to Know: Health Equity

Posted: September 18, 2018

To have a productive conversation about health equity, we need to get one thing straight: equity is not the same as equality.

Striving for equality alone can actually perpetuate disadvantage. To remedy health disparities, some communities need more—not just equal—resources. Watch this brief illustration from the Robert Wood Johnson Foundation to get clear on equity vs. equality.

Truly attaining the “highest health of all people” starts with embedding fair opportunities for well-being into the whole of community life. The factors affecting health outcomes, collectively known as social determinants of health, include everything from socioeconomic status to the availability of public transport and recreational space—a mix of structural conditions that impact the physical and mental health of individuals and their communities.

Health equity is achieved when our knowledge of social determinants is put toward the cause of eliminating health disparities. But what does a commitment of that magnitude look like, and how can it be fulfilled? Below are three things that anyone wrestling with these questions should keep in mind:

1. Access for all doesn’t mean health for all.

In the U.S., envisioning and enacting systems-wide change requires challenging a long legacy of exclusionary policies, practices and structures that, to this day, derail health improvement for all. When it comes to finding and obtaining health or mental health services, historically marginalized populations know better than anyone that injustice, and lack of opportunity, can persist even in the absence of explicitly discriminatory legislation.

2. Community context matters.

Textbook history is one thing; the true history of a neighborhood or community is quite another. In bringing the intergenerational consequences of social determinants to life, stories of trauma and resilience from the past and present provide a rich, much-needed context for health equity interventions.

3. We’re all in this together.

Without cross-sector collaboration, achieving health equity is impossible. Fragmented systems and services—education, economic development, housing and so on—are far more likely to create disparities than those working in partnership with one another.


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