The other day I went to see a speaker on my college campus. Her name was Renata Schiavo and she is the founder and president of the Health Equity Initiative, a non-profit organization that is dedicated to building community, capacity and communication resources for health equity. Staying true to her mission of spreading awareness, she spoke to us about health equity and it’s importance. I personally found the presentation pretty interesting so I thought I would share some of her points.
Conventionally, people tend to talk about health and illness in the biomedical sense, as something that is just an issues with our physical bodies. This model, however, fails to take into the account the many social and economic circumstances that are powerful determinants of our health. Schiavo narrowed these determinants to environment, cultural/social influences, socioeconomic opportunities and access to service. These factors affect individual, community and social behaviors which then influence health outcomes.
As many (but not enough) of us know, not everyone’s social factors are the same. As a result, health care among different populations is not evenly distributed. Health disparities are present globally and continue reduce the opportunity for many countries to develop. There are places and people who are more vulnerable to diseases and disasters, and it prevents them from living fulfilling lives. The essential problem with health care in the global spectrum is the inability to provide adequate care to people living in remote places. Mainly, there is a difference in available resources. Furthermore, these issues are generally seen to affect the poor as they are the population with the worst health. Even in rich countries, it is those with low socioeconomic status who have the poorest health. Lack of education, lack of opportunities, unemployment, and unsafe living conditions are all issues that poor individuals are subject to.
Just an example of health inequity: did you know that 529,000 women die a year in childbirth worldwide? And 99 percent of these deaths occur in developing countries. That is hardly a coincidence. That is more than half a million people dying, not because they are ill or have a disease, but simply because they do not have the education or access to proper care. That’s more than half a million people dying, not because there is something wrong with them or their bodies, but because there is something wrong with our society.
So, what is health equity and why is it important? Health equity, as Schiavo defined it, is providing every person with the same opportunities to stay healthy and effectively cope with disease or health-related emergencies, regardless of their race, gender, age, economic conditions, social status, environment and other social factors. First of all, good health is a fundamental basic right of every human being. These social factors should not determine the quality of one’s health. And secondly, good health is a key determinant of economic and social development; it has a positive impact on people’s lives and presents opportunities. I guess the real question is, why is this still an issue when equity is the biggest concern for public health?
I think it comes down to two things. One, inequity is not common knowledge and equity is not necessarily a universal belief. Schiavo shared an interesting statistic: in the U.S. awareness of health disparities has only increased from 54.5 percent to 59% in the last decade and only 49 percent of 2,792 U.S. adults are aware of health disparities among minorities in the country. That means a large portion of people, even in a rich country like the United States, do not know health inequity exists and may not even know that it is affecting them. Not everyone thinks that health equity is something that is possible for everyone. They may agree that everyone should have the opportunity to good health, but they do not necessarily believe that it’s fair that a dying mother in India should receive the same quality of care as one in the States at our expense. But a life is a life, right? Who is to say anyone deserves more or better care than another solely based on their circumstance or geographic location? And the second thing is that health is complicated and multidimensional. It is affected by a myriad of different factors across different fields. It is not just the job of healthcare professionals to be concerned about human health. It takes a village to raise a child and it takes a society to build a healthy nation. Accomplishing good health is a community responsibility which requires community effort. This means that the health works along with the government and businesses should all be involved in improving health care. It must be a multi-sector initiative.
I know this is not as simple as I may be making it sound. I completely acknowledge the complexities of the healthcare field and the difficulties that arise in trying to get everyone to acknowledge and act on them. My point is that in regards to equal health care, we’re on our way but there is still a substantial amount to be done. The first step would be to expand the mission. Like I said, there are still so many people out there that take their health and opportunities for granted. We need to make an active effort to reach these people and show them that others are not so fortunate. With more consciousness, I’d hope that people will have more empathy and make more of an effort to get involved.