A Four-Pronged Approach to Health Equity

In the current landscape of global health, systemic disparities pervade, affecting marginalized communities at disproportionate rates. Achieving health equity for all is not just a lofty goal; it is an imperative for ensuring the well-being and vitality of our global community.

This blog outlines a roadmap for governments worldwide to ensure that health equity is achieved for everyone, touching on incorporating lived experiences, harnessing talent reflective of marginalized communities in decision making capacities, and dismantling systems underpinned by pure greed.

Understanding Health Equity Health equity refers to the attainment of the highest level of health for all people, regardless of gender, race and or social class. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities by equalizing the conditions for health for all people.

A Four-Pronged Approach to Health Equity

1. Policy Transformation that Includes Compliance Enforcement and Corrective Measures: Health Policies that are Monitored, Measured and Enforced: A standard like “Health in All Policies" approach, ensuring that health is a shared goal across all sectors of government and society. This incorporates health considerations into policymaking processes, aiming to improve the health of all communities and people. However, the policy must be monitored regularly, and publicly funded initiatives must promote transparency and accountability. These policies must be designed to ensure that agencies achieve measurable outcomes and to the extent possible, government regulatory bodies should consider imposing sanctions in areas where profit clearly outweighs patient health. One key indicator is when there is significant disparity where marginalized people are concerned.

Suggestions of low hanging fruit for policy makers to consider as immediate areas of focus for Health Equity outcomes include; maternal health, breast cancer mortality rates and the very low representation of marginalized people currently in clinical trials. These are three critical areas of opportunity for regulators to zero in on. For example, in 2023, Black women are three times more likely to die from a pregnancy related cause than white women. While there are multiple factors that cause this disparity, structural racism and implicit bias is at the center. Health equity initiatives, including physician input, are often led by non-minority personnel whose impressive academic achievement is often disconnected and not inclusive of the realities and actual lived experiences of marginalized people. The reality of circumstances for this impacted population is not currently at the core of the decision making. That may be one reason why there is a lag in the formation of relevant solutions to impact this mortality issue. Perhaps that is why in 2023, with some of the most groundbreaking research, significant resources and mind-blowing innovation, black women continue to fight for their lives during something as common as childbirth. Therein is the basis for this classification as a “low hanging fruit”, for example.

Equity-Oriented Policies: Governments should prioritize policies aimed at reducing health disparities, such as universal healthcare, affordable housing, food security, and accessible mental health services. The demand for Value must be across the board. Outcomes should be clearly defined, standardized, and required by all. One major win would be to impose sanctions or corrective measures for a lack of achievement, particularly where public investment is involved.

2. Engaging Marginalized Communities: Lived Experiences: Incorporating the lived experiences of marginalized communities is vital. Governments should create forums for these communities to share their experiences and insights, ensuring their voices are central in the development, implementation, and evaluation of health policies and programs. Organizations must center this experience into their daily operations in impactful ways and beyond lip service. Public awareness and public opinion can be leveraged to create outcomes with a unified approach. However, in cases where significant public investment is at stake, leadership must set the tone. Diverse Talent: Hiring individuals from diverse backgrounds, especially those from marginalized communities, helps to bring different perspectives to the table, ensuring more holistic and inclusive health solutions. This hiring must extend beyond the surface. While a skilled workforce is essential at all levels, it would be helpful to have diversity in independent and decision-making roles and beyond window dressing. 3. Dismantling Greed: Regulatory Measures: Implementing stringent regulatory measures can help dismantle greed within the health system. Governments must continue to regulate pharmaceutical companies, private healthcare providers, and other stakeholders to ensure access to essential healthcare services and medications for all, regardless of financial status. When significant profit is primary, it may be achieved at the expense of patients and even employees. Again, this should be analyzed closely in publicly funded contracts and initiatives to protect public investment. Global Collaboration: Promoting global collaboration can aid in sharing resources, knowledge, and expertise, thus diluting the greed within certain organizations in the healthcare industry. This includes partnerships to make medications and vaccines more accessible globally, particularly in low-income countries. 4. Investing in Social Determinants of Health: Addressing Social Determinants: Governments currently invest significantly in organizations that claim to address the social determinants of health, in areas such as education, employment, housing, food insecurity and in some cases the environment. In institutions that are committed to health equity outcomes, they are noted to have a profound impact and it can be measured. Yet others are lacking and profiting simultaneously. One proven way to achieve measurable outcomes is to employ and even standardize a much stronger tracker mechanism for impact and equity. This can be designed to ensure that organizations are not simply swallowing up significant public investment without honoring equity and measurable, improved health outcomes for all people. As the adage goes, we cannot manage what we cannot measure. The data confirms a disconnect.

Conclusion Achieving health equity for all is an essential goal that requires comprehensive, concerted, and global efforts. Simply put, follow the money, mandate, and monitor equity in patient care, reinvest substantial profit achieved with public investment and require organizations to be transparent and accountable. The roadmap outlined above, including policy transformation, engaging marginalized communities, dismantling greed, measuring outcomes and reinvestment (in publicly funded environments), and investing in social determinants of health, can guide governments in ensuring health equity is achieved for everyone. It is a journey that necessitates the commitment, collaboration, and courage of all stakeholders involved. Finally, I would suggest analyzing the data regularly. In instances where profit is substantial in healthcare organizations, health equity outcomes. lack of access to basic human needs and poverty are at dangerously low levels, in the very same communities, a reasonable mind can conclude the priority is not health equity and patient health. Furthermore, in these glaring situations, public investment should be closely scrutinized.