Defining Health Equity: Wolverine Pathways

 A Research Brief by Bushra Nimer bn

The ambiguity of words leave a lot of room for personal interpretation. We act on words, feel emotions because of words, and devote lives to causes because of words. When it comes to a word such as health equity, the implications it carries creates an overwhelming need to have an explicit definition. Through research, conducted as part of the Health Equity Leadership Pipeline Collaborative at the University of Michigan School of Public Health, I was able to analyze the usage of the word and its relevance in certain contexts. Surprisingly, the more I learned, the further I ended up from a concise definition of health equity. In Fabienne Peter's report Health Equity and Social Justice, she states, "What makes thinking about health equity difficult from the outset is that the concept of health itself is not easy to grasp and varies considerably across places and times." It is not just health equity that is ambiguous in the literature, but the idea of health in the context of social justice raises questions about the connected origin of health equity as a buzzword. When health equity is talked about, many researchers and journalists argue that it's ambiguity needs to come to an end, and that it requires more attention by healthcare leaders. Social media outlets enjoy explaining it as a new social term, which has brought a lot of much needed awareness and attention to the topic. Social media has also helped to more pressure on the entirety of the concept and a universal definition.

When many hear the term health equity, an often natural association is to relate it to health equality. But health equality and equity are two very distinct fields. Health equality operates to promote fairness, and wants to assure that everyone is treated the same. It argues that the only chance of this type of solution truly being successful is if everyone starts the same and are given the same resources to strive. The latter point is where health equity comes into play and differences are clearer to see. I believe health equity's driving force is in the notion of assuring that everyone is equipped with the adequate resources to succeed. It is not afraid to challenge the existing political and socio-economic histories that have lead to today's pre-disposed health disparities that affect all groups of citizens, but especially racial and ethnic minorities. In my definition, the heart of health equity is social justice.

In my research of popular research journals, the presence of health equity was accompanied by the term, health disparities. Healthy People 2020 defines a health disparity term as, "...a particular type of health difference that is closely linked with economic, social, or environmental disadvantage." The underlying research explains that these health disparities affect citizens that systematically experience more struggles and are at a disadvantage socially and economically, including any characteristics that have lead to any type of discrimination or exclusion in history. The Healthy People 2020 literature help me find my first working definition of health equity. Here, health equity is the principle that works to reduce all these determinants and work to ultimately eliminate all the ones that affect health. The aim of health equity is to reach the highest possible standard of health for all people, with more attention set on the people who are at higher risk due to social determinants and conditions.

The idea of health equity brings to light the distinction between healthcare and health itself. Although many groups of people can have access to adequate healthcare, it does not mean they are healthy. As a result of this distinction, a more concise outlook of the definition of health equity on the basis of health becomes necessary. The previously mentioned author, Fabienne Peter, spends a fair amount of her journal explaining the concept of health and ultimately comes to talk about the World Health Organization (WHO) definition of health, which states "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Building on this idea, health equity is not simply whether you will be able to have access to medicine once you sick, as much as it is being healthy is the first place.

In my research, health equity's entirety comes back to one fundamental principle, it is about all groups of people being equipped with the necessary resources to live a healthy lifestyle, and are at no disadvantage achieving this status, not socially, economically, or any other social determinate. The conclusion that I have come to is that the best way to reach the goal of health equity is through the elimination of pre-disposed health disparities. Achieving health equity addresses the situation that when two kids are born, one already has a socially higher standing than the other merely because of race, religion, sex, social class or whatever other titles that we have set that prevent the human race from being looked at as one.

My journey to a better definition of health equity is only the start. I believe the outlook on health equity is promising, and it is time for my generation to take responsibility to educate and act upon our findings. We need spend more of our time and resources into understanding the fundamental roots of this problem, educating the public, and making a plan to act upon. Studying health equity has given me a whole new lense on the world that I hope to explore. There is deep explanation to what socio-economical circumstances lead us to why we have this problem and there is a way to deal with it, and I hope to be the one to continue to study this with The Collaborative and initiate the change in the world that everyone is waiting on.