GTE Toolkit

Getting to Equity in Obesity Prevention (GTE) Toolkit

Key Health Equity Concepts and Definitions

Social Determinants of Health

The concept of health equity is based on the understanding that health disparities arise from adverse social and environmental conditions and systems and unjust or exclusionary policies.

The social determinants of health are nonmedical factors such as employment income, housing, transportation, childcare, education, discrimination, and the quality of the places where people live, work, learn, and play, which influence health, as well as health care factors.

See Figure for examples of social determinants of health from the Healthy People 2030 website.

Because of past and ongoing racial discrimination in housing, lending, and hiring policies and practices, there is great variation in the quality of the places where people of different racial or ethnic groups live, work, learn, and play; these differences in places often correspond to very different opportunities to be as healthy as possible. Opportunity means access to goods, services, and the benefits of participating in society.

There are many different kinds of obstacles to access in addition to financial barriers and geographic distance; obstacles can include past discrimination, fear, mistrust, and lack of awareness, as well as transportation difficulties and family caregiving responsibilities. To measure not only potential access but the real opportunities that different social groups have, that is, their realized access, we need to assess which groups actually have the relevant goods, services, and benefits.

Sources: https://health.gov/healthypeople/priority-areas/social-determinants-health
Robert Wood Johnson Foundation issue brief: What is Health Equity?
Health Equity

Health equity refers to reducing and ultimately eliminating health disparities—health differences or key health determinants that adversely affect marginalized or excluded groups.

Health disparities are addressed by special efforts to improve the health of excluded or marginalized groups, not by worsening the health of those who are better off.

Health equity is the principle or value that motivates us to eliminate health disparities between population groups.

Health equity means that everyone has a fair and just opportunity to be as healthy as possible, referring to both physical and mental health.

  • Progress toward health equity is assessed by measuring how these disparities change over time, in absolute and relative terms.
  • The gaps are closed by making special efforts to improve the health of excluded or marginalized groups, not by worsening the health of those who are better off.
  • Excluded or marginalized groups are those who have often suffered discrimination or been excluded or marginalized from society and the health-promoting resources it has to offer. They have been pushed to society’s margins, with inadequate access to key opportunities. They are economically and/or socially disadvantaged.
  • Examples of historically excluded/marginalized or disadvantaged groups include—but are not limited to—people of color; people living in poverty, particularly across generations; religious minorities; people with physical or mental disabilities; LGBTQ persons; and women.
Source: Robert Wood Johnson Foundation issue brief: What is Health Equity?