#5: Health disparities & health equity

Health outcome

-A measurable aspect of health for a population

-Measured using surveillance data

-Can reflect mental health, physical health, or overall quality of life

-Can be broad like a diagnosis, or specific like how severe the diagnosis is, as long as it is measurable

Health disparities

-A difference or variation in health outcomes

-Many health differences exist that are not health disparities

-Still important to address but these are not health disparities because they are not issues of social justice

Health disparity

-A specific kind of difference in measurable health outcomes among socially disadvantaged groups

-Health differences that are avoidable, unnecessary, and unjust

-Often used interchangeably with terms ‘health inequalities’ or ‘health inequities’

4 components for naming health disparity

Health Outcome among Population A

Health Outcome among Population B

Time

Location

Health equity

-Principle underlying a commitment to reduce and eliminate health disparities

-Striving for the highest possible standard of health for all people

-Giving special attention to needs of those at greatest risk for poor health based on social conditions

-Striving for health equity is what compels us to examine and address the causes of health disparities (social determinants of health)

Social disadvantage

-Someone’s relative position in a social hierarchy (pecking order)

-Groups experiencing discrimination or marginalization based on; economic resources, race, ethnicity, religion, nationality, gender, sexual orientation, disability

-Economic disadvantage: low income, lack of wealth, inability to purchase good, services, influence

-Environmental disadvantage: residing in neighborhood of concentrated poverty and social disadvantages that accompany it

Human rights agreement

-global consensus on fundamental values for all humans

-Implicit obligation to pay particular attention to segments of population who experience most social obstacles

Right to health

right to attain highest possible standard of health and the standard of living necessary to protect and promote health

Nondiscrimination and equality

everyone has equal rights and state is obligated to prohibit policies that have intention or effect of discriminating against certain social groups

Department of housing and urban development 4 categories for homelessness

1. Literally homeless

2. Imminent risk of homelessness

3. Homeless under other federal statues

4. Fleeing/attempting to flee Domestic Violence

Health and Human services homelessness definition

-is “a person who lacks housing” and “a recognition of the instability of an individual’s living arrangements”

-Includes extreme poverty coupled with a lack of stable housing

Health and homelessness

-Poor health, illness, injury, or disability can cause homelessness when it leads to insufficient income

-Living on street, facing stressors of unstable housing can exacerbate existing health problems or cause new ones

Medical respite care

-Acute and post-acute care for persons experiencing homelessness who are too ill or frail to recover from illness or injury on the streets, but not ill enough to be in a hospital

-A short-term residential care allowing people experiencing homelessness opportunity to rest and health in a safe environment

-May be in a freestanding facility, homeless shelter, nursing home, transitional housing

Cost of utilities

-Renters usually responsible for payment

-1 in 5 poor families missed utilities payments, 1 in 7 actually had it turned off

-Various programs exist to help poor families or those with medical conditions prevent shutoffs

-Cost of utilities can sometimes be higher for lower income households

Eviction and health

-Women, people of color, families with children are at high risk for eviction

-Association between eviction and COVID-19 morbidity and mortality

-Moratorium, emergency rental assistance, unemployment insurance kept rates low during the pandemic but these protections are ending