What is Health Equity?

Reading Time: 3 minutes

When we talk about the health of a community, there are many terms that get thrown around. In order to fully grasp the complexities of health and the role of Public Health in your community, it is important to get familiar with these terms. While certain terminology changes and evolves over time, there are some key concepts that are at the very foundation of the work that Public Health and our community partners do. So, to help in defining some of these, our new Community Health Planner for Equity and Inclusion has put together this helpful guide. To begin…

Health equity means that everyone in our community has a fair and just opportunity for healthy living. This requires removing the obstacles to individual and community health that arise from poverty and discrimination (whether based on race, education, gender identity, sexual orientation, job status, housing status, or disability) that result in compromised health and powerlessness. 

Health disparities are the differences in health outcomes across population groups. When we look at the cause of health disparities, we know that our health behaviors are important, such as eating nutritious foods, exercising, staying tobacco free, etc. However, those are only part of the bigger picture. Our health is also influenced by the social and economic conditions we live in. 

Social determinants of health are defined by the CDC as “the conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes.” Social determinants of health show up in people’s lives through their access to quality healthcare and education, opportunities for economic stability, and neighborhood and community context they live in. For example, the amount of funding a local public school receives, access to safe sidewalks and parks to get outside, proximity to grocery stores that carry healthy food, and whether there is high amounts of crime where someone lives. 

Image from the Interaction Institute for Social Change

So, how are these terms all connected? When targeting health equity issues in our community, we are often looking at the social determinants of health that are influencing health disparities. 

You may be asking yourself: “We have healthy food, doctors, and opportunities for exercise that everyone can equally access, so how come people don’t use those?” This is an important point to address. 

There is a difference between equality and equity. Equity involves trying to understand what is causing the health disparity and giving people what they need to enjoy a healthy quality of life. Equality, in contrast, aims to ensure that everyone gets the same things to enjoy a healthy quality of life. Like equity, equality aims to promote fairness and justness, but it can only work if everyone starts from the same place and needs the same things. The image below explains the differences in these concepts. We must remember that a “one size fits all” approach is not always the most effective way for everyone to get the same opportunities.    

At Skagit County Public Health, we are making efforts to achieve health equity in our community. For example, Community Health Workers and Promotores employed by Public Health are working hard to increase access to health and community resources for Spanish speaking and Indigenous communities, people with disabilities, and seniors. Public Health also facilitates the Population Health Trust, which is the community advisory board to the Board of Health. The Population Health Trust is comprised of a group of leaders in the community who develop health equity strategies for the entire county to improve health for all community members. 

To learn more about the Population Health Trust and the work they are doing, click here.

Meet the Population Health Trust, Part Three

Reading Time: 4 minutes

The Skagit County Population Health Trust (or “Trust”) is gearing up to publish its new Community Health Assessment; a document which provides a framework for what the County and its partners will focus on over the next several years. Trust members have been busily collecting data and community input over the spring and summer in order to identify the top health concerns of our residents.

This Assessment, called the CHA, would not be possible without a diverse group of experts coming together with a shared mission and vision. One of its members, Anneliese Vance-Sherman, has shared her thoughts about the importance of the Trust below.

What health topic are you most committed to improving for Skagitonians?

Anneliese Vance-Sherman, Ph.D.

My top priority on the Population Health Trust is improving economic health for Skagit County residents. While economic health is not necessarily what comes to mind first for most people, it is a social determinant of health. Economic stability makes it possible for individuals and families to access stable housing, healthy food, routine health checkups and be able to withstand unexpected stresses.

Economic health takes many forms, and shows up in an interconnected web of priorities. I am specifically committed to working with workforce and education partners to help build a financially stable, skilled, and resilient local workforce. I also work closely with economic development and business to attract, build and retain businesses that support jobs in the community. I am also committed to improving access to affordable housing, supporting mental and behavioral health, and ensuring that all families are able to access the resources they need to raise healthy children and pave a pathway for future success.

Which agency or organization do you represent on the Trust?

I represent the Washington State Employment Security Department (ESD). ESD’s mission statement reads “We provide communities with inclusive workforce solutions that promote economic resilience and prosperity.” Economic health and financial security are fundamentally connected to community health. Indeed, steady employment and reliable wages make it possible for individuals and families to access resources that contribute to their well-being and that of the community.

What have you/your agency been up to during COVID?

The Employment Security Department has been on the front lines of the COVID-19 employment crisis since day one, in a number of different capacities.

  • The Unemployment Insurance division has assisted an unprecedented number of Washingtonians seeking unemployment benefits. ESD brought in staff from other parts of the agency and even the national guard to process a tsunami of claims as quickly and effectively as possible, while simultaneously working to identify and block fraudulent applications.
  • The constellation of organizations and service providers that make up the WorkSource system reimagined service delivery during the pandemic. Staff assisted job seekers through online meetings and appointments. Many ESD staff in WorkSource also assisted the Unemployment Insurance division during the peak of the pandemic.
  • ESD launched the Paid Family and Medical Leave program during the pandemic.
  • The division I work for (Labor Market and Economic Analysis) collects, analyzes and publishes labor market information. The quickly-evolving situation brought on by the pandemic required us to think about data differently. Our team focused a great deal of attention to unemployment insurance data both because there was heightened demand for it given the nature of the crisis and because with a weekly cadence for reporting, unemployment insurance data helped us to keep closer tabs on the changing economy. 

I have spent the pandemic innovating with my ESD colleagues over zoom meetings and communicating frequently with partner agencies in the economic and workforce development arenas and the media. My desk has been my kitchen table, and my in-person co-workers included two young scholars attending school remotely, my spouse who was also working from home, two dogs, and two cats.

I also volunteered at the Skagit County COVID-19 testing center; first at the Skagit Valley College campus, then at the fairgrounds. It was humbling to see how many people were proactively getting tested, and rewarding to work alongside so many dedicated community-minded neighbors.

Why do you think the Population Health Trust is important?

If you tug on a single thread in a woven piece of cloth, the cloth will pucker and pull. Tugging on the single thread may even tear and destroy the integrity of the cloth. If you are only aware of or focused on the single thread, it is difficult to anticipate how a single action could impact the whole.

The Population Health Trust relies on deep multi-sector engagement of community leaders and stakeholders with a mission to explore and promote community health in Skagit County. The diverse composition of the Trust makes this possible. Our multi-sector team includes representatives from hospitals and health care providers, community organizations, education, state and local government, law enforcement, and more. Together, we explore issues that impact community health, and proactively work toward creative and sustainable strategies that will improve the well-being of communities throughout Skagit County.

Rather than each pulling on our own thread, we can collectively take a step back, understand the strengths, weaknesses, challenges, and connections within and between our communities, and explore optimal solutions through active and creative dialog that centers and prioritizes a broad understanding of health for Skagit County.

Want more information about the Population Health Trust? Go to: https://www.skagitcounty.net/Departments/PHTAC.