Health equity now: A state of play on public health and equity

This post by Tia Taylor Williams, director of APHA’s Center for Public Health Policy and the Center for School Health and Education, explores the state of play of equity in public health.

Public health is rooted in a tradition of serving the most vulnerable and bringing life-saving care to communities—predominantly minority and or low income—that would otherwise go without. In recent decades, our field has come to recognize that health outcomes are largely determined directly by social and economic factors. Concurrently, we’ve learned that many of our efforts to reduce health disparities have had limited success.

While overall the U.S. has made some progress impacting its leading health indicators, in some cases disparities have remained the same or even widened. Up to a seven year difference in life expectancy exists between racial and ethnic populations. The pregnancy-related mortality rate among black women is more than triple that of white women. As a result, the field is expanding its focus to more upstream solutions that address the social determinants of health.

Increasingly, public health professionals understand that inequities in education, income, housing, and other factors drive health outcomes and disparities. National health priorities have expanded from “eliminate health disparities among different segments of the population” in Healthy People 2010 to “achieve health equity, eliminate disparities, and improve the health of all groups” in Healthy People 2020.

On the front line and in their communities, public health professionals are building their capacity to advance equity. This includes addressing internal policies and practices, engaging in meaningful conversations with the communities in which they serve and working across sectors to address the complex factors that influence health outcomes and opportunities.

Still, there’s a key driving force of health inequities that remains largely unaddressed — racism. Despite its deleterious effect on the health of the nation, public health professionals struggle to make the connections to eliminating racism as essential to improving health outcomes. Some health professionals are hungry for solutions, but lack effective ways to talk about and address racism.

However, within our field and society as a whole, there has been reluctance to acknowledge, understand, and address how America’s legacy of racism, discrimination, and exploitation has created present day health inequities. In recent years, the surge in national media coverage of racism-fueled events and political discourse has thrust racism back to the top of the nation’s consciousness.

At APHA’s 2018 Annual Meeting and Expo, attendees will hear from thought leaders on what will take from all of us to engage in respectful conversations and meaningful action to address racism and other structures of inequity. The meeting will examine new solutions to address the historical policies and practices that drive present day inequities. Attendees will also have the opportunity to learn how public health practitioners are advancing equity by uncovering and addressing implicit bias, and explore research and interventions that apply strengths-based and culturally-tailored approaches to working with communities of color.

We cannot become the healthiest nation without addressing the structural inequities that deny some communities the opportunity to thrive. The time to shift our trajectory towards creating health equity is now.

APHA’s Annual Meeting is the largest annual gathering of public health professionals. Thousands of people attend, and thousands of new scientific papers are presented each year on every public health topic. APHA 2018’s theme, “Creating the Healthiest Nation: Health Equity Now” puts health equity at the center of our field’s attention.