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NPHW guest post: To improve health outcomes, we must address the inequalities of economics

Ebony JohnsonIt’s National Public Health Week! We’re spotlighting this year’s daily NPHW themes with a series of guest posts from APHA members. Today’s NPHW theme is economics, and our guest post comes from Ebony Johnson, MPA, CNP, director of place-based investments at United Way of Greater Atlanta. Johnson currently serves as chair-elect of APHA’s Community Health Planning and Policy Development Section.

This pivotal moment in time is shifting how our nation thinks about health and health care access. As we navigate our way through the coronavirus pandemic, it’s critical to understand how economics — or more simply put, “access to money” — affects how we think about and address our health.

You often hear stories of people making the difficult choice to put their health aside to ensure they have a place to live, food for their families and a viable means to and from work. Health outcomes are deeply affected by education, housing, race, gender and even geography. However, a single root-cause factor undergirds these issues: money.

Despite ranking among the 10 richest countries in the world, the U.S. experiences sizable disparities in health and health care access. From an economic standpoint, inequities hurt racial and ethnic minorities more than others because they make up a large proportion of the poor; are often isolated due to cultural and language barriers; and are often subject to implicit and explicit bias from health care professionals.

While it is estimated that most Americans do not have enough savings to cover a $1,000 emergency, a $50 or $100 medical bill would be absolutely devastating to many who are struggling to maintain basic needs. Unfortunately, emergency rooms have become a primary health care provider for those in low-income and impoverished communities, resulting in untold costs. Safety net hospitals across the country often bear the responsibility of helping those who lack health insurance.

For many communities of color, economic inequalities disproportionately affect earning potential and thus, access to affordable, quality health insurance. Economic inequalities also affect educational and entrepreneurial opportunities, which are key to achieving economic mobility. Ultimately, this lack of mobility greatly affects future generations born into environments that contribute to negative health outcomes.

To advance health equity, we must advocate for policies that improve educational opportunities and workforce training and create pathways for low-income communities to build assets for themselves. Communities know their environments better than anyone else and should be involved and engaged in all aspects of economic development to better effect the change they want to see.

We must be vigilant in dismantling systemic and structural practices that prohibit the upward mobility of marginalized communities. This work is hard — it is never easy to admit you are part of the problem. However, by acknowledging the issues and working together to correct wrong doings, we can set a course toward a more equitable and inclusionary society.

To learn more about National Public Health Week and get involved, visit www.nphw.org, follow @NPHW on Twitter and use the hashtag #NPHW. For resources, news and advocacy on the coronavirus pandemic, visit APHA’s COVID-19 page. For more on how each day’s NPHW theme intersects with COVID-19, visit nphw.org/nphw-2020/covid-19.