FOCUS
 

Health Equity Benefits Everyone  

Healthy People 2010 sets out two ambitious goals: The first, to increase quality and length of healthy life. The second, to eliminate health disparities. In fact, the two goals are inseparable. Achievement of one is not possible without achievement of the other. Health cannot be improved for all without eliminating health disparities—those inequalities or gaps between two or more groups related to age, gender, race or ethnicity, education or income, disability, geographic location, or sexual orientation.  

Health disparities affect the Nation’s quality of life—at the individual level as well as the workplace and community. Some groups of individuals do not enjoy the same health status as other groups, and many questions remain unanswered about why such differences exist:

 

•   Why is the heart disease death rate 40 percent higher for African Americans than the rate for whites?

 

•   Why are Hispanics living in the United States twice as likely to die of diabetes as are non-Hispanic whites?

 

•   Why is the infant death rate for American Indians and Alaska Natives almost double that for whites?

 

•   Why do women outlive men?

 

•   Why are gay male adolescents two to three times more likely than their peers to attempt suicide?

 

•   Why are population groups that suffer the worst health status also those that have the highest poverty rates and the least education?

 

•   Why do people with disabilities report more anxiety, pain, sleeplessness, and days of depression than do people without activity limitations?

 

•   Why is the injury-related death rate 40 percent higher in rural populations than in urban populations?

 

To be productive, the workforce must be healthy. Raising the health status of employees has a positive impact on individual companies and the economy as a whole.  

SPOTLIGHT

Call to the Nation

 

“Stunning advances in medicine, public health, and the overall standard of living have led to many important health gains. Yet, despite decades of progress in these areas and significant achievements in civil rights protections, health disparities have persisted and, in many cases, have worsened.”

 

These are some of the words included in the Call to the Nation to eliminate disparities in health by 2010. The Call signaled the establishment of a broad coalition of leaders in sectors relevant to population health status to prepare a national plan of action that will accomplish this goal. The document was signed by attendees of the historic meeting of the Steering Committee on the Elimination of Racial and Ethnic Disparities in Health held at the White House on October 6, 2000. David Satcher, M.D., Ph.D., Assistant Secretary for Health and Surgeon General, U.S. Department of Health and Human Services (HHS), and Mohammad Ahkter, M.D., M.P.D., Executive Director of the American Public Health Association (APHA), co-chaired the meeting.

The Committee consists of 27 national leaders from the private sector, representatives of 10 cabinet secretaries, a member of the U.S. Congress, and a representative from the White House.

Several key premises underlie this historic multisector partnership:

 

•   Disparities affect everyone and every element of American life. For example, as employers face a tight labor market and changing demographics in the workforce, this country’s ability to address health disparities effectively also becomes critical to the continued health of the economy.

 

•   The combined efforts of all sectors and disciplines of society—the public and private sectors, business and labor, nonprofit and community-based organizations, educational institutions, the faith community and others—are essential. “Everyone must be at the table” is the invitation and the charge.

 

The Steering Committee is the result of a collaboration by APHA and HHS, two of many organizations working to ensure that current and future generations are healthier, happier, and more productive. (See accompanying Health Disparities on the Web.) The Committee seeks to catalyze national efforts and promote coordination among the activities of government and nongovernment organizations, agencies, and individuals; and to advance research, knowledge, policy, and services. A national plan of action—to be developed by a larger coalition of some 300 people from national, State, and location organizations—is expected to be announced in fall 2001. (For more information, including names of Committee members, see http://www.apha.org/news/press/2000/elim_dispar.htm.)

Eliminating Disparities in Health

Healthy People 2010 challenges the Nation to eliminate health disparities in this decade. Achieving health equity requires the support of individuals, the communities in which they live, organizations, and businesses. Keys to success are highlighted below:

Awareness: The first step is increasing awareness that disparities exist. This Prevention Report issue is just one of numerous national, State, and local efforts to inform and educate people about the complex issues surrounding health equity and the benefits of improving health for everyone.

KnowledgE: Much work has been done to increase the science base about disparities. Many studies have documented disparities related to differences in age, gender, race and ethnicity, education and income, disability, geographic location, and sexual orientation. Risk factors and outcomes, low income and access to health care, mammography screening, heart disease and geographic location as well as gender—these are a few of the topics addressed in the disparity literature.

Increasingly, research is addressing the effectiveness of interventions designed to decrease disparities. “Best practices” are being identified and funding opportunities are being targeted to improvements in health services. (See Health Disparities on the Web.)

CommitmenT: With awareness and knowledge about what causes disparities and what works to eliminate them, individuals and organizations are better equipped to make decisions and promote communitywide safety, education, and access to health care. Healthy People 2010 provides the goals, the specific objectives, the measures for evaluating progress and, most important, the call to everyone to make a commitment to healthy equity. To learn more about ways individuals, organizations, and communities can demonstrate their commitment, visit http://www.health.gov/healthypeople/.
 

At the community level, many different factors affect quality of life and create health disparities. For example, residents of substandard housing may be at increased risk for fire, electrical injuries, lead poisoning, falls, rat bites, and other illnesses and injuries. Even the size of a community is a factor. According to the U.S. Environmental Protection Agency, small water systems (serving 25 to 3,300 people) account for 91 percent of the violations of its drinking water regulations. Safe drinking water is important to health; so are safe streets and roads.  

 

Relationship between household income and fair or poor health status.When certain groups and communities do not have access to quality health care, the long-term cost to individuals, the economy, indeed society as a whole, can be substantial. The future health of America as a whole will be influenced substantially by our success in improving the health of all populations.

 

Even when some types of health disparities are eliminated, other factors may come into play. Health disparities are extremely complex. For example, the long-standing gaps between life expectancy of men and women and between whites and African Americans have narrowed. Yet, major differences persist depending on income and education.  

Healthy People 2010 challenges everyone to take steps to ensure that good health, as well as long life, is enjoyed by all. Under the Healthy People umbrella, specific actions are under way. On the Web site http://www.health.gov/healthypeople/ read about implementation, find out how to “Be a Healthy Person,” and access the Healthy People 2010 Toolkit: A Field Guide to Health Planning, developed by the Public Health Foundation. With such tools as well as greater awareness and knowledge about the real costs of health disparities, everyone can commit to meeting the challenge of working together to achieve Healthy People’s ambitious and important vision: healthy people in healthy communities.

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