From a research point of view, placebos are often essential in determining the safety and efficacy of a treatment. On the other hand, research participants often hope they get active treatment, especially if it is for a disease they already have or might get.
Is it “fair” to research participants to randomly assign them to receive either an active drug or an inactive substance? What about someone with a terminal illness, and the research drug is their last chance? What can be done to make the situation “more fair”?
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Health Equity
Health Equity Home
What is Health Equity? On This Page
Factors Affecting Health Equity (Social Determinants of Health)
OMHHE’s Role in CDC’s CORE Commitment to Health Equity
What You Can Do to Promote Health Equity
References
Health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health. Achieving this requires ongoing societal efforts to:
Address historical and contemporary injustices;
Overcome economic, social, and other obstacles to health and health care; and
Eliminate preventable health disparities.
To achieve health equity, we must change the systems and policies that have resulted in the generational injustices that give rise to racial and ethnic health disparities. Through its CORE strategy, CDC is leading this effort, both in the work we do on behalf of the nation’s health and the work we do internally as an organization.
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Preventable Health Disparities Health disparities are preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by populations that have been disadvantaged by their social or economic status, geographic location, and environment. Many populations experience health disparities, including people from some racial and ethnic minority groups, people with disabilities, women, people who are LGBTQI+ (lesbian, gay, bisexual, transgender,
[1]
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queer, intersex, or other), people with limited English proficiency, and other groups.
Across the country, people in some racial and ethnic minority groups experience higher rates of poor health and disease for a range of health conditions, including diabetes, hypertension, obesity, asthma, heart disease, cancer, and preterm birth, when compared to their White counterparts. For example, the average life expectancy among Black or African American people in the United States is four years lower than that of White people. These disparities sometimes persist even when accounting for other demographic and socioeconomic factors, such as age or income.
Communities can prevent health disparities when community- and faith-based organizations, employers, healthcare systems and providers, public health agencies, and policymakers work together to develop policies, programs, and systems based on a health equity framework and community needs.
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Factors Affecting Health Equity (Social Determinants of Health)
Social determinants of health are the conditions in the places where people live, learn, work, play, and worship that affect a wide range of health risks and outcomes. Long-standing inequities in six key areas of social determinants of health are interrelated and influence a wide range of health and quality-of-life risks and outcomes. Examining these layered health and social inequities can help us better understand how to promote health equity and improve health outcomes.
Social and Community Context (including Discrimination and Racism)
Healthcare Access and Use
Neighborhood and Physical Environment
Workplace Conditions
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Education
Income and Wealth Gaps
OMHHE’s Role in CDC’s CORE Commitment to Health Equity
CDC is transforming its public health research, surveillance, and implementation science efforts to expand beyond listing the markers of health inequities to identifying and addressing the drivers of these disparities. Through the CORE strategy, CDC is integrating health equity as a foundational element across our work – from science and research, to programs, partnerships, and workforce. As part of the initiative, OMHHE has adopted four CORE goals.
Cultivate comprehensive health equity science
OMHHE will facilitate and accelerate health equity principles’ adoption across CDC programs, policies, data systems, and funding structures.
OMHHE is working to:
Standardize health equity language and principles.
Establish standards in health equity data collection.
Provide guidance on analyzing and using data to assess health equity and manage public health programs.
Incorporate health equity principles and data collection standards into Notice of Funding Opportunities that support research and non-research public health programs at the state and local level.
Potential Impact: National, state, local, tribal, and territorial public health staff will have a better
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understanding of health equity, the increased capacity to use data to integrate health equity into public health systems and interventions, and ultimately eliminate health disparities in the communities they serve.
Goal in Action: CDC’s CORE Commitment to Health Equity Science and Intervention Strategy
Optimize interventions
OMHHE/Office of Women’s Health will collaborate with partners to address and reduce the impact of gender discrimination and gendered racism in the workplace.
OMHHE is collaborating with internal and external partners to:
Provide input to a national survey to assess the status and impact of gender discrimination and gendered racism in the U.S. population.
Compile and communicate strategies, policies, and best practices intended to reduce gender discrimination and gendered racism in the workplace.
Develop and implement strategies for strengthening organizational capacity to achieve and sustain systems changes that promote health equity in the workplace.
Potential Impact: Systems changes will occur in the workplace, including workplaces that set the standard for gender equity best practices, that decrease experiences of gender discrimination and gendered racism, and ultimately, improve mental and physical health among people of all gender identities.
Goal in Action: Evaluation of data on perceptions and experiences of gender discrimination and gendered racism in the workplace.
Reinforce and expand robust partnerships
OMHHE will mobilize partners to develop and implement strategies addressing health disparities and long-standing inequities including social determinants of health.
OMHHE is providing guidance and support to partners who respond to public health needs to:
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Develop partners’ capacity to work with CDC to address health inequities, health disparities, and structural and social determinants of health in response to public health crises.
Design new, or evaluate and refine existing, evidence-based strategies that address health equity and long-standing health disparities and inequities; and develop guidance for implementation of these strategies in diverse communities.
Potential Impact: CDC partners will be engaged and ready to respond to public health emergencies and address long-standing health inequities, health disparities, and structural and social determinants of health.
Goal in Action: National Initiative to Address COVID-19 Health Disparities Among Populations at High- Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities
Enhance capacity and workforce engagement
OMHHE will transform the public health workforce to ensure diversity and health equity competencies in existing and future staff.
OMHHE collaborates with internal and external partners to:
Expand access to undergraduate student internships by linking CDC Undergraduate Public Health Scholars (CUPS) grantees with state, local, and community partners interested in hosting students or establishing pipeline programs.
Integrate competencies of health equity as well as racism and health into the CDC and public health workforce.
Potential Impact: National, state, local, tribal, and territorial public health agencies will have increased opportunity to support underserved undergraduate students and the current public health workforce with learning how to integrate health equity competencies into public health work. Ultimately, we will create a public health workforce that reflects the communities we serve and is responsive to the country’s changing demographics.
Goal in Action: CDC OMHHE Student Programs
What You Can Do to Promote Health Equity
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You—as a community member or member of an organization—can join the effort to ensure that all people have equitable access to resources to maintain and manage their physical and mental health, including easy access to important information, goods and services, and affordable medical and mental health care. Community- and faith-based organizations, employers, healthcare systems and providers, public health agencies, policy makers, and others play a key part in promoting
fair access to health, improving opportunity, and ensuring all communities can thrive.
Communities can promote health equity by adopting policies, programs, and practices that:
Support equitable access to quality and affordable health and other social services (e.g., education, housing, transportation, child care) and accessibility within these services.
Recognize, respect, and support the diversity of the community they serve.
Partner with trusted messengers and community health workers/promotores de salud to share clear and accurate information tailored to a community’s languages, literacy levels, and cultures.
Include community engagement efforts that can help strengthen partnerships between community members and public health entities, build trust, and promote social connection.
Engage trusted leaders known by the community and who share the same race and ethnicity, sexual orientation, and cultural or religious beliefs as the community to share information, collect input, or conduct outreach.
Use clear, easy-to-read, accurate, transparent, and consistent information from a reputable source that is locally and culturally relevant in terms of language, messaging, tone, images, and format. Information should be suitable for diverse audiences, including people with disabilities, limited English proficiency, low literacy, or people who face other challenges accessing health information.
Below are examples of additional actions that organizations and agencies can take to support health equity.
Community and faith-based organizations can:
Help connect people with healthcare providers, goods (e.g., healthy foods, temporary housing), and services to meet their physical, spiritual, and mental health needs.
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Work with others to address misinformation, myths, and lack of access to appropriate resources. This might include working with trusted local media, local public health departments, or community members to share information or community insights that help connect individuals to resources and free or low-cost services.
Employers can:
Train employees at all levels of the organization to identify and interrupt all forms of discrimination; provide them with training in implicit bias .
Establish and maintain equitable leave policies that are fair and flexible to meet the needs of all employees.
Healthcare delivery systems can:
Deliver all health-related services in a culturally appropriate way and according to the needs of patients. This may include providing the necessary patient supports (e.g., translator, patient navigators).
Ensure providers show awareness of and respect for culture when providing care.
Collect and report race and ethnicity data on all patients and educate staff and patients on why this information is an important part of making sure populations are receiving equitable access to care.
Public health agencies can:
Build partnerships with different sectors (e.g., community- and faith-based organizations, racial and ethnic minority-serving organizations, tribal communities, school and transportation systems, scientific researchers, professional organizations) and community members to share information and collaborate to advance health equity in communities.
Address misunderstandings about why people are being asked for personal information, including race and ethnicity, and why this information is important to allocate resources and information sharing to people who need them most.
State, tribal, local, and territorial governments can:
Explore options to provide free or low- cost broadband Internet access so people can
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use telehealth and get information on health care and social services.
Reassess policies that create barriers for healthcare providers to collect and report data on race and ethnicity and social determinants of health.
Partner with public health agencies to evaluate current and proposed policies in transportation, housing, community development, and more for their impacts on health, using a Health in All Policies framework. Prioritize health for communities experiencing health disparities in all policy change.
Explore options to protect renters from evictions.
Work to expand childcare service options.
Increase public transportation services (e.g., free access to city bike programs).
References
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Last Reviewed: July 1, 2022
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