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How to Measure Health Equity

Written by: North Carolina Central University   •  Nov 13, 2023
A group of health care workers talking around a doctor holding a tablet.

How to Measure Health Equity

Access to medical care is a basic human right. This is what the concept of health equity represents — everyone should have equitable access to the resources that allow them to reach their highest standard of health, regardless of their background, identity, or socioeconomic status. However, the U.S. health care system is not currently equitable — some populations experience disproportionate rates of mortality, disease, and discrimination, or lack access to quality care.

The U.S. has a long way to go before it achieves health equity. In this blog, let’s explore how to measure health equity, its current state, and the ways to best promote it so that equitable care is accessible to all.

What Is Health Equity?

Health equity means that everyone can fairly achieve an optimal state of health via the tools and resources they have access to. However, some populations face barriers that lead to health disparities, which can be informed by the social determinants of health. According to Healthy People 2030, the social determinants of health are as follows:

  • Economic stability
  • Education access and quality
  • Health care access and quality
  • Neighborhood and built environment
  • Social and community context

Measuring health equity should examine which populations have access to health care resources compared with other populations. For example, if a low-income area of 5,000 people has one hospital, compared with an affluent area of the same size with five health care facilities, the residents in the affluent area have far more access to health care services.

Socioeconomic gaps are just one driver of health inequity. Other elements that affect health equity include the following:

  • Low health literacy
  • Ethnic and racial discrimination
  • Gender discrimination
  • LGTBQIA+ discrimination
  • Low-income housing or lack of housing
  • Lack of government support
  • Lack of access to health care facilities and resources

Health Equity vs. Health Equality: What’s the Difference?

Health equity is not the same as health equality, and it’s important to understand the differences between health equity vs. health equality to measure and promote health equity.

Health equality means equal treatment and availability of health care services to all people. Health equity, on the other hand, seeks to provide equitable access and treatment while taking into account any factors that may influence a patient’s access or barriers to health care services.

While health equality may seek to promote fairness, it does not consider the intersecting backgrounds, biases, and nuances that may affect quality of or access to care. Increasing health equity means understanding these factors and creating solutions that support and uphold positive health outcomes for all communities.

The Current State of Health Equity in the U.S.

Despite our social, educational, and technological advances, countless areas and populations experience disproportionate levels of death, disease, disability, and injury. According to the Centers for Disease Control and Prevention (CDC), the populations at the highest risk of experiencing health disparities are people from ethnic or racial minority groups, members of the LGBTQIA+ community, people with little to no proficiency in speaking English, and other minority groups.

Nationwide, people and communities primarily made up of minority groups have a lower average life expectancy and are at a higher risk of experiencing heart conditions, diabetes, obesity, cancer, preterm birth, and several other health care challenges, according to the CDC.

Additionally, numerous social and socioeconomic factors impact health equity, including the following:

  • Ability to take time off work
  • Lack of child care resources
  • Means of transportation
  • Lack of insurance
  • Educational disparities
  • Wage gaps

Organizations such as the CDC and World Health Organization (WHO) are aware of the health equity problem in the U.S. The problem is nothing new, and more data is available than ever that illustrates which groups and geographic locations are most affected. The challenge is orchestrating the necessary collaborative effort to implement solutions.

How to Measure Health Equity

To create effective solutions, it’s essential to identify inequities in the health care system by knowing how to measure health equity. While there are many ways to measure and document inequities in our health care system, a policy brief funded by the California Health Care Foundation outlines some of the main criteria for doing so in a larger report on Medicaid quality measurement. The criteria for measuring equitable health care are as follows:

  1. Identify indicators of social determinants of health.
  2. Establish comparison groups, including a “standard” group unaffected by the data or determinants and one affected by them.
  3. Select the relevant health quality metrics, such as mortality rates, vaccination rates, or quality measures.
  4. Use benchmarks, such as comparisons to national metrics.

These criteria help define measurements of health equity so they can be accurately assessed. From there, health care leaders can work towards creating relevant, effective solutions.

CORE Commitment to Health Equity

The CDC is one of the main organizations leading the charge to improve the state of health equity in the U.S. The CDC’s Office of Health Equity (OHE) is entirely devoted to tackling this problem. Naturally, this begs the question of how OHE plans to do it.

The CORE Commitment to Health Equity is a strategy that aims to incorporate health equity as a foundational element in every sector of the organization. The CORE acronym represents the following steps:

  • Cultivate comprehensive health equity science.
  • Optimize interventions.
  • Reinforce and expand robust partnerships.
  • Enhance capacity and workplace diversity, inclusion, and engagement.

Of course, the CDC can’t change the state of health equity in the country alone. The CORE plan includes a series of action items, including the following:

  • Setting goals that have concrete milestones
  • Determining how to measure health equity
  • Deciding which indicators are meaningful when monitoring progress
  • Developing key partnerships from various sectors
  • Backing policies and legislation that promote health equity
  • Promoting cultural competency and diversity in nursing

Take the Steps to Elevate Your Nursing Career

Health is a basic human right. Through the efforts of organizations such as the CDC and WHO, the country can address health equity issues by removing the barriers that inhibit access to health care services. Furthermore, these organizations know how to measure health equity using reliable sources of data that paint an accurate picture of today’s health care landscape. By addressing the social, economic, and biological factors that restrict certain groups and populations, we can make meaningful progress toward health equity in which everyone has access to medical resources and services.

As a nurse, you can be a part of the solution by providing high-quality medical care to underserved populations within your community. When you enroll in the RN to BSN program at North Carolina Central University, you’ll learn all the most in-demand clinical skills and competencies so that you can deliver culturally sensitive care.

Additionally, graduates of the program qualify for numerous leadership roles in health care, including nurse case manager, occupational health nurse, and nursing manager. By investing in your education, you can expand your career opportunities.

Learn more about the program and how it can support your professional goals in health care.

Recommended Readings

Nurse Manager Salary and Job Description

Oncology Nurse: Salary and How to Become One

Why Intercultural Competence in Nursing Matters

Sources:

California Health Care Foundation, New Analysis Sums Up How to Measure Health Equity

Centers for Disease Control and Prevention, CDC’s CORE Commitment to Health Equity

Centers for Disease Control and Prevention, What Is Health Equity?

Florida Health, Health Equality, Health Equity & Health Barriers

Healthy People 2030, Health Equity in Healthy People 2030

Healthy People 2030, Social Determinants of Health

Hinge Health, What Is Health Equity? Definition & Policy Examples

Journal of Public Health Management and Practice, “How Do We Define and Measure Health Equity? The State of Current Practice and Tools to Advance Health Equity”

KFF, “Disparities in Health and Health Care: 5 Key Questions and Answers”

National Committee for Quality Assurance, Advancing Health Equity: A New Measurement Framework for Medicaid

National Committee for Quality Assurance, Advancing Standardized Health Equity Quality Measurement

World Health Organization, Health Equity

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