health equality
giving everyone the same opportunities and care
--> opening a clinic for both Hannah and Jane's communities
health equity
everyone has a FAIR opportunity for full health potential, not
necessarily equal
e.g. providing a wheelchair ramp for Jane (paralyzed) but not
Hannah
E.g. provider giving the same test to everyone at the same
interval, without regard to risk factors. This only works if
everyone starts at the same place and needs the same things. so
now we give more frequent tests to those with more risk factors.
health inequity
may be equal but its not fair --> certain groups experience worse
health and are more often the least likely to receive health care
e.g. those in remote regions not having access to nutritious foods
and water (inequality) leading to poorer health (inequity)
e.g. Jane can't get into her clinic because there's not wheelchair
ramp --> leads to poorer health outcomes
,what is often a key indicator of health inequities
maternal mortality
who are the working poor
those who are the working poor will often experience inequities
in health care and are more likely to have:
- less stable jobs
- unpredictable working hours
- fewer benefits (which they need more)
- greater health problems
working poor is more likely to be
marginalized/racialized groups
social gradient
variation in health of individuals and groups due to outcome aka
if you have a lower income you're more likely to experience
poorer health
this is a general concept and not always true
example of social gradient
tale of 2 zip codes: illustrates the importance of community
resources on LT health e.g. access to healthy foods, doctors,
accessible walking routes, more secure housing
what is the nurses role in addressing health inequities (4) use the
example of transportation and accessibility in a community
assistance, adjustment, advocacy, alignment
, adjustment: Telehealth or home health to reduce risk of falls and
address transportation issues/adjust env at home
advocacy: HC organizations work with partner social care
organizations to promote policy to create assets or resources -->
e.g. work to promote policies that fundamentally change
transportation infrastructure
alignment: invest in community ride sharing - understand
existing community assets and promote and deploy them
assistance: transportation vouchers
proportionate universality approach
take action on the social gradient of health and address
heterogenous distribution of risk in a population
--> programs/services/policies that are universal but with a scale
and intensity that is proportionate to the level of disadvantage in
a group, focused on systemic factors
(everyone can have access to car but those who need more of it
can use more)
intervention generated inequalities example
mass media campaigns for risks associated with smoking --> not
everyone has access to social media
printed communication materials --> language barriers and
literacy levels vary