Health is influenced by many intersecting factors. The root causes of disparate health outcomes often include racism and bias, structural flaws in the health care system, lack of social and community support, and deep inequities within these determinants of health. Profound racial and ethnic disparities in health and well-being are not new and have long been the norm in the United States. Addressing the link between these social conditions and health outcomes are the first step in creating a fairer health system.
Understanding Health Disparities
The World Health Organization, or WHO, defines equity as the absence of unfair, avoidable, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically or by other dimensions of inequality (e.g. sex, gender, ethnicity, disability, or sexual orientation). Issues around cost, affordability, and access to care also contribute to these inequities.
Long-standing racial and ethnic health disparities, highlighted by the COVID-19 pandemic, continue to affect many groups. In New York City, for example, Black and Latino residents faced death rates more than twice as high as predominantly White neighborhoods. This disparity stemmed from higher rates of essential work, crowded living conditions, and pre-existing health disparities like diabetes and hypertension.
Health Equity and Community Engagement
Effective community engagement is critical to advancing health equity. Community-based interventions tailor healthcare services and resources to meet the unique needs of underserved populations, ultimately improving health equity.
Community members can play a key role in supporting health care organizations in understanding the unique needs and assets of the communities they serve. Community ambassador/liaison programs train community members to disseminate essential public health messages within their community and relay feedback to health care organizations. This community engagement model is proven to improve the efficacy of programs by increasing trust between patients and providers, improving the linguistic and cultural responsiveness of services, and facilitating greater patient engagement.
Addressing health disparities is vital not just for equity, but also for the overall well-being and economic health of the nation. Racial and ethnic disparities in health contribute to higher rates of illness and death—leading to costly medical expenses, lost productivity, and economic losses due to premature death. Research highlights the importance of tackling these disparities to improve the country’s health and economic prosperity.
The Impact of Community Engagement in Health Equity
Community engagement is central to addressing systemic inequities and structural discrimination in health systems. By fostering trust, identifying unforeseen or unintended barriers to care, and improving the effectiveness of programs, organizations can drive equity. However, community engagement is not guaranteed in equity advancement. To actualize its full potential, community engagement must be culturally tailored with equity as its leading principle.
Organizations often make policy and programmatic changes without engaging the people directly affected. The COVID-19 pandemic highlighted how vital outreach and engagement are in creating successful health initiatives for minority populations. Effective engagement improves communication, enhances program outcomes, and fosters ongoing collaboration with those who have firsthand experience with state-run systems.
To avoid deepening mistrust, states should evaluate current community engagement initiatives and infrastructure as the first step in moving towards transformational community engagement. To do this, state agencies and healthcare organizations must identify where their organization’s existing community engagement efforts fall in the context of health equity. Once a benchmark is established, the next step is evaluating agency resources and setting goals to advance equitable community engagement.
Examples of strong community engagement goals include:
- Creating opportunities for exchanges of ideas to understand community needs.
- Identifying gaps and barriers in policy design and implementation.
- Gathering feedback to improve process, quality, outcomes, and messaging.
- Sustaining equitable changes that improve the experiences of those directly impacted.
Health Equity at Veterans Health Administration
While these gaps continue, several government agencies are looking to close the gap on health equity through innovative systems and solutions. For example, the Veterans Health Administration (VHA) uses innovative tools such as telemedicine, mobile health clinics, and other alternative approaches to traditional care that have dramatically improved access to care for underserved populations. These innovations allow rural, low-income, and minority Veterans and communities to receive care tailored to their needs, breaking down barriers like distance and cost. For more information on VA’s focus on health equity, view The Office of Health Equity’s Action Plan.
Blackberg is proud to deliver strategy, project management, and communications support services to several innovative healthcare programs at VHA designed to close the gap of health equity. Learn more about some of our recent work under case studies.
