For the first time since the Civil Rights Act of 1964, the American Public Health Association (APHA) has a policy specifically dedicated to health equity, giving its members key facts so they can push their legislators for policies to eliminate health disparities in the United States.
Development of the “Key Opportunities for Achieving Health Equity in the United States” policy was led by Dr. Tiffany Gary-Webb, an associate professor in the University of Pittsburgh Graduate School of Public Health’s departments of Behavioral and Community Health Sciences and Epidemiology, and passed by a narrow margin at the recently concluded APHA Annual Meeting in San Diego. The Society for Analysis of African American Public Health Issues collaborated on the policy.
“Decades of surveillance and research in the U.S. has documented health disparities, particularly among racial and ethnic minorities and among those with lower socioeconomic status,” said Gary-Webb, who is chair-elect of the APHA Epidemiology Section. “Although health equity is an APHA priority and core value, until now there was no comprehensive, up-to-date policy to achieve that.”
Persistent health disparities in the U.S. stretch from birth to old age: Infant mortality is twice as high in black infants as whites. Cardiovascular disease death rates grew by 10 percent in rural, compared to urban, communities since 1990. Diabetes and obesity have grown by epidemic proportions over the past several decades, particularly among black and Hispanic people.
Research has shown that racism and classism create stresses and lack of opportunity, both of which lead to poor health outcomes.
The new policy presents several evidence-based strategies that could be used in the quest for health equity, many of which are discussed in the National Academies of Medicine reports “How Far Have We Come in Reducing Health Disparities?” and “Communities in Action: Pathway to Health Equity.”
At its conclusion, the policy lays out multi-pronged action steps for policymakers to take at national, state and local levels, as well as things that nongovernmental agencies and individuals can do. These range from fully funding the Affordable Care Act to provide access to health services to everyone and congressional funding for social “safety net” services like quality education, housing, jobs and transportation; to encouraging citizens to understand their legal rights and advocate for enforcement of civil rights and disabilities laws.
“We all have a part to play in fighting health disparities and making the United States a place where everyone has health equity,” said Gary-Webb. “Our hope with this policy is that APHA’s membership and advocacy will make a strong statement demanding health equity across all sectors of society such that everyone can live a long life in optimal health.”