Unraveling Health Inequalities: Understanding, Measuring and Taking Action 

APCO Intern Yuna Chen, co-authored this piece.

Health inequalities, which are systematic disparities in the health status and experiences of different population groups based on social determinants, have gained significant attention within the public health domain in recent years. This focus has been amplified by the global impact of the COVID-19 pandemic and the momentum of the racial justice movement. According to a study published by the American Journal of Public Health, individuals with higher socioeconomic status and better access to health care typically enjoy improved physical and psychological well-being, leading to lower mortality and morbidity rates compared to their less privileged counterparts. Given this pressing context, understanding and addressing the underlying drivers of health inequalities is crucial for corporate health care leaders not only for equitable outcomes but also for the broader enhancement of global health and economic well-being.

Understanding the Drivers of Health Inequalities

Health inequalities stem from a multitude of complex and persistent drivers. Factors such as income level, geography, gender, health care access and discrimination significantly impact an individual’s health outcomes. Recognizing the drivers of health inequalities is the first step towards finding effective interventions. Some social determinants of health (SDOH) include:

• Socio-economic status & Economic Stability: Studies investigating the relationship between socioeconomic status and health status reveal that individuals with lower incomes often encounter barriers in accessing quality health care, leading to poorer health outcomes. In studies conducted in Europe and the United States, it was found that people with higher incomes, occupation, or education levels tended to have lower mortality and morbidity rates.
• Gender: Gender also plays a role in health inequality. Although women generally outlive men, they often experience worse health outcomes throughout their lives, partly due to their vulnerable positions in the workplace, where mistreatment and discrimination may occur, as well as the impact of unequal social roles, income and resources.
• Racism and Discrimination: Race and ethnicity is a driver that cuts across all others. Racial minority groups, both in the United States and globally, often face discrimination when seeking care, hindering their access to essential health services and leading to higher morbidity and mortality rates. For instance, a study conducted in France showed that immigrants and their children from Sub-Saharan Africa, North Africa, and French overseas territories were more likely to experience discrimination when seeking care, resulting in the avoidance of subsequent medical treatment.
• Neighborhood and Built Environment: Where people live can have a profound impact on their health outcomes. For example, locations with easier accessibility to health care facilities, good transportation networks and green space have beneficial effects on health. The impacts of environmental racism should be considered since disadvantaged populations are more likely to live in substandard housing and compromised communities, facing a higher possibility of hazardous environmental exposure.

Measuring Health Inequalities

According to the World Health Organization (WHO)’s central goal of the 2030 Agenda for Sustainable Development, it is of upmost importance to measure and monitor health inequalities. Gaining a comprehensive understanding of the scope and impact of health inequalities begins with a needs assessment and necessitates a combination of qualitative and quantitative approaches. Quantitative data, derived from population statistics and surveys, facilitates the identification of trends and patterns, thereby enhancing data analysis and predictive capabilities. On the other hand, qualitative research conducted through interviews and focus groups provides deeper insights into individual experiences and attitudes related to health inequalities.

• Quantitative research methodologies, such as population statistics and surveys, can provide data on valuable information about income, gender, educational attainment and health distribution across a population. Through the analysis of such data, researchers can uncover connections between underlying drivers and health inequalities.
• Qualitative research methodologies can add a human-centered lens to health research, delving into personal experiences and attitudes concerning health care experiences and outcomes. Through interviews and focus groups, patients, physicians and other health care leaders can share their unique perspectives and experiences, shedding light on potential discriminatory practices and systems, while also exploring disciplinary backgrounds and views on health disparities research.

Together, these approaches offer a comprehensive view of the complexities of health inequalities and the social determinates that give rise to them.

Addressing Health Inequalities

It is incumbent upon corporate health care leaders to take proactive steps to mitigate health inequalities. Here are some actionable measures that can help make a difference:

1. Increasing awareness. Establishing training programs and educational sessions for corporate health care leaders can heighten awareness about health inequalities. Equipping employees with cultural competency training, for example, enables health care organizations to understand and help reduce ethnic health disparities, improving health care experiences and outcomes.
2. Partnering with organizations. Collaborating with agencies, organizations and councils that focus on addressing the root drivers of health disparities can lead to more impactful initiatives. Diverse partnerships can help build a comprehensive approach to addressing health inequalities, while also centering the voices of those most impacted by them.
3. Linking services for vulnerable individuals. Building social services tailored to the unique needs of vulnerable or high-risk communities can make a meaningful difference. Integrating health care with social support to provide cost-effective medical services and education for low-income families, for example, can improve health outcomes among vulnerable populations.
4. Measuring impact through continuous evaluation. Effectively tackling health inequalities requires the establishment of clear metrics and consistent evaluation of initiative outcomes. This involves gathering and analyzing data related to health outcomes, health care access, and patient experiences across diverse demographic segments. Through ongoing monitoring and evaluation, corporate health care leaders can pinpoint effective strategies for reducing health disparities as well as areas warranting further improvement.

Conclusion

The responsibility to address health inequalities rests heavily on the shoulders of corporate health care leaders. The global ramifications of the COVID-19 pandemic and the racial justice movement have brought the disparities in health experiences and outcomes across diverse groups into sharper focus, emphasizing the need to understand and address the multifaceted drivers of health inequalities. By fostering awareness through education and training, forging collaborative partnerships, tailoring services for vulnerable populations, and unwaveringly measuring impact through continuous evaluation, tangible strides can be made towards equitable health care experiences and improved health outcomes.