Last week at the White House, Office of Minority Health Director J. Nadine Gracia asked an expert panel how they would create health equity in our lifetime — if they could spend $300 billion to create it.
“I’m not sure I’d spend any of it on health care, not until we addressed the social determinants of health,” said APHA Executive Director Georges Benjamin, MD. “Health equity has got to be something more than access to quality care, it also includes income equality, racial discrimination and other non-health sector determinants. The pathways include using transportation as a health improvement tool, housing as a health improvement tool, and environmental quality as a health improvement too.”
The event, “Where the Curve Ends: Health Equity in Our Lifetime,” commemorated National Minority Health Month, but included conversations outside the traditional health sector lens. In addition to APHA, leaders from the National Congress of American Indians, the White House Council on Women and Girls and faith-based entities joined the roundtable discussion to discuss how public health works in their communities. As Gracia said, “Sometimes we get stuck on the disparities and thinking that they’re intractable and they’re not. We still need to break down silos and that’s why we’re here today.”
Dr. Pernessa Seele, founder and CEO of The Balm In Gilead, Inc., said that Healthy Churches 2020 — a new coalition of faith leaders, health directors, coordinators, nurses and congregation members — has the same goals and objectives as Healthy People 2020, but can reach constituents in real time.
“The goal is to bring Sister Mary and Brother John to the table to give them skills, whether they have a clinic or whether they’re just putting a health tip in their bulletin on Sunday,” Seele said. “It’s important as we look at our evidence-based interventions and ask, ‘How can we take it down for it to be palatable for the communities we serve?’”
Benjamin said that the Affordable Care Act, which has helped 16.4 million previously uninsured Americans gain coverage, continues to bring us closer to health equity.
Additionally, he said that his hypothetical multi-billion dollar investment in health would center on education.
“I’d focus on changing the development of the environment of young kids, with universal preschool, quality child care for every kid, making sure we pay a lot of attention to elementary school education and having great teachers. Education is central to be ready to be healthy.
“The end-stage goal as I say metaphorically is that health equity looks like all of us equally having access to living as long as we can, as well as we can and having a short but glorious ending. It looks a lot different than what we have today, but we have a lot of pathways. We have other nations that have achieved pieces of this. We have made improvements. We have the tools to understand that health equity is achievable.”