Domains of the Health Equity Thread
There are significant racial and ethnic disparities in health, well-being, and life expectancy among people identified as Black, Indigenous, and Latinx/Hispanic in the United States. Achieving health equity with respect to race and ethnicity involves identifying and dismantling the drivers of inequities including, structural determinants such as systemic racism and discrimination. Students learn about historical and contemporary injustices that contribute to disparities in health outcomes. The HET presents opportunities for students to devise systemic and individual interventions to address long-standing inequities in care.
The HET examines disability from an equity perspective. This involves a careful examination of the environment in which healthcare is delivered, including equitable access to health services that attend to the needs of individuals with disabilities. Our goal is to expose students to a range of disabilities, helping them to identify structural and social barriers that hamper the delivery of appropriate healthcare services. We acknowledge the intersection of disability with race, ethnicity, sex, gender, LGBTQIA+ identity, immigration, and economic status. These intersecting identities play a critical role in generating poorer health outcomes for people with disabilities. Students learn about the history of disability rights, and through several activities, begin to devise more inclusive solutions and promote a more equitable healthcare environment for people with disabilities.
Climate change poses a threat to human health – however, the risks and consequences of climate change are not evenly distributed across populations. The HET addresses the structural and socio-behavioral factors that lead to the disparate impact of climate change particularly in low-resourced communities, the young and elder populations, and communities of color living in divested neighborhoods. Issues related to environmental injustice are explored through workshops, case studies, and didactic sessions.
Health equity for immigrant populations involves addressing barriers to healthcare access, occupational injustice, racism, and xenophobia. The HET examines the differential effects of policies, structures, and institutions related to the provision of health services based on the patient’s citizenship status, linguistics, and cultural factors. There is an examination and demonstration of the use of medical interpretation services, provision of culturally appropriate health services, and use of community resources focused on supporting the health of immigrant communities.
There is an urgent need to address the health status of the population affected by carceral systems. Achieving health equity in the context of incarceration requires addressing the health challenges faced by individuals, families, and communities disproportionately affected by incarceration. Through its educational activities, the HET recognizes and addresses the acute and chronic health conditions exacerbated by direct and indirect exposure to carceral systems.
Low resource vulnerabilities encompass a range of economic and social factors that can affect health. Access to healthy housing, proper nutrition, clean water, unpolluted air, and a living wage are some of the factors that play an integral role in disease development and worsening health outcomes over generations. The HET addresses in the curriculum the social, psychological, and political challenges that confront people experiencing poverty that keep them from achieving equitable health outcomes. Students learn the direct health effects of poverty on physical and emotional growth and development, life expectancy, and development of chronic health conditions.
Health equity related to sex and gender involves recognizing and addressing the biological and genetic differences related to sex and the unique health needs and the challenges faced by people with different gender identities. It is important that students are aware of the sex differences in clinical presentation, management, and outcomes of commonly encountered health-related problems. The exploration of the effects of gender bias on patient care is an additional area of focus.
Health equity in the context of sexual orientation and gender identity involves recognizing and addressing the unique health challenges faced by LGBTQIA+ individuals. The HET draws on the Minority Stress Model emphasizing the collective experiences of people with LGBTQIA+ identities who access the healthcare system. Students have the opportunity to learn about gender identity and expression, sexual orientation, and the implications for health needs and healthcare experiences. Learning occurs through didactic lectures, panel discussions, clinical skills workshops, and patient care experiences.