Health equity means that everyone has a fair and just opportunity to live their healthiest lives possible. If that sounds like a no-brainer, it may be surprising to learn just how much disparity exists in health outcomes and access to treatment at a societal level. For example, the maternal mortality rate for African American women is two to three times higher than for that of white women, according to the CDC. In cancer research, “Black patients, Latinx patients, people from underserved communities, and also the elderly, are not adequately represented in clinical research studies, are not receiving the care that they need, and are experiencing worse outcomes,” says Cary Gross, MD, director of the Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center at Yale. Incarceration has unique impacts on health, and disproportionately affects Black and Latinx people and the poor. And when COVID-19 arrived, it ravaged communities that were already at a disadvantage. “The disproportionate impact of COVID-19 experienced by people of color highlighted longstanding disparities in underlying conditions that we know are linked to severe COVID-19 illness,” explains Carol Oladele, PhD, MPH, Director of Research at the Equity Research and Innovation Center at Yale. Socioeconomic status and ethnicity play an outsized role in determining one’s health in the United States. “I think a statistic people often find surprising, maybe even staggering, is that if we think about what contributes to your health, it’s a small piece of that pie that has to do with healthcare, somewhere in the order of 20 percent” says Marcella Nunez-Smith, MD, MHS, Associate Dean for Health Equity Research, and who also leads the health equity task force for the Biden administration. “Health means more than simply getting the medicine or surgery that you need,” says Dr. Gross. Jobs with a fair income, stable housing, educational opportunities, and access to healthy food all combine to be larger drivers of health. “In order to get us all living our best life, we have to all the structures and institutions that put people at a disadvantage to start,” explains Emily Wang, MD, Director of the SEICHE Center for Health and Justice, whose research focuses on health and incarceration. Community engagement, representation and inclusion in clinical trial data, and asking different kinds of questions are all key to advancing health equity research. “How do we make our health system work for those that are most disenfranchised, most vulnerable to poor health outcomes?” asks Dr. Wang. “This is the task at hand.” Health equity research has the power to “make the invisible visible,” says Dr. Nunez-Smith, ultimately leading to transformation and change in our healthcare systems.
