Health Equity

What is Health Equity?

Health equity means everyone has a fair and just opportunity to be healthy.

In 2022, Governor Kathy Hochul signed into law a bill that formalized New York State's acknowledgment of health inequities, health disparities, and structural racism. The enacted state legislation, now state law, formalized definitions in New York Public Health Law for health equity, health disparities, and social determinants of health. The law reads,

"Health equity means achieving the highest level of health for all people and shall entail focused efforts to address avoidable inequalities by equalizing conditions of health for those who have experienced injustices, socioeconomic disadvantages, and systemic disadvantages. Health equity is about addressing the needs experienced by individuals and communities."

In July 2024, the New York State Department of Health released its Health Equity Plan which expands on this statutory definition of health equity.

At the New York State Department of Health, health equity means everyone has a fair and just opportunity to be healthy, where no one is limited in achieving optimal health because of who they are or where they live. This means that to work towards health equity, everyone must be able to access and experience the conditions in life that contribute to optimal health: safe and secure housing, steady and livable income, quality education, social support networks, quality health care, nutritious food, safe transportation, green spaces, clean air and water, and freedom from discrimination based on race, gender, sexual orientation, disability status, or any other part of one's identity. In a world where health equity is the norm, everyone has fair and just access to these conditions, and therefore, has a fair and just opportunity to achieve optimal health.

To give everyone the opportunity to achieve optimal health, services and programs must be tailored to meet the different and unique needs of individuals and communities, rather than providing everyone with the same services and programs and expect to achieve the same results. Working towards health equity requires an understanding of the role that systemic discrimination has played in causing health inequities. Simply providing the same services to everyone, which is defined as health equality, is not sufficient to meet the needs of those who have been historically prevented from accessing the conditions in life that contribute to optimal health (such as stable housing, nutritious food, livable wages, freedom from discrimination, etc.). The goal of health equity is to eliminate health inequities that are avoidable and unjust through proactive and inclusive processes.

What are Health Disparities?

Health disparities refer to measurable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health between population groups.¹

Health disparities may lead to differences in health outcomes that are avoidable, unfair, and unjust. For example, the national maternal mortality rate for Black, non-Hispanic women is 2.6 times the rate for non-Hispanic White women.² Even with comparatively low infant and maternal mortality rates to other states across the nation, even wider racial disparities exist in New York State. Black, non-Hispanic women are five times more likely to die of pregnancy-related causes than White, non-Hispanic women.³ This is an example of a health disparity and a health inequity, because it is unfair, unjust, and avoidable.

For additional definitions of health disparities, visit Healthy People 2030 and the Centers for Disease Control and Prevention (CDC).

What are Social Determinants of Health?

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Social determinants of health is a term used to describe the different conditions in a person's life that can influence their ability to be as healthy as they can be. Some of the conditions in a person's life that influence their ability to achieve optimal health are:

• Access to safe and secure housing;
• Living wages, secure employment, and safe working conditions;
• Access to quality education;
• Access to quality health care services;
• Access to affordable and nutritious food;
• Freedom from racism, homophobia, transphobia, sexism, ableism, and other forms of discrimination;
• Access to social support networks;
• Access to transportation;
• Access to safe green spaces, and;
• Access to clean air and water; community is free from environmental hazards.

While many people assume that health is a product of genes and individual behaviors, research has shown that may be only 20% of what impacts individual health. The social determinants of health (or conditions in life that are necessary for achieving optimal health) listed above may be more important.^[2]

It is not an accident that not all people have equal access to the social determinants of health or conditions in life that are necessary for achieving optimal health. The disparities in access to social determinants of health are the result of decades of structural and interpersonal discrimination, the legacy of which persist to the present day.

Prevention Agenda

The Department is working on the next iteration of the Prevention Agenda. Learn more about the State's 2019-2024 Prevention Agenda.

New York State Health Equity Reports

To address health disparities, we must first be able to identify and measure them. Having good data is critical to these efforts. The New York State Department of Health issues New York State Health Equity Reports with state and county level data on health disparities on an annual basis.

References

1. "Health Disparities", Center for Disease Control and Prevention, May 26 2023.
2. Hoyert DL. Maternal mortality rates in the United States, 2021. NCHS Health E-Stats. 2023.
   DOI: https://dx.doi.org/10.15620/cdc:124678.CDC
3. The New York State Report of Pregnancy-Associated Deaths in 2018
4. Greer ML, Garza MY, Sample S, Bhattacharyya S. "Social Determinants of Health Data Quality at Different Levels of Geographic Detail." Studies in Health Technology and Informatics, PubMed, May 18, 2023.