by Paula Braveman, Elaine Arkin, Tracy Orleans, Dwayne Proctor, Alonzo Plough
Definitions can matter. While differences between some definitions may represent stylistic preferences, others can reflect deep divides in values and beliefs that can be used to justify and promote very different policies and practices. Clarity is particularly important in the case of health equity because pursuing equity often involves a long uphill struggle that must strategically engage diverse stakeholders, each with their own agenda. Under those circumstances, if we are unclear about where we are going and why, we can more easily be detoured from a path toward greater equity; our efforts and resources can be co-opted, and we can become lost along the way.
This brief from the Robert Wood Johnson Foundation and University of California San Francisco was released to stimulate discussion and promote greater consensus about the meaning of health equity and the implications for action within the Culture of Health Action Framework. The goal is not for everyone to use the same words to define health equity, but to identify crucial elements to guide effective action.
This issue brief is the first in a series examining important issues faced in advancing health equity. Throughout this brief, the term “health” refers to health status itself, distinguished from health care, which is only one of many important influences on health. The concepts presented here are based on widely recognized ethical and human rights principles and are supported by knowledge from health sciences.