Some Basics

Health disparities: differences in health status (burden of disease, injury, violence, or opportunities to achieve optimal health) between populations closely linked to social and demographic factors

Health care disparities: differences in health care (access + patient experience + clinical outcomes) between populations related to social or demographic factors

Social and demographic factors include race, ethnicity, socioeconomic status, health insurance status, level of literacy, English proficiency, sexual orientation, gender and gender identity, and disability.

These disparities reflect modifiable health differences which systematically and negatively impact less advantaged groups.

Health care disparities

  • are preventable
  • signal gaps in care quality
  • can compromise health system finances (e.g. readmissions, under/over-utilization of resources)

Reductions in health disparities are one way we can measure our progress toward achieving health equity.

Health Equity = Everyone has a fair and just opportunity to attain their highest level of health
Health Care Equity = Equitable access + Equitable quality of care
                                 = Equitable access + Equitable patient experience + Equitable clinical outcome
Social Determinants of Health = conditions in which people are born, grow, live, work and age --- requires community and civic partnerships outside of the health care delivery system to address
Health Care Equity + Social Determinants of Health ➜ Health Equity

chart explaining social determinants of health
illustration showing figures watching a baseball game
The images above illustrate that people are all equal in ability/value/potential, but the fence and the ground give them unequal opportunity. “Equality” provides them all with the same level of support, whereas “Equity” assures they all achieve the same outcome.



Other Resources


• STEP UP Certificate Readings - SDoH and Structural Competency
• Region V Public Health Training Center: Population Health and Health Equity

• STEP UP Readings & Resources
• Dialogue 4 Health: Ending the Triple Pandemic: Advancing Racial Equity by Promoting Health, Economic Opportunity and Criminal Justice Reform
• Practitioner’s Guide for Advancing Health Equity

• Michigan League for Public Policy: Valuing different ways of knowing and learning
• Health Equity Guide

Some Additional Well-Known Readings and Multimedia

White Fragility by Robin DiAngelo
How to be an Antiracist by Ibram X. Kendi
So You Want to Talk About Race by Ijeoma Oluo   
Caste: The Origins of Our Discontents by Isabel Wilkerson
White Fragility Lecture with Dr. Robin DiAngelo
Brené Brown with Ibram X. Kendi on How to Be an Antiracist
The 1619 Project (all the articles) | The New York Times Magazine
1619 Podcasts (New York Times)

BONUS: Showing Up for Racial Justice


• Learn how to support and advocate for marginalized communities.
• Follow, support and/or join advocacy of groups that advance equity. Includes:

Antiracism Center: Twitter
Audre Lorde Project: Twitter | Instagram | Facebook
Black Women’s Blueprint: Twitter | Instagram | Facebook
Color Of Change: Twitter | Instagram | Facebook
Colorlines: Twitter | Instagram | Facebook
The Conscious Kid: Twitter | Instagram | Facebook
Equal Justice Initiative (EJI): Twitter | Instagram | Facebook
Families Belong Together: Twitter | Instagram | Facebook
Justice League NYC: Twitter | Instagram + Gathering For Justice: Twitter | Instagram
The Leadership Conference on Civil & Human Rights: Twitter | Instagram | Facebook
The Movement For Black Lives (M4BL): Twitter | Instagram | Facebook
MPowerChange: Twitter | Instagram | Facebook
Muslim Girl: Twitter | Instagram | Facebook
NAACP: Twitter | Instagram | Facebook
National Domestic Workers Alliance: Twitter | Instagram | Facebook
RAICES: Twitter | Instagram | Facebook
Showing Up for Racial Justice (SURJ): Twitter | Instagram | Facebook
SisterSong: Twitter | Instagram | Facebook
United We Dream: Twitter | Instagram | Facebook

• Adopt basic advocacy skills such as in AAFP Grassroots Advocacy Resources.
 - Learn about how government works and who your legislators are in your district.
 - Find out what advocacy is being done on health equity topic of interest.

• Educate the public or work community about current and emerging health issues impacting underserved populations.
 - Write a letter to the editor, commentary or op-ed.
 - Participate in a community-based educational activity.
 - Promote understanding of health disparities in your field and possible solutions  through written briefs, personal presentations, community lectures, or media appearances.

• Learn about and support adoption of  a roadmap to health equity at your institution.
• Advocate for public health policies, programs, and resources:
 - Prepare testimony to deliver before a legislative or regulatory body.
 - Prepare a policy brief.
 - Participate in a legislative visit.
 - Advocate for policies, programs, and resources at work that advance health equity.


• Small Acts of Kindness: Micro-affirmations and Campus Climate

• Start effort to equip new and existing faculty with tools to engage learners in topics of health disparities, social justice, bias, and racism in the classroom and clinical environment:
 - Anti-Racism and Race Literacy - A primer and toolkit for medical educators

• Participate in a Quality and Equity Improvement (QEI) project that specifically targets a  public health system or underserved population.
 - Apply the science of improvement in the How to Improve 
 - Include Ingraining Equity into Quality and Safety: A System-Wide Strategy

• Change a policy/practice/structure at work, school, or community to advance health equity.
 - Health Equity Must Be a Strategic Priority
 - Integrating Social Care Into the Delivery of Health Care
 - A Roadmap to Reduce Racial and Ethnic Disparities in Health Care
 - Promoting Health Equity Through Accountable Communities for Health
• Help health departments implement Health Equity and Social Justice program
 Become a Culture of Health leader

BONUS: How to Raise a Generation who are Brave about Race