HEALTH MATTERS: Social factors play into health equity goals

To understand health equity, it helps to imagine three people, each standing on a box to reach for apples on a tree branch. The people are three different heights. If they each stand on the same size box, only the tallest person can reach the fruit. Health equity attempts to give each person a box that is tall enough to let him reach the fruit.

Equality and equity are not the same concept. While equality offers everyone the same size “step” toward good health, equity recognizes that some people need a boost to compensate for disparities that limit their potential to improve their health. Health equity tries to decrease the disparities that prevent people from having a fair chance to be healthy.

While personal lifestyle choices and heredity definitely influence our health, health inequities are also reflected in differences in the lengths of people’s lives and the quality of their lives. Factors described as the “social determinants” of health affect our ability to reach our goals. Those social determinants include income, social status, gender, education, jobs, where we live, our culture and other factors.

The contaminated drinking water in Flint, Mich., dramatized just how much where we live can affect our health. In rural communities, those social determinants may include the distance people live from the nearest doctor or mental health professional. social determinants are sometimes broadly described as the factors leading to health that occur outside a doctor’s office.

At RiverStone Health Public Health Services and the Healthy By Design coalition, we work on policies to improve the health of the whole community. We work toward expanding access to health care and toward making health a consideration in all community policies. Our work on Complete Streets centers on improving safety for everyone from pedestrians and cyclists to those who drive or take the bus. Complete Streets also expand opportunities for exercise, which can improve people’s health.

The Community Health Assessment, a survey done every three years, offers a lens to examine health equity and the influence that community efforts can have on health. RiverStone Health partners with St. Vincent Healthcare and Billings Clinic to conduct the assessment, which includes a phone survey, a survey of key informants, and an examination of national data. A community forum to review the preliminary data collected last summer will help prioritize our goals.

The data should shed light on existing health disparities in our community. After the forum, we will pursue the work of figuring out how we can successfully improve community health. By decreasing inequities, we seek to enable all citizens of Yellowstone County to have a fair shot at reaching for that imaginary apple that represents the chance to lead a healthier life. When health is considered in all community policies, Billings and Yellowstone County will be a more equitable place to live, work, and play.

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