Why It Matters
This primer explains commonly used health equity terminology.
These days, we’re hearing more discussion than ever before about health care’s role in achieving health equity.
But we risk confusion or miscommunication if we don’t first establish a common lexicon. Some terms can seem interchangeable, but have distinct meanings that are important to understand. IHI’s white paper, Achieving Health Equity: A Guide for Health Care Organizations, offers a primer on important terms to the discussion of health equity to help you make sense of it all. Here are some of the key terms to know:
- Population health: “The health outcomes of a group of individuals, including the distribution of such outcomes within the group,” as defined in a 2003 article in the American Journal of Public Health by David Kindig, MD, PhD, and Greg Stoddart, PhD. Health care organizations generally define population in two different ways: either the communities in their geographic service area or the patients actually seen in their organization.
- Social determinants of health: “The circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics,” as defined by the World Health Organization (WHO).
- Health equity: To define health equity, the IHI white paper turns to the work of Professor Margaret Whitehead, head of the WHO Collaborating Centre for Policy Research on the Social Determinants of Health. Most countries use the term “inequalities” to refer to socioeconomic differences in health — that is, health differences “which are unnecessary and avoidable but, in addition, are also considered unfair and unjust.” Whitehead goes on to state that, when there is equity in health, “ideally everyone should have a fair opportunity to attain their full health potential and, more pragmatically, no one should be disadvantaged from achieving this potential, if it can be avoided.” This is the definition IHI uses to guide our work on improving health equity.
- Health disparity and health inequity: Health disparity is defined as the difference in health outcomes between groups within a population. While the terms may seem interchangeable, “health disparity” is different from “health inequity.” “Health disparity” denotes differences, whether unjust or not. “Health inequity,” on the other hand, denotes differences in health outcomes that are systematic, avoidable, and unjust.
- Health care disparity: “Racial or ethnic differences in the quality of health care that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention,” as defined by the Institute of Medicine. The IHI white paper, Achieving Health Equity: A Guide for Health Care Organizations, focuses on disparities in health outcomes rather than the provision of health care; however, the equitable provision of health care is essential to reducing disparities in health outcomes.
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