About This Guide

Assessing Healthcare Equity

The last several years have shined a light on healthcare disparities in our community, most recently due to the pandemic. Since it has been quite relentless for many, some have experienced a lack of health equity more than others. With this, a push to improve health equity across healthcare is expanding throughout the country. “Health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health. Achieving this requires focused and ongoing societal efforts to address historical and contemporary injustices; overcome economic, social, and other obstacles to health and healthcare; and eliminate preventable health disparities,” states the

Centers for Disease Control and Prevention (CDC).

This includes the need for expanding and removing social and economic obstacles that lead to inadequate health outcomes. Some barriers include unsafe or unhealthy environments, quality of housing, poverty, lack of access to jobs with health insurance, which can lead to a denial of needed healthcare for individuals. It has also been found that there is a lack of health equity for those with disabilities and for those who reside in rural communities.

“Many people face such barriers and are prevented from accessing the care, services and resources they need to live a healthy life, often leaving minorities in communities impacted by disinvestment. As a result, many minorities experience limited access to healthy foods, lower quality education, difficulty earning a living wage and unsafe environments,” said Dr. Kelli Tice, Florida Blue chief health equity officer, in an interview. Tice continues, “At Florida Blue, we are working to collect and analyze data about members’ challenges, which allows us to better meet their needs, identify resources and create programs that are tailored to them. COVID-19 shines a spotlight on health disparities that exist among minority populations. In communities across the United States, minorities faced higher

rates of disease transmission and financial impacts associated with the pandemic. Minorities, while overrepresented in higher risk jobs, consistently have decreased access to testing and vaccines.” In Volusia County, Florida Health Charts reported that 88.5 percent of civilian non-institutionalized population had health insurance. Flagler County had 86.6 percent and Brevard County had 89.8 percent. This is versus the state percentage of 87.2. This comparison seems fairly consistent over the different counties, but it highlights the fact that many are having health equity issues and need access to care, which can be hard to get when uninsured. Organizations throughout Florida have been working relentlessly to transform public health research and implementation to promote health equity efforts. Jacksonvillebased Voices Institute, launched by Selena Webster-Bass, MPH, is a consulting and research group focused on advancing and promoting health equity efforts that address physical, mental and emotional well-being needs in families, communities, organizations and systems. Voices Institute has training and consulting including health equity professional learning, equity organizational assessments, equity plans, cultural humility, young development, organizational assessments and more. Some of the health education and promotion services include mental health literacy, racial literacy, health literacy, grief and loss support and COVID-19 vaccine hesitancy education. Health studies are also available with qualitative research, focus group facilitation and multicultural community engagement. In the Daytona area, the Florida Department of Health (DOH) in Volusia County has created the Protocol for Assessing Community Excellence in Environmental Health (PACE-EH). This initiative is a tool that has been designed to encourage local health officials and community members to work together to identify and address community environmental health issues. “The Midtown Health Equity Action Team (HEAT) is a community based, grassroots PACE-EH initiative focused on achieving health equity within the Midtown Community of Daytona Beach,” states the Florida DOH of Volusia County. The Florida DOH has also enlisted the Project Public Health Ready, a section of the Emergency Preparedness and Response department. “This partnership program between the Florida Department of Health, the National Association of County and City Health Officials and the Centers for Disease Control and Prevention is an effective tool for increasing community preparedness,” said the DOH. This public health program assesses local health department capacity and capability to plan for, respond to and recover from public health emergencies. Working together can help prioritize the concern that continues to build in regard to health equity. In an article, Health Affairs and Project Hope pointed out that a need to better understand health equity through measurement could help assess the effectiveness of the efforts to improve equity. “There is no national standard method for capturing data on key variables needed to assess health equity. Some organizations, such as the Office of Management and Budget, the Health Resources and Services Administration and National Committee for Quality Assurance, have developed guidelines for collection of race and ethnicity data, but they are not always consistent,” stated Health Affairs and Project Hope. “There is even less consensus on what categories to use to capture data on other variables, such as language, sexual orientation, gender and disability status. There are also no standard measures for assessing performance in improving health equity. The latter is essential to creating accountability and transparency for health equity.” As we learn more about health equity, we will be able to properly work with those that would benefit from improved health equity. In a recent article, Alison Yager, executive director of the Florida Health Justice Project, stated that philanthropic donations have streamed toward health equity issues, but the pandemic has underscored how underprepared the state is to deal with these problems. Tice circled back around in the article and stated, “We know that Florida has systematically disinvested in our public health infrastructure year after year for the past decade. It’s in a moment like this where those decisions have really come home to roost. We’ve seen how our systems have really lost (their) muscle.” With this in mind, it is important to move forward with a positive outlook in order to expand the resources available for those facing health inequity. In Tice’s interview she said, “Rather than trying to convince you this is an actual thing, we can work together to solve it.” Now assessments can be conducted and organizations such as the Voices Institute and the Florida Department of Health can work towards a better outcome for healthcare prosperity in our community.