Health is a condition of optimum physical, emotional and social well being where infirmity and illness are absent. It implies that the state of health encompasses an individual’s total well-being. It is the sum total of all the dimensions of health, which includes physiological health, psychological health, social and bio-social health. It can be identified by its ability to provide a balanced approach to the three aspects of health.
The determinants of health state that what is happening to an individual at the time of his/her assessment or diagnosis. The determinants also include the environment, but these are the most important determinants. The three categories of determinants include external and internal factors, with the first consisting of the determinants identified through scientific study. In this case, the determinants are known as environmental factors. External factors include, e.g., exposure to hazardous substances, genotoxic substances, dietary influences, occupational exposures, psychosocial stress, traumatic events and the frequency and magnitude of disease outbreaks.
The second category is composed of individual behavior. It is comprised of those behaviors and attitudes that have an influence on health outcomes. The third category, behavioral attributes, refers to those aspects of an individual that has a direct impact on health outcomes. These include social factors such as family background, social support networks, school settings, neighborhood environments and individual characteristics (e.g., gender, ethnicity, socioeconomic status) affecting health care.
The challenge now is how to understand, identify and measure all these three determinants and incorporate them to improve health equity. Health Equity is the difference between the health of the majority of people and the health of the least privileged. It is also the difference experienced by people belonging to different groups in society. There is no way we can identify and measure all the socially embedded determinants that affect health.
This is precisely what the United Nation must address as it reviews its policies and programs with a view toward improving health equity, reducing health disparities and achieving sustainable health goals. At the national level, the review must focus on the creation of better policies and programs targeting key drivers of unhealthy behavior. Such policy efforts should be backed by effective programs to increase access to quality mental healthcare and promote better outcomes for those who experience health disparities. Efforts to address disparities will only be successful if they are coupled with increased social services and programs addressing disparity. The focus at the federal level must be to ensure that the federal Medicaid program plays a critical role in promoting health equity.
One strategy to reduce health care disparities among racial and ethnic groups is the development of community partnerships. Such partnerships build on the shared experience and expertise of local organizations to identify, treat and eliminate health care disparities. To achieve this, these partnerships should evaluate current strategies that have proven successful in the reduction of health care disparities by analyzing and evaluating the factors that lead to differences in health and wellness between racial and ethnic groups. Such assessments will serve as the basis for developing new strategies.
Another strategy to address disparities in health and wellness is to expand federal level programs and financing to target low-income and minority populations that are facing high health care costs. By far, the highest rates of health and wellness disparities occur in the minority populations. Health and disability insurance programs that are offered at the federal level can be made more comprehensive to include all medically underserved and uninsured individuals. In addition, special preventive care programs that are targeted at minorities can also help to reduce health care costs.
By making a concerted effort to address disparities in health, the goal is to bring down costs while maintaining quality of care. Improved access to quality healthcare at an affordable cost is the key to long term success. Adequate and stable health coverage is important to reducing uninsured and underinsured individuals. Reducing the largest disparity – the gap in health coverage and health outcomes between whites and other racial and ethnic groups – will go a long way toward closing this important gap. Moving forward, the focus should be on how best to reduce the enormous racial and ethnic disparities in health outcomes and cost.