“Equity is the only acceptable goal,” wrote the medical anthropologist and global health physician Dr. Paul Farmer. At Heluna Health, the nonprofit organization that I lead whose focus is health equity, our national team seeks to enhance the health, wellness, and resilience of every community we serve. For more than 50 years, Heluna Health, and the hundreds of partner initiatives we support each year, have identified systemic racism, poverty, and other social injustices as key drivers of health disparities in the United States and around the world. As such, our organization has worked tirelessly to measurably advance health equity with innovative strategies and evidence-based solutions, and by equipping partners with capacity building services to improve population health. However, the issues we face are so complex and so broad-reaching that it will take deep collaboration and transformational partnership with the business community in effecting real change.
Health equity is a circumstance that is accomplished when every person has the opportunity to attain and maximize their full health potential. To achieve that potential, communities and individuals may require different supports such as access to affordable housing, healthy foods, and/or enhanced open spaces to allow for physical activity. When health equity is not achieved, health disparities arise. The U.S. Centers for Disease Control defines health disparities as “preventable differences in the burden of disease, injury, violence, or in opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and other population groups, and communities.” Too often, health disparities exist because of circumstances that community members do not entirely control—circumstances like social position, neighborhood, educational opportunities, or other socially determined factors. In fact, research has shown that the zip code in which you are born matters just as much to your physical health, if not more, than your genes.
The disproportionate burden of COVID-19 on women, economically disadvantaged, Black, Latina/o, Indigenous, and other ethnic or immigrant communities is the latest example of how systemic racism and other forms of discrimination can lead to devastating health outcomes. Heluna Health has been deeply involved in pandemic relief efforts, including through disease surveillance, case investigation and contact tracing, community vaccination operations, support for laboratory testing and clinical trials, school-based Covid-19 testing programs, and services for individuals experiencing homelessness. During this most recent pandemic year, Heluna Health has hired 1,668 new employees in our effort to help staff our own and our partner COVID-19 response programs.
Pandemic response efforts remind us that the results of population health interventions are only as effective as the lens through which governments, philanthropic funders, and key stakeholders view and prioritize them. We must be mindful to scrutinize and tackle embedded ‘norms’ that enhance, rather than dismantle, health disparities if we want to continue to advance health equity.
This work is done, in part, by raising broader awareness within the healthcare community and among policy leaders who can impact and incentivize our community, regarding the importance of the social determinants of health to the overall health of our population. Factors such as where people live and work, where/how they access care, their economic stability, education access and the availability of reliable transportation, can no longer remain sidelined in a small office within healthcare systems called ‘community benefit.’ These critical social, cultural and economic factors must be woven into more integrated and coordinated responses—a nascent and evolving practice that is sometimes less-than-artfully termed ‘whole person care.’
At Heluna Health, we work directly in local communities and with partner programs to implement and evaluate some of these important interventions. We are working to reduce racial/ethnic disparities in maternal and infant mortality by developing, assessing, and expanding innovative programs providing prenatal, perinatal and postpartum care, such as Heluna Health’s ‘Cinnamoms’—a peer breastfeeding support program for African-American women. We are addressing food insecurity and childhood obesity through services such as food security screening and linkages to local food banks and other food providers, nutrition counseling services, and other evidence-informed approaches. And, we are addressing school readiness through an evidence-based early literacy initiative that operates through federally-funded ‘Women, Infant and Children (WIC)’ nutrition programs.
These innovators are beginning to partner with nonprofit community-based population health organizations in addressing access to food, transportation and affordable housing as part of corporate social responsibility initiatives. Working together we can achieve healthy, strong communities for all.
Learn more at helunahealth.org.
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