Monthly Meeting Reflections: Health Equity & Transgender 101

e.shor, MPH

UW Population Health Service Fellow

HIV/AIDS Program, Department of Public Health

Madison, Wisconsin

On September 3rd the fellows, preceptors, and staff had our first monthly meeting for this "year" ...we kinda roll on our own timeframe. Our topic for this monthly meeting was health equity and for our skill building we discussed transgender 101. We had quite an epic day full of learning, games, and applying a health equity lens to our work.

Maybe you are thinking... oh my, what is health equity? I've heard this somewhere...but I can't put my finger on it.

There is no simple answer to this question...nor is there a simple solution. I am going to try my best here to explain health equity and link you to some resources.

Health equity does not exist in a is intimately linked to health disparities and health inequities. It is important to have an understanding of all of these things and social determinants of health (SDOH) to truly understand health equity. So let's start with social determinants of health...they are:
"The complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities. These social structures and economic systems include the social environment, physical environment, health services, and structural and societal factors. Social determinants of health are shaped by the distribution of money, power, and resources throughout local communities, nations, and the world" (World Health Organization 2008)
Here is a picture to help understand SDOH (there are lots of cool pictures of SDOH if you google it):

Illustration from Anthony B. Iton. "The Ethics of the Medical Model in Addressing the Root Causes of Health Disparities in Local Public Health Practice."
 So we know there are all these SDOHs out there impacting health...what happens next? These big structural systems make it easier for some people to have good health outcomes and they make it harder for others to have good health outcomes. This is health inequity. CDC (Centers for Disease Control) describes health inequities as:
A difference or disparity in health outcomes that is systematic, avoidable, and unjust
Then what is a health disparity? How is it different from health inequity? Good question smart reader...a health disparity is:
Variations or differences in health status among groups of people. This may refer to any difference in health, with no implication that these differences are unjust (American Medical Students Association)
A key workd that has cropped up a few times for us is unjust. This makes health a social justice issue. Social Justice refers to an equitable distribution of social, economic, and political resources AND when there is an unequal distribution of resources and opportunities is manifested through inequitable access and exposure to social determinants of health. Full circle.

Finally, that means health equity is:
When all people have the opportunity to "attain their full health potential and no one is disadvantaged from achieving this potential because of their social position or other socially determined circumstance" (CDC 2012, Braveman 2003)

This is just a brief overview of some things related to this ginormous area of public health. It is also an incredible shift in the way we approach public health and the world. Health equity is a frame of mind (and a science!) that is supposed to help us put context to the forces in the world that unjustly impact people's health. It is something that you have to believe in...and, ultimately, what we all have to work towards in our public health work.

And now onto Transgender 101...oh wait, maybe that is for next time :)