Promoting Health Equity Through the Power of Place, Perspective, and Partnership

Abstract

The 10 articles in the Preventing Chronic Disease (PCD) special collection on health equity highlight that a commitment to self-reflection, cultural humility, and lifelong learning are foundations of health equity science and that the field is interdependent with the perspectives and context of communities. Three themes — place, perspective, and partnership — emerged from the PCD special collection. The articles embody the principles outlined in the Healthy People definition of health equity and CDC’s CORE Health Equity Science and Intervention Strategy. They highlight the critical role that context, qualitative methods, and community-based participatory research play in efforts to achieve health equity. However, the science of achieving health equity is rooted in antiracism principles; the “inner work” of learning, unlearning, relearning, and co-learning; and the efforts to equip communities to act, research, and intervene for themselves. Without these added critical structural lenses, health equity science will continue to fail to achieve its goal.

Antiracism and Health Equity Science: Overcoming Scientific Obstacles to Health Equity

“…Thus, interventions must be anchored in the voices, perspectives, insights, and expertise of people who have lived experiences of the problem in context and have ideas about what is needed to mitigate or remedy the determinants of health inequities. [20][21][22][23][24] The information needed to understand and achieve health equity is integrally intertwined, limiting the ability to characterize and define intervention approaches in such a way that would guide us toward a solution. 13 Tested interventions and efforts to achieve health equity have been limited by resources, time, and other considerations external to the problem; these contextual factors are often outside the scope and skill set of public health professionals.…”

“…10,25 Achieving health equity is further complicated by the challenge of effectively framing racial and ethnic health inequities 26 and communicating to decision makers the problem's logic, status, complexity, and depth. 13,22 When and Why Should We Compare?…”

“…14 The goal of health equity tends to be imprecise and lack "SMART" goals (specific, measurable, attainable, realistic, and time-bound), 1 exacerbating the already complex issues that make health equity, not just racism, a wicked problem. 22 In the long history of social change traditions across the globe and in the United States, people of African descent and other populations have defined and focused on the goals that they seek to achieve rather than the barriers to achieving them. 31 In this spirit, I offer an approach to achieving health equity.…”

“…Thus, interventions must be anchored in the voices, perspectives, insights, and expertise of people who have lived experiences of the problem in context and have ideas about what is needed to mitigate or remedy the determinants of health inequities. 20-24…”

“…14 The goal of health equity tends to be imprecise and lack “SMART” goals (specific, measurable, attainable, realistic, and time-bound), 1 exacerbating the already complex issues that make health equity, not just racism, a wicked problem. 22…”