Health Equity Reflection: Growth, Disparities, and Advocacy

Summary of Personal Change and New Knowledge Attained

Over the past eight weeks, I have made observations and gathered knowledge and insights that have shifted my opinions, beliefs, and attitudes on multiple fronts — especially regarding health equity. Among other things, I have developed a better understanding of existing health disparities in our communities and am now more informed about the factors that trigger those disparities. Being better informed positions me to contribute more meaningfully toward eliminating them.

I became more aware of these disparities after engaging with the course content and supplementary resources, which painted a vivid picture of the differences people experience in terms of health and healthcare as a consequence of existing inequities. From my engagement with the topic of the history and legacy of social justice in public health, I came to understand that social justice underpins public health itself. As a result, I am now more appreciative of the need to focus greater attention on the social and economic issues that create health inequities, rather than centering our efforts exclusively on individual illnesses — which has historically been the focal point of public health practice.

Another topic that specifically interested me was the shifting lens of public health practice. I encountered ample evidence indicating that health and wellbeing are significantly influenced by a wide range of social factors, including — but not limited to — ethnicity, gender, income level, and employment status. These are commonly referred to as the social determinants of health. To advance health equity, public health practice must ensure that this knowledge is expressed as concrete practice changes. I am now convinced that we must be more appreciative of how health outcomes are affected by these factors, and therefore more committed to implementing interventions that — for instance — focus on reducing the risk of poor health by addressing people's socioeconomic circumstances.

Furthermore, thanks to the reading materials I was exposed to, I am now more accepting of the intimate connection between racism and health disparities. In the past, my understanding of this connection was largely superficial. Although I was aware that some racial minorities do not have just and fair access to healthcare services, I lacked data underscoring the full extent of existing disparities — particularly the significantly elevated morbidity and mortality rates among ethnic and racial minority groups. As a result, I may have failed to appreciate the severity of conditions on the ground, as well as the urgency of deploying relevant interventions to address prevailing concerns.

Problematic and Challenging Concepts

One of the concepts I find most challenging relates to systemic and institutional racism in public health. In my view, this represents a public health crisis that has not been adequately addressed, despite being embedded in both the historical and modern healthcare system. Resources and goods continue to be differentially allocated even though there is ample evidence that some minorities remain unfairly disadvantaged. This persists despite discrimination and segregation on the basis of individual attributes or economic factors being widely condemned as relics of a dark historical past. Having volunteered in marginalized communities, I recognize the need to embrace new approaches to address health inequity — approaches firmly rooted in contemporary realities rather than outdated frameworks.

Another concept I find challenging is the worsening state of health equity despite ongoing efforts to formulate and implement corrective strategies. This suggests that, for a variety of reasons, strategies deployed over time have been at least partially ineffective. In much of the Western world, and particularly in the United States, racial disparities are not meaningfully improving. Moreover, the economic landscape does not appear promising, with wealth increasingly concentrated among the affluent while poverty deepens for others. If nothing is done to address these structural conditions, it is reasonable to infer that health inequities will continue to worsen.