HEALTH EQUITY AS A CORE THEME
When a group experiences sub-optimal health because of policies, practices, or conditions that are preventable, unfair or unjust, the deleterious effects on those groups are referred to as health inequities.
Long-standing inequities, including some that have been introduced and promulgated by federal, state, and local policies, have put some population groups at increased risk of experiencing illnesses, having worse outcomes when they do get sick, and worse overall health. The National Academies of Sciences (2017) defines structurally-driven health disparities as those brought about by “the dimensions of social identity and location that organize or structure differential access to opportunities for health including race, ethnicity, gender, employment and
socioeconomic status, disability and immigration status, geography, and more. ”
Fortunately, many of these inequities are remediable. When a society is committed to health equity as a common value, people work together to ensure that everyone, regardless of race, neighborhood, or financial status, has fair and equal access to a healthy community of opportunity (PolicyLink, 2020). Extension is well positioned to serve as a catalyst for community-based efforts to address inequities. Doing so, however, will require a shift in Extension’s strategic direction, but it is one that is long overdue and one that is critical to continue growing Extension’s role in community health prevention and promotion. This new direction will require greater flexibility in the traditional Cooperative Extension model, with greater ability to see and do our work differently than in the past. The 2014 Framework acknowledged the importance of equity in shaping the health and well-being of individuals and communities but did not name it as a focus area for Extension’s health related work. By naming health equity as a core theme, Cooperative Extension moves from treating equity issues as an unfortunate contextual given to actively addressing the conditions that create them.
“ Extension is well positioned to serve as a catalyst for community-based efforts to address inequities. Doing so, however, will require a shift in Extension’s strategic direction, but it is one that is long overdue and one that is critical to continue growing Extension’s role in community health prevention and promotion. This new direction will require greater flexibility in the traditional Cooperative Extension model, with greater ability to see and do our work differently than in the past.”
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