Viewpoint: Stop talking about 'eliminating' health inequities

The idea that health inequities can and should be eliminated is misaligned with the definitions of equity and justice, according to an article published Oct. 24 in Health Affairs

The article was written by Tamarie Macon, PhD, an assistant professor at Chapel Hill-based University of North Carolina's school of public health and a health equity and policy executive with Mountain Area Health Education Center — a UNC-affiliated center in Asheville that trains physicians through residencies and fellowships and provides care to local residents. 

Dr. Macon describes three issues with the phrase "eliminating health inequities":

  1. Eliminating inequity centers "whiteness": It implies that other groups should be lifted to the white standard as opposed to viewing health inequities' through the minority's lens. "We can name health inequities without tethering our health priorities to a White standard," Dr. Macon wrote. 

  2. Eliminating inequity is mathematically ambiguous: To eliminate a difference between two values, the lower number rises to meet the higher, or the higher drops to meet the lower, Dr. Macon said. According to Dr. Macon, the Black-white infant mortality gap is closing in Buncombe County, N.C. However, this is not only because Black infant mortality is getting better — white infant mortality is getting worse. "Closing inequities doesn't (necessarily) mean that all groups are healthier. Why pit communities against one another as if it is a zero-sum game?" she wrote. 

  3. Eliminating inequity emphasizes "individual-level" thinking: It is not possible for all people to attain the same standard of health as the most privileged group while systems of oppression are in place, Dr. Macon said. This is not something individual behavior can shift. "In such a world — our current world — systems change is required for everyone to experience the highest standard of health," she wrote. 

Read the full article here

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