Equity

Health equity is about everyone in the community having the necessary knowledge, skills and resources to achieve and maintain good health and wellbeing. It is also about having the right services provided in the right ways and in the right places to support health and wellbeing.Health equity is concerned with ensuring the social determinants of health (see Determinants of health) do not act as barriers to individuals and communities improving their health and wellbeing.

Health equity is achieved by removing unfair and avoidable barriers that compromise health and wellbeing. The practice of health equity is focused on supporting fair access, fair chances and fair resource distribution to alleviate any disadvantage experienced by at-risk or vulnerable groups.

Health equity could exist but often does not. The goal of health equity − for communities, for service systems and for practitioners in their work − is to make sure no one experiences poor health and wellbeing because of such unfair and avoidable disadvantage.

There are significant reasons to reduce health inequities. Vulnerable, or at-risk population groups may include people who are:

  • Aboriginal and Torres Strait Islander
  • socio-economically disadvantaged
  • living in rural or remote areas
  • living with a mental illness, physical or intellectual disability
  • living with the affects of experiencing abuse or neglect as a child
  • affected by discrimination, social exclusion, incarceration, and
  • from cultural or linguistically diverse backgrounds, particularly refugees and survivors of torture and trauma.

Research shows these groups generally have increased health risks and are affected by inequities because of their daily living conditions.

Research also consistently shows people living in poverty receive less than a proportional share of public health funding relative to those who are better off. Discrimination based on gender, sexuality, race and ethnicity contribute significantly to inequities in health and in access to healthcare services. For example, in Australia the social disadvantage experienced by Indigenous people has contributed to the gap in health outcomes between Indigenous and non-Indigenous Australians.

In addition, men and women have vastly different health needs, so health service providers need to consider gender when planning for service delivery. For example, promoting a breast cancer screening service is more appropriate for a female audience.

Health equity is not the same as health equality, but it looks and sounds similar so it is easy to get confused. Health equality, or sameness, does not exist − we do not and cannot have exactly the same experience of health and wellbeing. This is because we are subject to vast individual differences, including biological factors such as genetics, sex and age.

Health inequities are avoidable. They result from decisions made by society such as policy or legislative measures on tax, welfare, healthcare funding and the creation of supportive environments.

An equitable approach in health promotion will:

  • prioritise at-risk groups and those most in need and ensure access to services
  • focus health promotion initiatives on the social determinants of health
  • use community development and community building initiatives to strengthen all aspects of that community (see Community participation)
  • advocate to reduce social inequities to ensure every individual, family and community group may benefit from living, learning and working in a health-supporting environment
  • work in partnership with other organisations.

For further information and to apply these principles in your work, view this checklist

Visit the evidence library to find more information about this principle.

To see examples of the Working in Health Promoting Ways Principles of Practice, view the case studies