Health equity language is value laden but often full of terminology only meaningful to public health insiders — and sometimes not even to them. We must promote the use of clear and effective language to foster powerful communication and action.
How we communicate about our partnership and our work is critical to our success. Knowing and understanding key terms and concepts related to public health and health equity helps us communicate more effectively about the complex issues affecting the health of all of us. Here is our guide some commonly used key terms.
ACCREDITATION: A process of review for health care organizations to show their ability to meet standards set by a professional accrediting agency. Accreditation is a way for organizations to demonstrate accountability to the individuals and communities they serve. Accreditation forms the foundation for policies and procedures.
CHRONIC DISEASE: Conditions that keep coming back, or persistent conditions, that are the nation’s leading causes of death and disability (i.e., high blood pressure, diabetes, asthma, heart problems, and mental illness). Most of the time, these conditions could have been prevented. They can lead to lifelong disability. They negatively impact an individual’s quality of life, and they lead to high health care costs.
CHRONIC DISEASE CLINICAL MANAGEMENT: Medical treatment of chronic disease that creates a partnership between the patient and the clinician to improve the patient’s health.
CHRONIC DISEASE SELF-MANAGEMENT: Non-medical treatment of chronic disease that gives patients the tools they need to improve their health. These interventions can reduce symptoms, build patient confidence to manage their condition, and improve their quality of life.
CLINICAL CARE/CLINICAL MEDICINE: Emphasizes disease diagnosis, treatment, and care for the individual patient. Clinical or medical healthcare professionals—doctors, nurses, or dentists, pharmacists—help individuals with personal healthcare issues.
CONTINUOUS QUALITY IMPROVEMENT: An approach to quality management that builds upon traditional quality assurance methods by emphasizing the organization and systems: it focuses on “process” rather than the individual; it recognizes both internal and external “customers;” it promotes the need for objective data to analyze and improve processes.
COMMUNITY BENEFIT PLAN: A document usually created with the nonprofit health care organization’s annual strategic plan that describes how an organization plans to fulfill both its mission of community service and its charitable, tax-exempt purpose. It includes a description of community benefit priorities, projects, staffing, resources, evaluation procedures and expected outcomes, and a description of community involvement.
COMMUNITY HEALTH ASSESSMENT: The ongoing process of regular and organized collection, analysis, and distribution of information on the health needs of the community. This information includes statistics on health status, community health needs, gaps, problems, and assets.
CULTURE: An integrated pattern of learned core values, beliefs, norms, behaviors and customs that are shared and transmitted by a specific group of people. Some aspects of culture, such as food, clothing, modes of production and behaviors, are visible. Major aspects of culture, such as values, gender role definitions, health beliefs and worldview, are not visible.
DISTRIBUTION OF HEALTH OUTCOMES: Variation in health outcomes by gender or geographic area, or for different groups, such as socioeconomic, racial/ethnic, or age groups.
DIVERSITY: The visible and invisible mixture of differences and similarities between people that frame how we see the world and interact with others.
ENVIRONMENTAL FACTORS: Conditions that impact the health of people and communities. The amount of money, power, and resources that people have in their daily lives shapes these conditions. Examples include access to healthy food, as well as safe places to play and exercise; levels of stress; financial instability; insufficient or lack of employment; lack of quality education; unstable housing; and substandard health care.
EQUALITY: The quality or state of being equal and refers to the identical distribution of resources, decision making and outcomes regardless of level of need.
EQUITY: Providing all people with fair opportunities to achieve their full potential.
EQUITY LENS: The lens through which you view conditions and circumstances to assess who experiences benefits and burdens as the result of a program, policy, or practice.
FOOD DESERTS: Urban neighborhoods and rural towns without ready access to fresh, healthy, and affordable food. Instead of supermarkets and grocery stores, these communities may have no food access or access only to fast food restaurants and convenience stores that offer few healthy, affordable food options.
GREEN SPACE: An area of grass, trees, or other vegetation set apart for recreational or aesthetic purposes in an otherwise urban environment.
HEALTH OUTCOMES: A change in the health of an individual, group, or population which is attributable to a planned intervention or series of interventions, regardless of whether such an intervention was intended to change health status.
HEALTH CARE INSTITUTION: Every place, institution, building, or agency, whether for profit or nonprofit, which provides facilities with medical, nursing, screening, and other related health services.
INCLUSION: Active, intentional, and ongoing engagement with diversity, including intentional policies and practices that promote full participation and sense of belonging among all members of a group or organization.
INEQUITY: Differences in well-being between and within communities that are systematic, patterned, unfair, and can be changed. They are not random, as they are caused by our past and current decisions, systems of power and privilege, policies and the implementation of those policies.
INSTITUTIONAL RACISM: Discriminatory treatment, unfair policies and practices, and inequitable opportunities and influence within organizations and institutions, based on race.
INTERNAL REVENUE SERVICE (IRS): Federal governmental body that requires nonprofit health systems to complete a community health needs assessment and community benefit plan.
INSTITUTE OF MEDICINE: An independent, nonprofit organization that works outside of government to help those in government and the private sector make informed health decisions by providing evidence about important health-related issues across the country.
KEY PRIORITIES: HIP-Cuyahoga refers to key priorities as serious threats to health and/or determinants of health which if addressed, improve health and wellness and reduce inequities.
LARGER HEALTH SYSTEM: An organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations. This includes both clinical care (comprised of many health care systems in Cuyahoga County) and local public health (three local health departments in our county – Cuyahoga County Board of Health, Cleveland Department of Public Health, and Shaker Heights Health Department).
LIFE EXPECTANCY: The average number of years a population of a certain age is expected to live, given a set of age-specific death rates in a given year.
LOCAL PUBLIC HEALTH DEPARTMENT: a government agency on the front lines of public health. The three public health departments in Northeast Ohio are the Cuyahoga County Board of Health, the Cleveland Department of Public Health and the Shaker Heights Health Department.
NUTRITION: The intake of food, considered in relation to the body’s dietary needs.
OPPRESS/OPPRESSION: The systematic targeting or marginalization of one social group by a more powerful social group for the social, economic, and political benefit of the more powerful social group.
PEOPLE OF COLOR: Refers to groups of African Americans, Asian & Pacific Islanders, Native Americans, and Hispanics.
PERSPECTIVE TRANSFORMATION: The process of becoming critically aware of how and why people’s assumptions limit the way they perceive, understand, and feel about the world and how they act on this understanding.
PHYSICAL ACTIVITY: Any body movement that works muscles and requires more energy than resting. Physical activity generally refers to movement that enhances health.
PLACE MATTERS: An initiative of the National Collaborative for Health Equity focused on building the capacity of leaders and communities around the country to identify and address the social, economic, and environmental factors that shape health and health inequities. Cuyahoga County has a local PLACE MATTERS team (http://cuyahoga placematters.com).
POPULATION FOCUS: The geographic area and population on which interventions will focus.
POPULATION HEALTH: The health outcomes of a group of individuals and the distribution of outcomes within the group.
POPULATION HEALTH OUTCOMES: The result of many factors that combine together to affect the health of individuals and communities, including clinical/medical care, public health, genetics, behaviors, social factors, and environmental factors. Population health is now a well-defined term that is an accepted and valid measure of outcomes for both health care and public health.
POWER: Access to resources and to decision makers as well as the ability to influence others and define reality for yourself and potentially for others.
PRIVILEGE: When one group has something of value that is denied to others simply because of the group they belong to, rather than because of anything they have done or failed to do.
PUBLIC HEALTH: Public health promotes and protects the health of people and the communities where they live, learn, work and play. Public health deals with health from the perspective of populations, not individuals.
PUBLIC HEALTH SYSTEM: The public health system includes both other public-sector agencies (such as schools, Medicaid and environmental protection agencies, and land-use agencies) and private-sector organizations whose actions have significant consequences for the health of the public.
QUALITY OF LIFE: An individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It is a broad ranging concept affected in a complex way by the person’s physical health, psychological state, level of independence, social relationships, personal beliefs, and their relationship to important features of their environment.
SOCIAL DETERMINANTS OF HEALTH: the circumstances, in which people are born, grow up, live, work, and age. These circumstances are, in turn, shaped by a wider set of forces: economics, social policies, and politics.
SOCIOECONOMIC: Relating to, or concerned with, the interaction of social and economic factors.
STRATEGIC ISSUES: Fundamental policy choices or critical challenges that must be addressed in order for a community to achieve its vision. It is important and forward thinking and seizes current opportunities. It can either stand alone, or it can guide actions that will improve health.
STRUCTURAL RACISM: Racial bias across and within society. It’s the cumulative and compounded effects of an array of factors such as public policies, institutional practices, cultural representations, and other norms that work in various, often reinforcing ways to perpetuate racial inequity.
URBAN OR SUBURBAN SPRAWL: The expansion of human populations away from central urban areas into areas with less population density; car-dependent communities.
VALUE: The regard that something is held to deserve; the importance, worth, or usefulness of something.; one’s judgment of what is important in life.
VULNERABLE COMMUNITIES: Neighborhoods or places at risk for experiencing societal injustices based on such factors as race/ethnicity; income level; gender; age; sexual orientation; and physical or learning disability.