What Is The Difference Between Health Equity and Health Equality?
While the term health equity is used widely, a common understanding of what it means is lacking. Health equity, first of all, does not mean “equality.” The Robert Wood Johnson Foundation proposes, "Health equity means that everyone has a fair and just opportunity to be as healthy as possible.” So equality is ideal, but achieving health equity is a process.
Working towards decreasing barriers such as poverty, geographic discrimination, lack of education, and accessing fair wage employment, adequate housing, and healthcare provides a foundation for health equity. Uncovering and reducing the consequences of powerlessness requires steady perseverance in all sectors, health and wellness coaching included.
The health and wellness coaching industry must base its training and develop competencies recognized by ethical and human rights organizations and supported by health sciences research. A clear dialogue about how to act is essential.
The Robert Wood Johnson Foundation advises four ways to reduce health disparities to increase health equity.
First, we have to identify them. Healthcare professionals, including health coaches, must consider educational variables, geographic location, working environments, poverty levels, and social inclusion/exclusion.
Second, we must shift our focus to marginalized groups and change the policies, laws, and practices of exclusion. As health and wellness coaches, we can begin with the environments that affect our patients.
Third, we must go to the source and end institutional social conditions that create inequities. Ongoing monitoring of gaps between the advantages and disadvantages is imperative.
For all sectors of society, certain healthcare and health and wellness coaching must reassess their strategies, look at outcomes, record data, and continue to develop strategies to address disparity issues. For coaches, more and more research shows the possibilities. (Braveman, et. al 2017)
In an article entitled “Navigating the System: The Rise of Health Coaching,” researchers from the Rockefeller Foundation concluded that based on research conducted on the health of the urban working poor, Health Coaches play critical roles in conveying patient history, motivation, and cultural context while delivering care. Coaches assess individual needs, make realistic recommendations and assist patients with health system navigation. (Muraguri and Munn, 2016)
Based on their research, former Sr. Associate Director Mwihaki Kimura Muraguri and former Senior Program Associate Monica Munn summarize their findings from the Rockefeller Foundation, demonstrating that successful health coach programs in diverse, lower socioeconomic populations demonstrate three essential qualities:
1. They use local health coaches from similar backgrounds, cultures, and ethnicities as the patients they care for. Inside community knowledge helps with effective behavioral influence.
2. Health coaches need continuous training regarding the specific health needs of a population, like diabetes testing, local eating and movement habits, and cultural dietary restrictions. Coaches need “refresher courses” and continuing education.
3. Coaches establish long-term relationships with patients and provide consistent care, increasing their healthcare knowledge and elevating their well-being.
An Inclusion Health and Wellness Coaching Certificate will give you the tools and knowledge to serve more diverse and marginalized populations based on the following:
Effective Prevention Requires a Comprehensive Approach
The CDC states that we must recognize gaps in action to serve diverse sectors. Ignoring them hurts all populations. (Centers for Disease Control and Prevention, “Prioritizing Minority Mental Health,” July 12, 2022) The Wellness Coaching Elevated Inclusion Course emphasizes that society will benefit when people from BIPOC, LGBTQ+, lower socioeconomic groups, and those that move little can access physical and mental health care and experience more supportive social conditions, as well as freedom from lacking access to mental and physical health resources. Heath coaches can adapt some of the CDC guidelines to approach equity by:
Receiving culturally informed training and trauma-informed training
Offering sliding scale fees,
Offering free and confidential resources to help people of color navigate the issues of stigma in their communities,
Administering self-help questionnaires or self-assessments that release patients from the burden of stigma while allowing them to share their needs,
Reaching out to families, neighbors, friends, and other members of their communities to discuss wellness issues, utilizing language that avoids stigmatizing while encouraging conversations about mental and physical health and spiritual well-being,
Learning about microaggressions and how to prevent them, understanding implicit biases and other forms of discrimination to alleviate the problem in oneself and the wellness community.
Doing the deep, personal work of addressing one’s biases and attending impactful training on anti-racism.
Health coaches can coordinate with public health organizations using different strategies, such as:
Promoting diverse programming that is appropriate for people of racial and ethnic minority groups at all levels,
Engaging in the planning, implementation, and evaluation of diversity studies,
Using the data on wellness needs to identify populations that need help and develop organizational priorities and programs,
Utilizing the Social Determinants of Health (SDoH) to facilitate and design wellness programs - putting words into decisive actions,
Keeping track of the impact of racism among patients, measuring it, and using it to develop better practices to reduce disparities between BIPOC and LGBTQ+ communities.
Changing health-related materials to ensure they are culturally and linguistically appropriate,
Examining any language used or communication reflects so it reflects Health Equity principles.
Partnering with organizations that will fill gaps in expertise.
A Nurse and Health Coach Help Alleviate Food Insecurity
Meg Jordan, Ph.D., RN, NBHWC, served as a case investigator and contract tracer in a COVID-19 hot zone. She worked in a neighborhood in San Francisco with Hispanic families in the spring of 2020. Jordan reports that she continually used her National Board Certified Health and Wellness Coaching skills during the pandemic. Alleviating food insecurity with coaches and facilitating brainstorming sessions proved effective. In one example, a homeless couple transformed a local food bank into a discounted farmers market with fresh produce and nonperishable items for their peers. It did not substitute for Medicaid or SNAP (food stamps); however, those who received the benefits of coaching became empowered and influenced their peers and families. Jordan proved that group and one-on-one coaching worked effectively with public health initiatives to moderate the social determinants of health (SDoH). (Jordan, 2021)
An Inclusion Health and Wellness Coaching Certificate will give you the tools and knowledge to serve more diverse and marginalized populations based on the following:
Race
Ethnicity
Gender
Age
National origin
Religion/No Religion
Ability
Sexual orientation
Size
Socioeconomic status
Education
Marital status
Other identities
Health and wellness coaches are ideally situated to work towards inclusive healthcare practices as part of interdisciplinary teams with organizations or in a clinical setting.
Braveman P, Arkin E, Orleans T, Proctor D, Plough A., “What Is Health Equity?”, Robert Wood Johnson Foundation, May 1, 2017, Seen on: https://www.rwjf.org/en/insights/our-research/2017/05/what-is-health-equity-.html May 6, 2023
Jordan, M. A., “The Role of the Health Coach in a Global Pandemic. Global Advances in Health and Medicine”, August 9, 2021 https://doi.org/10.1177/21649561211039456
Mental Health California, Brother Be Well Course Series, “The Impact of Intergenerational and Community Trauma,” 2023, Please see: https://brotherbewell.com/
Centers for Disease Control and Prevention, “Prioritizing Minority Mental Health,” July 12, 2022
Global Wellness Conversations “The Doctor is INclusive: Wellness in the African American Community,” January 2023, Courtesy Global Wellness Summit via YouTube
Muraguri, Mwihaki Kimura, and Monica Munn, “Navigating the System: The Rise of Health Coaching,” The Rockefeller Foundation, March 14, 2016, Seen on: https://www.rockefellerfoundation.org/blog/navigating-the-system-the-rise-of-health-coaching/
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