It’s no secret that a person’s overall health and wellness can depend a lot more on factors outside the doctor’s office than inside it. A person’s housing, education, access to healthcare, social inequities, institutional inequities and other social determinants of health play into a person’s overall health. 

Health equity challenges exist around the globe. However, the COVID-19 pandemic and social challenges in the U.S. have put social determinants of health and health equity into the spotlight. 

“You need passion. You need commitment. You need a good understanding of the issue. These are complex issues. These are things that are much larger than purely health,” Dr. Walter Suarez, Executive Director for Health IT Strategy and Policy for Kaiser Permanente's Technology Risk Office, said today at HIMSS21. “You need a large network of people to address this.”

Around the world there are glaring inequalities when it comes to access to housing and food. 

“Truly the statistics are staggering. Around the world more than 1.5 billion people lack adequate housing, one of the elements critical in the health of an individual. Over one billion people face hunger. It’s not just who faces hunger, but how many people are malnourished,” Suarez said. 

But this isn’t a new challenge. “Inequities and disparities have existed for [the] entirety in society, the economy, and in health and healthcare,” Suarez said. “It does exist around the world.”

Suarez noted that health equity and health disparities are different. For example, he said health disparities are the differences in health and healthcare. 

“Health equity can be viewed as both a process in reducing disparities as well as an outcome of the ultimate goal of eliminating disparities,” he said. 

Traditionally, healthcare providers have focused on treating patients after they get sick. However, if providers start looking at inequities early, that could change in the future. 

“Inequities upstream lead to disparities downstream. Traditional healthcare has focused on downstream interventions to address incidents of disease. … Now we are only recently paying attention to the moving actions upstream,” Suarez said. 

Tech may be able to help capture social determinants of health information, he said. 

However, there are several challenges in data capture and exchange including consent management including data sharing, SDoH data standardization, concerns over data collection and unnecessary medicalization of social determinants of health, Suarez said. 

“First take, of course you need to identify health disparities and the levels that those exist [on] … Then we need a policy agenda. Here it's not just a national policy agenda or regular framework. It’s also a policy agenda for organizations to implement practices that eliminate disparities and structural elements in the organization that fosters disparities. Then execute those and evaluate those using short-term and long-term measures. Then you assess.” 

Suarez proposed a framework for both countries and healthcare systems to help tackle inequities. His suggestions for countries include dismantling structural racism and discriminatory practices, as well as establishing policy to remove financial barriers. The recommendations also include establishing a global observatory on health equity. 

“Many countries have implemented digital health plans or e-health plans. They should not develop a plan to address health equity.”

As for the future, looking at inequities instead of disparities could change the care paradigm. 

“This is not just about health, this is also about the wellbeing of individuals. We are moving up the stream, which is a larger concept of wellbeing.”