By Diana Weber, M.D., Medical Director, Blue Cross and Blue Shield of New Mexico
April is National Minority Health Month, an opportunity to raise awareness about disparities in health care that disproportionately affect minorities. This year’s theme for National Minority Health month is “Give Your Community a Boost!”
As we experience the waning of COVID-19 in our state, it is important to maintain our vigilance by making sure all are vaccinated and receive a booster against COVID-19. This is especially important in those who are older than 65 and those with underlying medical conditions. During the pandemic, we have observed how these disparities can impact minority, elderly and rural communities.
What is health equity?
Health equity means optimal health for all. As defined by the Centers for Medicare & Medicaid Services, “Health equity means that everyone has a fair and just opportunity to be as healthy as possible.” Equity is not the same as equality. Equality means that everyone receives the same funding or services. Equity means that people receive funding and services based on their needs to achieve equal outcomes.
Here is one way I have heard the difference described: Equality is like giving everybody the same bicycle, regardless of an individual’s size, age or abilities. Equity means everyone is given a bicycle based on their needs. So, a child would get a very small bicycle, perhaps with training wheels, and a taller adult would get a larger bike.
When we talk about health equity, we mean that care is allocated differentially based on the needs of the populations. In New Mexico, for example, some populations have a higher incidence of diabetes. Therefore, we need to expend more resources on controlling diabetes in those communities to achieve health equity.
How do social factors impact health?
Our health is determined by more than the medical care we receive. Our well-being can also be dependent on what are called social determinants of health. These include our physical environment, our social circumstances, genetics and biology, and our individual behavior. Health varies by determinants such as neighborhood, education level, economic prosperity, exposure to toxins in the environment, language, safety, and access to transportation and high-quality food.
How did COVID-19 impact communities of color?
Nationally, we saw that COVID-19 infection rates were higher in communities of color, and complications and hospitalizations from COVID-19 were also higher in this group. Explanations for this disparity include the fact that many minorities were more likely to be essential workers and unable to work from home, to live in multi-generational and higher density environments, and to experience gaps in infrastructure and resources that lead to decreased access to health care.
In New Mexico, we saw how Native communities were affected due to factors such as higher rates of underlying medical problems — including diabetes and hypertension — and lack of access to medical care, personal protective equipment, internet connection and running water.
How are rural communities impacted by health inequity?
Another group that can be affected from health inequity and adverse social determinants are those living in rural communities, which includes a large segment of New Mexico. People living in rural or frontier areas are often older and have more underlying medical conditions. Their access to primary care physicians, pharmacies and grocery stores is limited. These factors can lead to health inequity.
What can we do to bring awareness to health inequity in our communities?
As a community, we can acknowledge how long-standing lack of investment in infrastructure, poor access to health insurance and health care, insufficient minority representation in the physician workforce, suspicion of the health care establishment by racial and ethnic minorities, and language barriers can result in health disparities. When we recognize how our neighbors have been impacted by health inequity, we can commit to building equitable and healthier communities.
If you have a health question that you would like to be considered in Ask a Health Care Professional, please email [email protected] BCBSNM will select questions that may appear. Questions will not be personally answered. The opinions expressed in this column are solely those of the author and not necessarily those of BCBSNM. This column is not intended to be a substitute for professional medical care.