The Robert Wood Johnson Foundation (RWJF) provides the following definition for health equity: “Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”
The obstacles to health equity are social and structural in nature. The World Health Organization (WHO) defines social determinants of health as “the conditions in which people are born, grow, live, work and age.”
The addition of structural determinants to the framework of social determinants of health further elucidates the causation of health inequities. Structural determinants are the “social and political mechanisms that generate…stratification and social class divisions in society and that define individual socioeconomic position within hierarchies of power, prestige, and access to resources” (World Health Organization’s (WHO) Commission on the Social Determinants of Health.
Structural determinants therefore operate through social determinants in shaping health outcomes. For example, racism shapes public policy, which differentially impacts peoples’ living and working conditions, ultimately resulting in inequitable health and wellbeing.
Health equity research interrogates the dynamic, cumulative, and interrelated structures of power, environmental conditions, and economic systems that produce inequities in health between different populations. Health equity research also identifies, promotes, and leverages unique community-informed protective factors that are traditionally undervalued and understudied.