To increase health equity in Philadelphia, focus on the social determinants of health | Expert Opinion
Health equity attempts to bridge the gap between the “haves and have-nots” by facilitating access to quality, affordable health for all people.
I’m not a Philadelphia native. I was born thousands of miles away in southeastern Nigeria. Yet, one thing that resonates in both my native Enugu and Philadelphia is the stunning impact of the social determinants of health. According to the CDC, the social determinants are “conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of-life risks and outcomes.”
Simply put, the wealthier you are, the better your health outcomes.
Health equity is integral to the social determinants. Health equity attempts to bridge the gap between the “haves” and “have-nots” by facilitating access to high-quality, affordable health care for all people. Achieving health equity, eliminating disparities, and improving the health of all groups is a top priority for health officials everywhere, including Philadelphia’s new health commissioner, Cheryl Bettigole.
» READ MORE: Philadelphia names Cheryl Bettigole new health commissioner
However, sometimes I wonder whether we can ever truly achieve health equity. The aftermath of slavery and systematic racism in the United States and decades of colonialism and neglect in African countries such as Nigeria have resulted in what can appear to be insurmountable barriers to overall well-being for Black people all over the world. Moreover, socioeconomic status is a consistent and reliable predictor of a vast array of outcomes across a person’s life span, including physical and psychological health.
The COVID-19 pandemic has exposed and aggravated severe and pervasive health and social inequities in America and the rest of the world. It is shocking that almost 1 in 4 Philadelphia residents lives in poverty, and people of color represent the vast majority of the city that is considered the poorest in the United States. In my native Nigeria, the number goes up to 40% of the total population or roughly 83 million who live below the country’s poverty line.
If we focus on mental health, it is well-demonstrated that Black people are less likely than their white counterparts to seek treatment for conditions such as anxiety and are also more likely to prematurely end treatment. Furthermore, if we draw parallels between Black people in both Philadelphia and Nigeria, there are common themes of lack of access and knowledge of resources to address conditions such as depression and anxiety. These deficiencies have resulted in job losses, separation from families, incarceration, and even suicide and substance abuse for many Black people who are unable to effectively cope with mental health issues.
There are hopeful signs. For example, in March 2020, Philadelphia City Council announced a poverty action plan with new investments and strategies to lift 100,000 Philadelphians out of poverty by 2024. Globally, the United Nations Secretary-General has established a dedicated COVID-19 Response and Recovery Fund to complement efforts in low- and middle-income countries to address the socio-economic impact of the COVID-19 crisis.
Industry is also getting in on the action. In March 2021, Merck, became the ninth manufacturer to join the global network of another pharmaceutical giant, Johnson and Johnson, in an effort to increase worldwide access to J&J’s COVID-19 vaccine worldwide. Only time will tell the impact of these fairly nascent collaborations, but sustainability in these concerted efforts will help to facilitate the much-needed change that we need to ensure health equity.
Digital health is also making a difference because mobile apps, websites and even telehealth are enabling patients to gain access to innovative tools that can provide real-time support by using medical experts and peer-to-peer networks. Tailored solutions such as the African American Wellness Project (AAWP) hold promise based on shared experience and heightened access to innovative health solutions. However, there is still room for improvement in training the next generation of physicians, allied health professionals, and minority health experts who are racially and ethnically diverse.
Sophia Ononye-Onyia is a Yale-trained molecular oncologist and founder of the Sophia Consulting Firm, a New York City life-sciences marketing and communications consultancy. She is also the host of her firm’s Amplifying Scientific Innovation Podcast.