Diversity, Equity, and Inclusion (DEI) in Post-COVID Times
Your age, education, zip code, or employment background can determine your health status and access to quality healthcare in the U.S. and other parts of the world. To raise more awareness about this occurrence, public health experts and educators mark January as Social Determinants of Health (SDH) Month. This month-long observance presents an opportunity to recognize how economic and social factors can enhance or hinder health.
Social Determinants of Health and Their Influence
Social determinants of health (SDH) influence various aspects of our lives, including our ability to preserve our health, get needed medical attention, stay safe, and enhance our quality of life. SDH typically includes:
- Prevalence of discrimination, racism, and race-based violence
- Access to exercise and nutrition
- Air and water quality or the presence or absence of pollution
- Educational background and opportunities
- Income and employment opportunities
- Literacy and language skills
- Safe neighborhoods, transportation, and housing
SDH has tremendous impacts on health inequities and disparities. For example, your nutrition might suffer if your neighborhood does not have a park with lots of green space or if you do not live close to a grocery store with healthy food. You may also be at risk for obesity, diabetes, and other chronic conditions. Also, being subjected to regular episodes of racial discrimination can affect your mental health, making you more susceptible to anxiety, depression, and other psychological issues.
Understanding and recognizing the significant role of SDH can increase awareness of and advance diversity, equity, and inclusion (DEI) in all aspects of life, especially in medicine and healthcare. These social determinants represent resources essential for enhancing people’s quality of life. They also keep people safe from harm, allowing them to obtain gainful employment and find adequate medical attention when they get sick or injured.
Unfortunately, people living in some neighborhoods or belonging to marginalized groups do not have equal access to these resources, putting them at risk for diminished health and lower quality of life. Data from the U.S. Bureau of Labor Statistics also shows that jobs with low wages or hazardous conditions are disproportionately held by people of color, who can have a more challenging time accessing proper nutrition and adequate medical care. People of color also experience unemployment at higher rates than their white counterparts.
DEI after the COVID-19 Pandemic
With the post-COVID return to physical workplaces, DEI gaps are still present. The world of work can impact a person’s health, given that one social determinant relates to working conditions and employment opportunities.
A 2021 Gallup poll found that 25% of Black employees have reported workplace discrimination. Another Gallup survey revealed that only 17% of LGBT workers “strongly agree” that their companies care about their well-being. Lower wages and other forms of discrimination can adversely affect mental and physical health, making it more challenging to receive necessary care.
Our slow emergence from the pandemic will continue to impact DEI in schools, social contexts, and workplaces for years. Employers, schools, and organizations will need to allocate resources to address disparities that have already existed but were intensified because of the pandemic. Actions that raise diversity appreciation and inclusion will need to be “must-have” rather than “nice-to-have” elements.
Addressing SDH and Improving DEI in Public Health
Increasing awareness of DEI is a start to improving public health and minimizing disparities. It also requires substantive action.
The Centers for Disease Control and Prevention (CDC) initiated Healthy People 2030 to “improve health and well-being over the next decade.” The CDC established an SDH Workgroup that identified ways health experts, decision-makers, community leaders, and educators can promote DEI. Their work focuses on five domains:
- Community and social context
- Economic stability
- Education quality and access
- Healthcare quality and access
- Neighborhood and built environment
The workgroup identified eight objectives for which they are conducting research, collecting data, and tracking progress:
- Increase the number of high school graduates attending college the following fall.
- Raise the employment rate among working-age individuals.
- Increase the number of children living with at least one full-time working parent or guardian.
- Raise the amount of federal data sources that include country of birth.
- Increase the percentage of voter-eligible citizens who vote.
- Decrease the number of people living in poverty.
- Reduce the proportion of children with a parent or guardian who has been incarcerated.
- Decrease the number of families paying more than 30% of their income on housing.
Several agencies and organizations have stepped up to enhance DEI at the local level. For example, the Boston Center for Independent Living in Massachusetts enlisted legal help for community members with disabilities by adopting more accessible equipment and raising care standards. The Minneapolis Health Department in Minnesota increased efforts to help grocery stores in the area stock and sell more vegetables and fruits, reducing food insecurity.
Regardless of the DEI element of community receiving focus, organizations must connect their DEI-related actions to their missions or strategic plans. They also need to set realistic but ambitious goals that have objectively measured outcomes.
Research and materials for this article were compiled, written, and distributed on behalf of the National Public Health Information Coalition. The views and opinions expressed in this blog are those of the various authors. They do not necessarily reflect the official policy or position of the National Public Health Information Coalition or its members.
References
https://health.gov/healthypeople/priority-areas/social-determinants-health
https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0312
https://www.bls.gov/opub/reports/race-and-ethnicity/2018/home.htm
https://news.gallup.com/poll/328394/one-four-black-workers-report-discrimination-work.aspx
https://www.gallup.com/workplace/393983/lgbt-employee-experiences-know.aspx
https://health.gov/healthypeople
https://health.gov/healthypeople/about/workgroups/social-determinants-health-workgroup