“Equality is giving everyone a pair of shoes, 
​Equity is giving everyone a pair of shoes that fits.”
​~ unknown

The fight for reproductive dignity, care, and autonomy is neither new nor singularly faceted. Inequities exist in health outcomes by a person’s sex and/or gender identity, which in turn impacts gender equity, a major determinant of health equity. These ongoing health inequities have been highlighted, especially in recent months. In fact, women are currently faced with significant adversity in relation to reproductive rights, which ultimately affects the health of all women, both physically and mentally. Women are experiencing ongoing attacks on their reproductive rights and are losing the ability to choose outcomes for themselves. This is in addition to other ongoing crises, such as the disproportionate rates of adverse maternal health outcomes within the Black community and other groups that have been marginalized - or experience disadvantage and bias - as the result of related health, racial, and social inequities. 

The COVID-19 pandemic has caused hardship and many stressful situations for young people in the United States. Amongst many other challenges, the mental health of many college-aged students has drastically been affected by the pandemic. College-aged students, between the ages of 17 and 22, have reported an increase in feelings of anxiety and depression since 2020. Main causes of such increase include social isolation as well as the health effects and the stress related to a long state of uncertainty. It is also difficult for many to receive adequate support from mental health professionals.

As we enter 2022 with the hope for an increased emphasis on advancing health equity in our society, we want to mark today the 6th National Day of Racial Healing, which takes place annually on the Tuesday after Martin Luther King Jr. Day, and seeks to bridge racial divides to transform our communities for our children and future generations. This national day of truth telling, dialogue, and collective purpose is part of the W.K. Kellogg Foundation’s Truth, Racial Healing and Transformation (THRT) efforts, and a much needed reminder on the importance of standing together against racism and promoting healing.  

by Tina Wong, Melanie Mc Dermott, Toni Lewis, and Renata Schiavo

​In the United States, local governments play a key role in providing, promoting and regulating health services, economic advancement, education, land use and transportation, and safe neighborhoods with clean air and water.  Even absent explicit discrimination, when that role is affected by implicit bias—the attitudes or stereotypes that unconsciously affect understanding and behavior—it leads to unequal access and unequal allocation of resources in these critical domains.  The ability to vote, approvals of FHA loans, and access to quality education, greenspace and more, are just a few areas contributing to our overall health and wellbeing in which municipal bias continues to produce inequitable outcomes. Communities of color, low-income groups, people living with disabilities, LGBTQI+ groups, immigrants, and other marginalized social groups experience barriers to critical opportunities as a result. These inequitable outcomes are further reinforced by structural racism and other forms of social discrimination that exist in biased policies and practices in our local governments. 

Urban design is a critical concept for supporting the infrastructure and well-being of a city, catalyzing a higher quality of life, and optimizing equitable built environments (1,2). When constructs of urban design are paired with human design frameworks, approaches, practices, and principles, the potential to positively shift the social and political factors of health (SPFOH) in an equitable manner is more attainable (3,4). Without such frameworks, approaches, and inclusive practices, the concepts of urban design negatively impact people globally. When urban design has been paired with motives of xenophobia, racism, or gender bias, the comprehensive SPFOH have compromised livelihoods as seen in historical and recent examples in both the United States and Europe (5-7). 

We hope you will be able to dedicate some time to relax and spend time with family and friends after a year of world-shifting events. Our team at Health Equity Initiative has been catching up on reading and listening these past few months, and these are examples of what we are reading or listening to on health, racial and social equity. Happy summer, and stay healthy and safe! 

If you're reading this blog, chances are you care deeply about achieving equitable outcomes. But how do you know if you're making progress?
 
Working for health equity—defined as “all people having a fair and just opportunity to be as healthy as possible” (1)—is necessary, but how do we know when we have created environments that foster equity? And how do we ensure that terms like equity and inclusion aren’t just flimsy buzzwords, or worse, used to “equity-wash” something that isn’t equitable at all?
 
To address these concerns, Gehl (an urban research and design consulting firm) teamed up with the Robert Wood Johnson Foundation (RWJF) and colleagues at the former Gehl Institute, to create the Inclusive Healthy Places Framework, which defines principles and metrics to guide and evaluate public space projects that support health equity (2). The Framework aims to demonstrate that public realm is a key component of health equity, and to create a platform through which more cross-sector partnerships can develop.

Sadly, many students are not provided with an opportunity to learn about how their government works and may feel powerless about their ability to make an impact. Some may feel cynical and disconnected from public institutions and from centers of power. Educating students about local government, and modeling how to engage with those in authority would give them access and agency—both in local matters and in decisions affecting their lives. Most importantly, it would provide them with the skills they need to assess the impact of policies throughout their lives.