Fact Sheet: Top 10 Ways to Improve Health and Health Equity

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The health of Americans has been declining for decades, with harmful effects distributed inequitably across American society.1 Improving health and focusing on the most vulnerable populations will not only improve health outcomes and social well-being, but will also strengthen the economy and help build a strong and equitable future.

To improve and restore the health of Americans, policymakers must make sustained, long-term investments to prevent disease, promote health, and prepare for and respond to ongoing and urgent health threats. By addressing the social determinants of health, such as income, education, housing, employment, transportation, environmental conditions, and neighborhood conditionspolicy makers can improve health, reduce racial disparities and contribute to economic mobility.

This fact sheet and accompanying report outline 10 priorities for improving the nation’s health.

1. Stop the spread of COVID-19

COVID-19 has ranked among the top three causes of death in the United States for most of the pandemic. It has affected mental health, led to long-term illness and disability, and caused economic disruption, with a disproportionate impact on women, the elderly, people with disabilities, residents of congregate care facilities, and people of color. .

To minimize the impact of COVID-19, policy makers should:

  • Continue to invest in national and global response and preparedness.
  • Use multiple layers of protection for communities, rather than just focusing on individual risks.
  • Monitor trends and stay prepared for future surges, while centering equity and identifying early signals that indicate the need for stronger prevention strategies.

2. Invest in public health infrastructure

The public health system significantly affects health, with increased spending leading to outcomes such as reduced low birth weight, foodborne illness, sexually transmitted disease rates, and deaths. Yet the system is both inconsistently funded and chronically underfunded, resulting in a lack of resources for disease prevention, health promotion, responding to emerging threats, labor shortages work and underdeveloped data systems.

Policy makers can strengthen public health infrastructure by taking the following actions:

  • Establish adequate, flexible and sustained annual funding.
  • Enact federal efforts such as the PREVENT Pandemics Act to improve nationwide preparedness.
  • Implement workforce initiatives that encourage worker entry and retention.

3. Address the Epidemic of Opioid and Substance Use

Drug overdoses are the leading cause of rising death rates among young and middle-aged adults, largely due to opioid abuse. The opioid crisis is a challenge to national security, law enforcement, and public health in the United States, but overdoses and deaths are preventable.

Policy makers should fund and prioritize interventions that:

  • Address the root causes of addiction, such as systemic inequalities, poverty and the harmful effects of the criminal justice system.
  • Fund and expand access to prevention, evidence-based treatment, harm reduction and recovery through a whole-of-government and inter-agency response.
  • Target funding to communities most affected by addiction to opioids and other substances.

4. Mitigate climate change and invest in environmental justice

Climate change is described as the “greatest threat” to global public health.2 Climate change and localized pollution disproportionately affect children, the elderly, people with disabilities, low-income communities and people of color. Transformative programs are essential to stabilize the climate, reduce pollution, improve health and save lives.

To this end, policy makers should:

  • Fighting environmental racism and centering equity and justice.
  • Fund transformative programs, such as incentivizing the production of renewable energy and zero-emission technologies and implementing coastal restoration and resilience projects, to ensure global warming is limited to 1.5 degrees Celsius.
  • Reduce carbon emissions from the healthcare sector and prepare it to respond to the health impacts of climate change.

5. Reduce poverty and improve economic stability

Economic stability is essential for health, as people who lack stable employment are more likely to have poor health outcomes. Yet, due to centuries of marginalization, people with disabilities, LGBT people and people of color are more likely to face unemployment and poverty. Interventions to improve economic stability can have lifelong effects.

Policy makers can take steps to reduce poverty and subsequently improve health:

  • Improve access to child care services, as proposed in the budget reconciliation package adopted by the House.
  • Permanently expand the Child Tax Credit and the Working Income Tax Credit to provide essential support to struggling families.
  • Reauthorize the Supplemental Nutrition Assistance Program (SNAP) through Congress.

6. Improve access and quality of education

Early childhood development and education are key predictors of adult health and well-being. Access to quality and affordable higher education is also key to improving economic stability and health. An insufficient supply of licensed child care and the underfunding of many schools, especially those in low-income and rural areas and communities of color, threaten access to quality and affordable education.

Decision makers should fund and prioritize initiatives that:

  • Expand grants and subsidies to child care providers to offset pandemic-related revenue losses and increased operating costs.
  • Address the failing physical infrastructure of schools, including the lack of adequate drinking water, heating, ventilation and air conditioning systems.
  • Detect and manage mental health needs in the school environment.

Reinvest in an accessible higher education system to address centuries of systemic inequities.

7. Improve access to affordable, stable, inclusive, healthy and climate-resilient housing

Housing security is key to ensuring people stay both safe and healthy. Yet 1 in 4 Americans struggle with the availability, quality, affordability and accessibility of housing.3 Housing instability and homelessness disproportionately affect people of color, LGBTQ+ people, people with disabilities, and those involved in justice.

Policy makers should act by taking the following steps:

  • Expand housing choice voucher programs to serve more low-income households.
  • Pass the White House’s fiscal year 2023 budget that includes funding to build affordable housing, make improvements to current public housing inventory, and expand homeownership opportunities.
  • Increase the supply of supportive housing units that integrate affordable housing, health care and other social services for special populations.

8. Improve access and quality of health care

Access and affordability of health care remains a major issue for many Americans, especially those with low incomes and historically marginalized groups. Expanding access to health coverage, reducing the costs of care and treatment, and improving the quality of health care services can improve health and reduce costs.

Policy makers should:

  • Close the Medicaid coverage gap. The budget passed by the House would extend market subsidies federally so those in the coverage gap would be eligible for low-cost or free coverage.
  • Cap beneficiary drug spending and limit price increases to improve access to prescription drugs.
  • Increase access to mental health services by ensuring insurance coverage and expanding laws on the scope of practice of mental health professionals and enforcing parity standards.

9. Strengthen social connections and community safety

Social relationships and interactions are an important protection against health and well-being problems and help to cope with toxic stress. Negative interactions, such as living in environments where discrimination, prejudice, violence, and stigma are prevalent, create toxic stress that results in negative health outcomes. Additionally, social systems, such as the police and the vote, are riddled with inequities that further marginalize people of color and perpetuate health disparities.

Decision-makers can improve community relations and advance population health through the following actions:

  • Support alternatives to policing, such as community intervention programs that empower and center communities.
  • Invest in research that addresses gun violence as a public health epidemic.
  • Pass legislation that protects the voting rights of marginalized communities.

10. Advance racial equity and inclusive policies

Systemic racism, discrimination, and structural barriers contribute to preventable health problems and related economic burdens, resulting in racism being declared a serious public health threat.4 Gaps in addressing the social determinants of health disproportionately negatively impact people of color, people with disabilities, LGBTQI+ communities, and other marginalized groups.

Policy makers should advance racial equity and inclusive policies by taking the following steps:

  • Commit to reducing the racial and economic inequalities that the pandemic has exacerbated.
  • Prioritize the most vulnerable and affected communities when investing in policies that affect the social determinants of health.
  • Partner with and focus on the needs of affected communities and address the root causes of racism and inequity.

Conclusion

New policies must target all drivers of health and recognize the intersectional nature of these issues. The inability of policy makers to address these issues has ramifications in other areas of society, limiting the ability to take meaningful action to improve health and health equity.

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