Following the COVID-19 pandemic of 2020, and the national declaration of a Public Health Emergency (PHE), many government agencies in the world became concerned with the concept of health equity and started to build and bolster their programs in service of it. Health equity generally manifests in government healthcare agencies via a collection of efforts that are meant to positively impact health outcomes and eliminate disparities for historically marginalized groups. Health equity does not have one standard and consistent definition for what it is or how to advance it, even in its current application to government policies, strategies, and activities.
The experiences of the 2020 pandemic demonstrated that human lives are not valued equally as certain communities suffered disproportionately based on race, ethnicity, and social condition. The reality of how populations are socially valued and then stratified perhaps cannot be contained within the concept and actions of advancing health equity despite many governmental agencies building new programs with the intention of addressing the inequities highlighted by the pandemic. These new government programs and practices aiming to advance health equity include non-traditional methods to address health disparities, such as providing access to food security and housing to mitigate the impact that social condition has on health.
This dissertation aims to answer the questions, what is health equity? And, once we know what health equity is, can it be achieved? As exemplary of advancing health equity through policy, initiatives, and strategic plans, this dissertation includes analyses of health equity concepts within Public Health Emergency (PHE) policy and actions during the pandemic, and resulting policy, strategy, and action that was inspired by the pandemic at a California state Medicaid department.
This dissertation also includes a discussion of the missing elements of advancing health equity within government policies and practices, and why the same elements may be absent from social welfare programs altogether. Lastly, this dissertation includes a discussion of where we might go from here with this knowledge and under current conditions if we wish to live in a more equitable society.