What’s Public Health got to with… Infusing Health Equity Across the Life Span

The Centers for Disease Control defines health equity as “the state in which everyone has a fair and just opportunity to attain their highest level of health.” When the conditions for health equity are not met, health disparities arise in the form of “preventable differences in the burden of disease, injury, violence, or in opportunities to achieve optimal health.” These disparities can exist across a variety of dimensions, including race, ethnicity, gender, sexual orientation, disability status, socioeconomic status, and age. Furthermore, the concept of “cumulative aging” recognizes that social and economic conditions that exist early in life, whether positive or negative, may “accumulate” over the life course. Recognizing that disparities experienced by older adults can be exacerbated by early-life social and economic disadvantages helps underscore the importance of public health prevention activities, from childhood to older age.

For older adults, inequitable conditions can lead to poor health outcomes:

To address and eliminate these disparities, public health practitioners can work across sectors to improve upstream factors that impact older adults’ health. This can include considering how social determinants of health either contribute to or mitigate the impacts of disparities on the health of older adults.

The February 2024 AFPHS training highlighted key resources presented by the National Council on Aging’s Center for Healthy Aging and Justice in Aging that are designed to increase understanding of health disparities and offer strategies to improve health equity. In 2022, the National Council on Aging released Chronic Inequities a report measuring the financial and health impacts of multiple chronic diseases in older adults. The major findings of this report include that women and people of color are more likely to experience higher treatment costs and greater lost wages due to chronic diseases, while also having the fewest financial resources to draw upon. These results demonstrate the need for intersectional, equity-centered solutions to one of the most common problems American older adults face today: the impact of chronic disease.

Last year, Justice in Aging released Justice for Tribal Elders: Issues Impacting American Indian and Alaska Native Older Adults  which examines the specific health and economic barriers for tribal elders and introduces the cultural competencies needed to best serve this population. This report also includes policy and programmatic recommendations for addressing structural inequities for tribal elders. During the February 2024 AFPHS training, Justice in Aging attorney Sahar Takshi noted that community members were involved at every step of the process of planning and researching the report, providing one example of how Justice in Aging prioritizes equity organizationally.

Advancing health equity is at the core of the AFPHS 6Cs Framework. Here are further examples of how the Framework can guide efforts for integrating equity and healthy aging in all areas of age-friendly public health activities:

  1. Creating and leading a commitment to integrating health equity into work across the age-friendly ecosystem. 
  2. Connecting and convening multi-sectoral partners to act on health disparities from a variety of perspectives and with a diverse range of collaborators.
  3. Coordinating with relevant agencies to support robust data collection and find new ways to collaborate on equity-related issues.
  4. Collecting, analyzing, and translating data to ensure that all older adult communities are well-represented, especially hard to reach populations or those that have typically been underrepresented in research.
  5. Communicating health information in culturally and linguistically accessible formats, as well as through channels that are proven to be effective with older adults.
  6. Complementing existing community-level programs that work to mitigate health disparities in the older adult population.

See these resources for additional information: