I’m a transplant from Washington, D.C.; I know and understand the issues of large cities.
Philadelphia has so much to offer: a wonderful history (including being the first World Heritage City in the U.S.), beautiful art, and fabulous dining experiences. In addition, it’s a city of many medical firsts — the first hospital, the first medical school, the first pharmacy, and the first children’s hospital in the U.S. Unfortunately, it also has some of our state’s worst health outcomes.
A lot of people today are talking about health equity — and it’s about time! At Independence Blue Cross (Independence), we consider health equity and improved health outcomes to be among our most urgent priorities, so you will be hearing a lot about it from us — in this blog and elsewhere.
I’d like to take a moment to explain what health equity means and why it matters. Because before we can all work together towards health equity, we have to start with a shared understanding of this issue.
What Is Health Equity?
Health equity means that everyone has a fair opportunity to be as healthy as possible, regardless of who they are or where they live. And it’s clear that in our city there are vast disparities between communities when it comes to health.
Health is incredibly complex. There are multiple factors that contribute to our overall health and well-being. Among these factors are social determinants of health (SDOH), variables that may create huge differences in the experiences and exposures of people in different demographics.
SDOH can either serve as advantages or disadvantages to our health, and can include:
- Financial situation
- Social connections
- Employment opportunities
- Language fluency and literary skills
- Housing conditions
- Healthy environments
- Access to healthy food
- Access to health care
- Experiences of discrimination
The differences in health outcomes we see are the result of hundreds of years of a pattern of structural barriers for some Americans and opportunities for other Americans.
The Health of Philadelphia
The sixth-largest city in the U.S., Philadelphia is also highly segregated, and is the lowest-ranked county in Pennsylvania for both health outcomes and factors. That is no coincidence. If you look at the life expectancy in Society Hill versus in Strawberry Mansion — two neighborhoods fewer than five miles apart — there’s a 20-year difference.
Philadelphia also has the highest poverty rate of any U.S. city with a population of over one million. Nearly one quarter of Philadelphians live below the poverty line (24.3%). That number is even higher (40%) for our Latino neighbors.
The COVID-19 epidemic has made racial health disparities clearer than ever before. Higher percentages of Black and Latino Philadelphians have been infected with the coronavirus, and have suffered a higher COVID-19 mortality rate, than non-Hispanic white Philadelphians. These differences are not caused by race but by racism, which negatively impacts the social determinants that help support good health.
Due to systemic racism and gaps in opportunity, Black and Latino people:
- Are more likely to work in front-line, lower-wage jobs that offer less flexibility.
- Are more likely to live in crowded, multigenerational housing settings where physical distancing is much harder.
- Have had lower vaccination rates, due in part to less access to the things that make vaccination easy (like time off work and transportation) as well as an understandable distrust of the medical community because of a history of systemic racism.
- Face increased risk for the chronic health conditions that can make COVID-19 infections more severe, like heart disease, diabetes, and obesity.
Health Equity is Not Just Race-based
Many other health disparities exist in our society and in our region. Different people have different levels of risk for poor health outcomes based on:
- Gender and gender identity
- Sexual orientation
- Body size
- Formal education
- English fluency
- Literacy and technological skills
- Physical abilities
- And more
In upcoming health equity blogs from Independence, we will look at many of these health disparities, illustrate the challenges that various populations face, and explore what we can all do about them.
Things Can Change
Health disparities of any kind are unacceptable. The causes of disparities are complex and deeply rooted. And at Independence, we’re committed to doing whatever we can so all of our members can access the same high-quality health care.
We have been partnering with The Philadelphia Tribune for the last year on the “Our Community, Our Health” public education campaign. We are collaborating with the Urban Affairs Coalition and Mother Bethel Church on the Ending Racism Partnership. We recently announced our partnership with Accelerate Health Equity, a city-wide coalition to prioritize and address health disparities.
But that’s just the beginning. Look for more news in the coming months about how we plan to help all our communities access not only affordable health insurance, but also many services and resources that can make a big difference.
I feel hopeful for a future where we achieve health equity in Philadelphia. I’m absolutely certain that, given the energy and effort that local and national institutions are devoting to these efforts, we will improve health outcomes in our area.