Group of patient wearing face masks, standing in lines at vaccine check in desk
Health1/04/2021 12:00:00 AM

Care equality vs. care equity – what’s the difference?

Covid-19 has clearly made a significant impact on the world today. Before the pandemic, we had already begun hearing a great deal about the social determinants of health and their importance on society. But the effects of Covid-19 have only brought this matter into sharper focus.

Research shows that 80-90 percent of healthcare outcomes today are impacted by the social determinants of health, with variables being broken down into five key areas:

  1. Neighborhood and built environment (where you live, or your zip code)
  2. Health and healthcare (access to care)
  3. Social and community context (your personal support system)
  4. Level of formal education (highest degree of schooling you have successfully completed)
  5. Economic stability (income and ability to afford food, housing, and clothing)

The bottom line is where you live, how much you make, and your education level make a significant impact on your ability to be and stay healthy.

Even prior to the pandemic, the notion of living in a country that could provide “equal care for all” just wasn’t the complete answer. Individual needs are based on individual circumstances, so many healthcare systems began creating specialized “centers of excellence” for cardiac, stroke, and orthopaedic care, for example. And while these centers certainly provided the best outcomes for individuals bearing these circumstances due to the high volume of cases they saw, many people weren’t able to access or benefit from their efficacy simply because they couldn’t get to them. Think about it, if you don’t have access to a car to drive to these centers, let alone possess a drivers’ license, or if there isn’t any available public transportation, these centers of excellence suddenly become more like centers of inaccessibility.

COVID-19 pandemic emphasizes care equity

COVID-19 revealed fractures in our healthcare and social system. People lost jobs, had food and housing insecurities, and continued to lack access to healthcare. So, in order to have a fighting chance against this new and novel virus, many healthcare systems finally realized they would need to move care and testing into the community, thereby changing the focus from care equality to care equity. This was in recognition of the fact that different people have different circumstances, so different resource options and opportunities need to be made available so that everyone can reach the same outcome. In other words, care needs to be brought to where and when people need it — not just where and when it’s most convenient for healthcare systems.

Palliative care should be part of the treatment plan from the time of diagnosis of an illness through end of life and hospice care.
Karen Mulvihill DNP, APRN, ACHPN, FNP, ACHPB

Care equity is about recognizing a “one-size-fits-all” approach doesn’t work in healthcare. Different populations have different needs; we need to provide care and resources that best meet those individual needs. Care equality meets the needs of a healthcare system, but care equity meets the needs of the community.

As we begin to move forward and out of this pandemic, we need to begin to change the conversation from care equity to care equality. There’s a world of difference between the two, and we should all aim to work together to realize and take the necessary steps to address this significant difference.

Anne Dabrow Woods
Chief Nurse of Health Learning, Research & Practice, Wolters Kluwer
Dr. Anne Dabrow Woods is the Chief Nurse of Wolters Kluwer, Health, Learning, Research and Practice business at Wolters Kluwer where she drives the strategic development of evidence-based solutions for nurses and nursing institutions.
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