Health Equity: What Does it Mean?

The upcoming November APHA meeting has as its central theme Health Care equity. For a nation and a world in deep trouble because of global warming, human trafficking, worldwide drug and arms trafficking, increasing risk of resumption of an arms race that includes nuclear weapons along with the emergence of nativist autocracies, one might ask "Who Cares?" The answer isn't Blowing in the Wind (apologies to Peter, Paul and Mary) The answer is we all must care because at its core is the question of the role of government.

We have examined issues around gun violence, anxiety/depression, opioid addiction, alcoholism, the critical nature of appropriate use of emergency facilities etc. and the vulnerability of our key health care providers to all of the vulnerabilities that beset the rest of us.

That vulnerability manifested by higher addiction rates, higher suicide rates, increased burnout, increased evidences of criminal moral turpitude places healthcare, already under attack for its governmental (our taxes) dollars into a category of breathable port of entry for both adventitious and subversive attack.

In continuation of the theme of conversion of protective assets into relative effectiveness into lesser potency and even a venue for attack,we find that women, the bulwark of family health scrutiny and defense have a 10 to 20% increase in addiction, crime and nearly 50% in suicide. Their failure in nurturance and child care has brought aging grandparents back into the picture of childcare and education causing them to require more attention while having less to provide healthcare for themselves. Superimposed on all of this is the surging women's rights movement characterized by me-tooism. Worldwide in influence and support the women's rights movement is in support of civil liberties, abortion rights, etc. The "blue wave" that is expected to surge across much of America is expected to come largely because of women (mostly suburban and educated) with much less support from males. In a world of symbolic interaction violence against women has increased and that includes arrest and police shooting. I have seen and experienced numerous protests and attempts by women to gain redress or to claim power. In my limited experience, none has ever succeeded. Most have foundered by significant women settling for much less and or opting for the protection of male dominance of the "Father knows best" variety. It is hard to know whether or not this has evolutionary survival value but the avoidance of the autocratic state wherein healthcare responsibility is not seen as a function of government and may depend on the defeat of primal instinct.Joseph Telfair president of the American Public Health Association has declared: "We can and will make our country and the broader world a better place. We can advance. We will make our little drops of water into a mighty ocean." Let's hope he is right and a public health perspective can win out over privatism, greed and stupidity.