Health Equity “Providing all people with fair opportunities to attain their full health potential to the extent possible.” Braveman, 2006 Health Equity & Prevention Primer Available at

What is Health How do we define what health means……

What is Health? “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

And… “Health is not a condition, it is an adjustment. It is not a state, but a process. The process adapts the individual not only to our physical, but also our social, environments" (President’s Commission, 1953, p. 4)

Prerequisites for health What are they? What do we need in order to maximize our health?

Prerequisites for health Safe and secure food Safe and stable housing Adequate income Access to education Access to health care Stable ecosystem Sustainable resources Peace Social Justice

Social Determinants of Health The circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics. (Social Determinants of Health Key Concepts, World Health Organization)Social Determinants of Health Key Concepts

Social Determinants of Health

So is everyone in our society Equally healthy? Examples…….

Health Disparities “Differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States” National Institute of Health

“Disease is a socially produced phenomenon…Critical perspectives on emerging infections must ask how large-scale forces come to have their effects on unequally positioned individuals.” Paul Farmer, Infections and Inequalities

What are Public Health Interventions? Preventative rather than curative Population-level, rather than individual-level Prevent rather than treat a disease through surveillance of cases and the promotion of healthy behaviors. surveillance In addition to these activities, in many cases treating a disease may be vital to preventing it in others; distribution of condoms are an example of a public health measurecondoms Evidence-based

Structural changes are……new or modified programs, practices or policies that are logically linkable to HIV transmission and acquisition and can be sustained over time, even when key actors are no longer involved.

Structural Interventions These changes may directly or indirectly impact individuals. Structural interventions for HIV prevention aim to modify the social, economic and political structures and systems in which we live. Rather than attempting to change individual behaviors, structural interventions aim to change environments