Anne Warhover is president and CEO of the Colorado Health Foundation.
Editor's note: This piece originally appeared in the winter 2013 edition of Health Elevations, the Foundation's quarterly journal.
No matter where you live in America, you are entitled to what Thomas Jefferson eloquently called life, liberty and the pursuit of happiness. And what can be more fundamental to those unalienable rights than health and health care?
Like education, good health and health care ought to be considered a birthright of every American. During the past century, we have closed disparities in our public education system with laws intended to give every child – regardless of his or her ZIP code – the opportunity to become educated, contributing members of society. While there is still much work to be done, we have identified a good education for all as an ideal worth attaining.
Yet the ideal of attaining the highest level of health for everyone is often fraught with sensitivities. In fact, when the Colorado Health Foundation made health equity the theme of its 2012 Colorado Health Symposium, we expected to generate controversy since many Americans believe that good health is a personal responsibility, not a right per se. I would argue it is both, but more about that later.
Wherever you stand on the debate, it's indisputable that stark health disparities exist in Colorado and nationwide. Study after study shows that your neighborhood, ethnicity, education and income levels determine the quality of and access to the health care you receive, your access to healthy food, your ability to engage in physical activity and ultimately your life expectancy – for better or for worse. Should people from affluent neighborhoods live longer and healthier lives than people who reside in a poor subdivision? I'd like to think that most Coloradans would answer "no."
The latest edition of Health Elevations explores the issue of health equity while looking at how innovative thinkers are bridging the divides by improving health and health care for all. We ask experts (including speakers from the 2012 Symposium) to examine why and how these divides affect individuals' lives and the economy.
As I said earlier, the question about whether health is a personal responsibility or a right isn't an either/or proposition. But taking personal responsibility is more challenging when communities lack the resources where people can practice healthy living; obtain health coverage; and gain access to quality, coordinated care.
In Colorado, I'm encouraged by the work that safety-net clinics and other nonprofits are doing to bridge these health divides. But despite innovative programs and growing public will, the goal of true health equity remains elusive statewide and nationwide.
We live in America, where everybody is entitled to aspire to a quality of life that includes health. Why should we aspire to anything less?
By making health equity a shared value, we can improve life and the pursuit of happiness for hundreds of thousands of Coloradans.
Great conversation, Anne. I think the operational words that Jefferson underscored are inalienable right to 'pursue happiness'. Health is certainly one factor to happiness, as is education and economic circumstances. In the CHF annual symposium, I loved the new perspective Elizabeth Carger brings to the 'social determinants of health'. It may be that the shortest road to health equity and happiness equity will be community engagement. Local community, supported by state and federal programs, should be seen as the critical nexus of change. Creating a 'meta-index' for community engagement is essential to effectively empower collaboration between the key stakeholders. As Elizabeth put it, 'health starts where we live, learn, work and play.'
Posted by: George Swan | 03/02/2013 at 01:07 PM