By Emily Gratopp, MS, Extension Educator in Lancaster County
Lincoln has many wonderful qualities as a community — one of them being the interconnectedness of a lot of the organizations in Lincoln. In fact, I’ve heard often that Lincoln feels like a “big small town.” Amongst all of the strengths and assets [see “Lincoln’s Strengths and Assets” below], Lincoln also has some opportunities for improvement.
Lincoln has both quantitative and qualitative data showing that access to health care is not equal for all Lincolnites. Did you know that there is up to a 20-year life expectancy gap between the downtown Lincoln neighborhood and the Southeast Lincoln neighborhood? Did you know that neighborhoods in Lincoln with the lower life expectancy are the same areas where poverty rates are the highest? Did you also know that those same areas where poverty is high, are also areas with higher numbers of Lincolnites who are considered people of minority?
Clearly, there are associations that can be made between neighborhood, poverty, minority status and health care. These are big opportunity gaps in Lincoln. The good news is that Lincoln, likewise, has many strengths and assets. There are a lot of interconnected people who are ready and willing to take a hard look at these opportunity gaps, and take action to make a difference.
HEALTH EQUITY COALITION
Nebraska Extension in Lancaster County, with funding and resources from the Robert Wood Johnson Foundation and National 4-H Council Well Connected Commuities grant, has helped initiate a new effort to build health for all community members — equitably — by convening a Health Equity Coalition. The Coalition started in January with the spark and ingenuity of two Master Health Volunteers — one each from the adult and youth Master Health Volunteer cohorts from 2020.
The mission of the Health Equity Coalition is to take intentional, collective action — alongside all community members, adults and youth together — to achieve health equity for all and eliminate the 20-year life expectancy gap between neighborhoods in Lincoln.
There are over a dozen community sectors (ie: healthcare, housing, schools, social services, high education, parks and recration, etc.) represented on the Health Equity Coalition, including youth. The Coalition has started by seeking a deeper understanding of health disparities by hosting focus groups with community members impacted by health inequities in Lincoln. The Coalition will take this deepened understanding and an assets-based approach to complete a strategic planning process and form task forces that will focus on making systemic, environmental and policy changes that increase health equitably for all Lincoln residents.
What does it mean to provide health equity? A few definitions can help provide clarity.
WHAT IS EQUITY?
Equity is defined by the World Health Organization as, “The absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically.” (http://www.who.int/healthsystems/topics/equity/en)
WHAT DOES IT MEAN TO BE HEALTHY?
Health is defined by the World Health Organization as, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” (http://www.who.int/about/who-we-are/constitution)
WHAT DOES HEALTH EQUITY MEAN?
We can put the two definitions for “equity” and “health” together to help us define health equity. The Robert Wood Johnson Foundation summarizes health equity well in their statement: “Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”
The image of the bicycles provided by the Robert Wood Johnson Foundation is an excellent depiction of equity — especially equity in contrast to equality. As you can see from the image, it is not one-size-fits all-when it comes to a community making health accessible and achievable for all. Equity recognizes the different contexts (from societal to personal) in which people live and allocates resources accordingly.
A great resource on the differences between equity and equality is the article, “Equity vs. Equality: What’s the Difference?” provided by the Milken Institute School of Public Health at The George Washington University (https://onlinepublichealth.gwu.edu/resources/equity-vs-equality).
Let’s consider a tangible example of equity in a community. I think the Lincoln City Public Libraries are a wonderful resource. Equality in the libraries may mean that the libraries are equally distributed throughout the city boundaries, all libraries have the same hours, and the same books, computers and internet resources. Equity within the libraries in Lincoln would look different: perhaps there would be more libraries in neighborhoods with higher poverty rates. Those libraries would have longer hours, more books and computers, and faster internet than the other libraries in town — because the libraries located in the areas of higher household poverty are probably one of the few sources of internet for families and students.
Similar to the example of building on the strengths of the current library system, the Health Equity Coalition is choosing to see health equity work through an asset-based lens. That means the coalition is asking “what is working well?” and attempting to then build on those strengths and resources and expand on them into the opportunity gaps.
GET INVOLVED
Everyone is part of the solution and everyone brings strengths to offer in building health equity in Lincoln. Even you, reader, have strengths to offer in building health equity in Lincoln.
You are invited to join the Health Equity Coalition in the work of building health equity. There are many roles and ways to be involved, which may or may not involve attending the monthly Coalition meeting. Being involved means you will use your personal strengths and assets to bring health equitably to fellow Lincolnites. This work is everyone’s work. Find out how to get involved, learn more, ask questions or join the Health Equity Coalition meetings at https://lancaster.unl.edu/wellconnectedcommunities or by emailing Emily Gratopp at emily.gratopp@unl.edu.
One great way to get involved in health equity work is by becoming an Extension Master Health Volunteers (MHV). Nebraska Extension in Lancaster County is seeking new applicants for adults and youth who want to become MHV. Youth must be in high school. MHV receive robust education in the areas of health equity, mental health, nutrition, physical activity, health marketing and leadership development. Previous adult MHV are finding ways to incorporate health equity into work they are already doing. Being a MHV has helped some youth get accepted to colleges and health programs. Email emily.gratopp@unl.edu with interests and inquiries.
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LINCOLN’S STRENGTHS AND ASSETS
I asked adult and youth Lincolnites what the strengths and assets of Lincoln are. Here are a few of their responses:
• Community and Culture Centers
• Community Learning Centers
• Youth sports
• Collaborations between nonprofits
• Community garden programs
• Ethnic markets and access to healthy foods
• Markets and stores that accept SNAP and WIC
• Double Up Food Bucks
• Agencies like Bluestem, Health360, Clinic with a Heart, Aging Partners and Milkworks
• Lancaster County Health Department
• Community Health Endowment
• Tightly knit resident communities
• Case managers and family engagement coordinators who connect and advocate for others
Comments from youth Master Health Volunteers include:
• “Everyone is really polite, friendly, nice ... and everyone always waves at me while I’m running on the trails. Overall, the sense of community is really strong and I love being in the environment of Lincoln.”
• “I like that Lincoln is diverse. There are a lot of people who are working together that are from different ethnicity and race. There are a lot of help programs where people can get help when needed.”
Tell us about YOUR favorite strengths and assets in Lincoln by taking the survey at https://go.unl.edu/LNKstr.