This module will address issues around health equity and COVID-19. By the end of this module, participants should be able to define health equity terminology, describe how COVID-19 has exacerbated longstanding health inequities, and describe the impact of COVID-19 on vulnerable populations. The United States has a long history of racial and socioeconomic health disparities. The coronavirus pandemic is exacerbating these disparities with vulnerable communities experiencing disproportionate rates of COVID-19 illness and death. In this module, we will review the impact of COVID-19 on communities at highest risk, including communities of color, those with low socioeconomic status, and the elderly. Within the context of COVID-19, there's been increased discussion regarding health equity. While many of the terms used in health equity discussions may appear interchangeable, it is important to understand their distinct meanings. The next two slides include key terms that are frequently used to describe issues related to health equity. Understanding appropriate use of these terms will help you to communicate clearly when discussing COVID-19 related health disparities. Historically, communities that have been marginalized by race or ethnicity and socioeconomic status, have also faced systemic-structural and institutional barriers that have negatively impacted their health. Consistent with this, communities of color and those with lower socioeconomic status, bear a disproportionate burden of illness from COVID-19. These disparities are largely driven by socioeconomic and environmental factors. While the effects of COVID-19 on the health of racial and ethnic minority groups is still emerging, data suggests a disproportionate burden of illness and death among racial and ethnic minority groups, highlighting long-standing inequities in the United States. In the following slides, we will share examples of pervasive disparities that exist related to income and race. As this slide demonstrates, individuals with lower income are much less likely to have a usual source of care and are more likely to report delay in care, not being able to afford prescription medications, and experiencing problems paying medical bills relative to individuals with higher income. These issues related to access, make lower income individuals particularly vulnerable in public health emergencies like COVID-19. While mortality rates among African Americans in the United States have declined, African Americans continue to have increased risk of premature death at all ages. A higher prevalence of many chronic health conditions and lower prevalence of some healthy behaviors. Combined, these factors have heightened the risk of poor outcomes due to COVID-19 in African American communities. For more information about how COVID-19 has increased existing health inequities, review the following resources. This popular image illustrates the difference between equality and equity. In this picture, three individuals of different heights are attempting to peer over a fence to watch a baseball game. In order to treat them equally, they would all be given the same size box to stand on to improve their lines of sight. However, doing so doesn't help the shortest person see the field, as well as the tallest person. In order for the three individuals to be treated equitably, each person would need to be given a box to stand on that would enable a clear view over the fence allowing them all to see the game. In the final image, all three can see the game without any support because the cause of the inequity has been removed. To better understand the importance of health equity, watch as Dr. Donald Berwick shares a patient's story. Health equity occurs when there are efforts to ensure that all individuals living within an area have access to resources that promote and protect health. To achieve health equity, particularly as we navigate the COVID-19 pandemic, it is important that we have a robust public health infrastructure that addresses the physical, social, behavioral, and environmental factors that influence health. Importantly, this infrastructure must be capable of supporting program development and implementation, evaluating the effectiveness of these programs, and informing policy to improve population health. The social determinants of health are the conditions in the places where people live, learn, work, and play. These conditions can have a greater impact on health outcomes than individual level factors. Thus, addressing social determinants of health is key to achieving health equity. COVID-19 related health disparities have magnified the link between the social determinants of health and health outcomes with issues like poverty, housing, and paid leave exacerbating the toll of COVID-19 on individuals and families that were already struggling.