One Size Does Not Fit All
Striving for Health Equity in Black History Month and Beyond
As we celebrate Black History Month and the accomplishments of African Americans in the history of the United States, we want to acknowledge that health disparities often impact Black communities more than others. We invite you to learn more and help Trillium Health Resources make sure every community and individual we serve has the opportunity to reach their fullest potential.
Health equity means we must recognize the history and change the policies that have created the health disparities that persist today. This timeline by KFF offers a historical view into the events that have shaped racial and ethnic health disparities.
Defining Health Equity
The Centers for Disease Control and Prevention (CDC) defines health equity as “a state in which everyone has a fair and just opportunity to attain their highest level of health.”
Getting to health equity means we have to:
- Address historical and current injustices;
- Fix economic, social, and other obstacles to health and health care; and
- End health disparities.
What are Health Disparities?
Health disparities are preventable. They are differences in illness, injury, or violence. They also refer to chances to have good health.
People with health disparities may also have low incomes or live in certain areas. They may also have environmental factors such as poor water quality.
What are Health Inequities?
The World Health Organization (WHO) defines health inequities as “systematic differences in the opportunities groups have to achieve their highest level of health, leading to unfair and avoidable differences in health outcomes.”
At Trillium, we believe that health disparities are health inequities.
Visualizing Health Equity: One Size Does Not Fit All Infographic
The image above from the Robert Wood Johnson Foundation uses a bicycle to show the difference between equality and equity.
Equality is when everyone gets the same bike and is expected to be able to ride it.
Equity is when everyone gets the bike they need so they are able to ride it.
A one-size-fits-all approach does not achieve health equity. Trillium’s Health Equity Principles focus on people, place, and partnership. We must listen to our members and community groups to develop strategies that can work. We alsolook for programs proven to work to meet their unique needs and preferences.
Trillium’s Health Equity Principles
People: Collaborating with Members and Stakeholders
Our members are the experts in their healthcare needs. They should be seen, heard, respected, and understood.
They will help us develop:
- Strategies
- Priorities
- Outreach
Place: Where Equity Happens
Where someone lives can affect health outcomes. Members can identify communities that may face barriers in getting health care.
Partnership: With Everyone in the Community
Our inclusive approach means that everyone in our communities should have a voice in their health care.
Place is believed to impact up to 80% of a person’s health. The U.S. Department of Health and Human Services Healthy People 2030 is a data-driven, national objective to improve health and well-being over the next decade. Healthy People 2030 defines Social Determinants of Health as a priority.
Social Determinants of Health (SDOH) or Unmet Health-Related Resource Needs
Social determinants of health are the conditions where people live, learn, work, play, and worship. These places can affect a wide range of health risks and outcomes.
Examples include:
- Safe housing, transportation, and neighborhoods
- Racism, discrimination, and violence
- Education, job opportunities, and income
- Ability to purchase nutritious foods and opportunities for physical activity
- Polluted air and water
- Language and literacy skills
Positioned for Change
In addition to Healthy People 2030, the federal government also announced Executive Order 13985: Advancing Racial Equity and Support for Underserved Communities Through the Federal Government. This order shows their commitment to improving health equity. In April 2021, the CDC declared Racism a Public Health Threat. The first step of the Centers for Medicare & Medicaid Services’ (CMS) Strategic Plan is also to improve health equity.
The Healthy Opportunities Pilots (HOP) is a unique opportunity in North Carolina to help improve health equity, too. HOP is the nation’s first program with up to $650 million to help pay for housing, food, transportation, and interpersonal safety. Medicaid members who have other health risks will be eligible..
NC Medicaid has also expanded health care coverage to more people. As of Dec. 1, 2023, NC Medicaid now covers people ages 19 through 64 years with higher incomes. People may be able to get health care coverage through Medicaid even if they did not qualify before.
At Trillium, our work matches Secretary Kinsley’s priorities for the NC Department of Health and Human Services. We are focused on behavioral health and resilience, child and family well-being, and astrong and inclusive workforce. We use data to help inform this work.
Trillium launched our first Health Equity Council in 2024. We invite people across our 46-county area to join our health equity team. It is an incredibly exciting time to start this Health Equity journey.
About Trillium’s Health Equity Council
Trillium’s Health Equity Council (HEC) helps our members get the health care they need. The HEC works with our communities to find the root causes of health inequity.
The HEC reflects the diverse populations served by Trillium. We want to have equal representation across our counties served. The council brings together many community groups. Members, local organizations, and our Consumer and Family Advisory Committees are all involved. It is important to meet the unique needs of each individual and community served.
The HEC meets monthly and reports to Trillium’s Chief Executive Officer, Joy Futrell.
Trillium’s Health Equity Council will:
- Improve access to health care using data.
- Increase stakeholder representation and engagement in improvement initiatives.
- Improve staff diversity, especially in leadership.
- Improve health education outcomes for historically marginalized populations.
- Develop new programs to promote health awareness.
- Help end policies, systems, and environments that create inequities.
Trillium is committed to bringing health equity to all our communities. We want to be an example for health equity in our state. Trillium’s Health Equity Council is important to Trillium’s vision for every community and individual we serve to reach their fullest potential.
If you are interested in serving on the HEC, please complete the Trillium Health Equity Council Application. If you have any questions or need assistance or accommodations to access and complete the application, please contact Hayley Sink, Director of Health Equity, at Hayley.Sink@TrilliumNC.org.
We also invite you to read our latest Health Equity Report. This report details over ten years of our work in this area.