Extension's National Framework for Health Equity

Definitions of Health Equity

Numerous definitions of health equity exist in the literature. For example, the Robert Wood Johnson Foundation argues that that health equity exists only when “everyone has a fair and just opportunity to be as healthy as possible.” The Centers for Disease Control and Prevention operate from the premise that

health equity is a state in which “everyone has the opportunity to attain their full health potential, and no one is disadvantaged in achieving this potential because of social or any other socially-defined circumstances.” The World Health Organization expands upon these definitions characterizing health equity as the “absence of avoidable, unfair, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically or by other means of stratification.”


“What is Health Equity?” – a 4- minute video from the American Public Health Association.

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Achieving Health Equity

Any individual is an amalgamation of a multitude of individual identities that include race, class, ethnicity, ability, gender identity and expression, sex, weight, veteran, marital, and documentation status. Society has enacted a system of laws, policies, norms, and expectations that intentionally or unintentionally allow differing access to resources and opportunities based on these identities. In this context, Extension’s work to advance health in communities through education and behavior change is incomplete when not coupled with a commitment to eliminating barriers to health that these laws, policies, norms, and expectations present.

Rurality and its Relationship to Inequities

Health trends are showing that non-Hispanic white people living in rural areas are experiencing smaller declines in deaths from cancers and cardiovascular diseases and larger increases in deaths from metabolic,

respiratory, alcohol-related, mental and behavioral diseases, and suicides as compared to urban areas. But mortality rates for cancer and cardiovascular disease among Black, Indigenous, and Latinx populations have decreased at an even slower rate than their white peers

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Rural Health Disparities

(Monnat, 2020). Many people who live in rural areas still lack many of the assets and resources needed to experience optimal health and well-being. These include broadband connectivity, a predictable source of healthy food, a quality education, steady employment, and access to health care.


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