Extension's National Framework for Health Equity


Since 2014, numerous societal and environmental influences have produced significant changes to the landscape in which people live their lives. This section highlights some of the those influences and their impact on the health of various groups. These influences include the opioid crisis, mental health, coronavirus pandemic, climate change, food insecurity, and the increasing costs of health insurance and healthcare.

America’s Opioid Misuse Crisis

Since 1999, more than 750,000 people have died from drug overdoses in the U.S. with two-thirds of those deaths involving an opioid (CDC, 2020). The opioid epidemic resulted from multiple factors, not the least of which was the over-prescription of highly addictive painkillers to reduce pain associated chronic health conditions. Communities experiencing poverty, joblessness, and low access to educational opportunities were among the hardest hit by the opioid crisis. For people of color, inequitable

access to evidence-based prevention and recovery services, reliance on punitive approaches to control drug use, and ongoing economic disinvestment have created even deeper inequities in health-related use outcomes (Kunins, 2020; Donnelly et al., 2020).

Mental Health

During the summer of 2020, 41% of adults in the U.S. reported having an adverse mental or behavioral health condition with younger adults, racial ethnic minorities, and essential workers experiencing disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation (CDC, 2020). Similarly, researchers at Boston University discovered that prevalence of depression symptoms in adults was three times higher during COVID-19 with the highest burden falling disproportionately on those already at increased risk (Ettman, et al., 2020). A recent survey suggests that mental issues may be even more prevalent in young people with 81% of teens indicating that they believe mental health is a major issue among their peers and 71% reporting that they were experiencing mental health struggles of their own (Harris Poll, 2020). SAMHSA warns that the effects of mental health issues experienced during the pandemic are potentially long-lasting and very consequential for individuals and their families.


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