We know from research and experience that people have a better opportunity for health when they have particular health assets available. When these assets are unavailable or inadequate, health equity is reduced, and health disparities result.
One of the most empowering things we can do to support health equity is to help vulnerable populations increase their health opportunity. Community Health Solutions developed the Health Opportunity Model to inform and guide this vital work at the community level.
The Health Opportunity Model is an evidence-based framework for improving health opportunity and achieving health equity at the community level. As illustrated in the graphic, the model defines the types of services and supports that are necessary to enable health opportunity that leads to health equity.
Health Equity. There is no single, standard definition of health equity. One widely cited definition is:
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. For the purposes of measurement, health equity means reducing and ultimately eliminating disparities in health and its determinants that adversely affect excluded or marginalized groups. (Paula Braveman, Health Affairs, 2017),
Health Opportunity. Health opportunity can be defined as the ability of individuals and populations to pursue their goals for health and well being. Health opportunity is necessary for health equity, and it is enabled by five types of health assets as outlined below.
Natural Supports. Natural supports can be defined as personal and community relationships that support health and well being. Natural supports are often overlooked as a key health asset.
Health Services. Health care services include the array of services that may be necessary for preventing and treating disease and disability. These include access to medical care, behavioral health care, dental care, eye care, pharmacy care, hospital care, long-term care, case management, and other clinical health care services.
Community & Social Services. Community & social services include the array of enabling services that may be necessary for sustaining health and accessing health care services. Examples include education, transportation, housing, nutrition, recreation, financial assistance, job supports, and legal supports in addition to state and local social services.
Supportive Environment. A supportive environment is one that supports health and well being for individuals and populations. Environmental settings include the home, the neighborhood, the workplace, and the school. Examples of environmental assets include safe housing, safe neighborhoods, safe streets, safe schools, safe workplaces, safe air and water, access to healthy food, safe spaces for physical activity, and freedom from violence.
Supportive Policy. Supportive policy is essential for enabling health opportunities that are essential for achieving health equity. Supportive policy is important not only in the realms of public health and health care, but also in public safety, education, transportation, housing, social services, employment, community financial services, environmental quality, community development, and economic development.
The Health Opportunity Model can be applied by professionals and volunteers to help individuals identify strengths and gaps in health assets that are essential for health opportunity. Here the individual may be a client, patient, co-worker, family member, or friend. A good starting point is to work together with the individual to answer six questions:
Who is the individual in terms of their personal characteristics, economic situation, and health status?
Do they have sufficient natural supports (e.g. family, friends, volunteers) to help them with health and wellness?
Are they able to get the health care services they need?
Are they able to get the community services and supports they need?
Do they have a safe and healthy environment in their home, school, neighborhood, workplace, and other settings?
Are there policy structures (public or institutional) that are preventing them from getting the services and supports they need?
The results of this assessment can be used to identify both strengths and gaps in health opportunity. The next step is to help the individual obtain the services and supports they need. If there are gaps in services or supports, or obstacles to obtaining what is available, think about working for system change in collaboration with community partners.
The Health Opportunity Model can be applied to improve health equity for any community population. Ideally this work is conducted collaboratively to optimize collective impact. The model can be applied using the following process.
Engage key stakeholders.
Define the particular population for whom you would like to assure health opportunity.
Engage members of the population as partners in working for system change.
Identify the strengths and gaps in health opportunity that affect health equity for members of the population.
Identify strengths and gaps in services and supports for members of the population.
Develop strategies to sustain strengths and close gaps in available services, supports, and policy structures.
Use data and feedback to track progress and inform action for achieving health equity through health opportunity..