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Wide Awake: The Movement for Health Equity Continues
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Journal Article
Wide Awake: The Movement for Health Equity Continues
2025
Overview
[...]of their tireless efforts, Abraham Lincoln was elected president, and the United States realized its first comprehensive, inclusive, and reticulated health policy prioritizing health equity and the social determinants of health among newly freed people and lower socioeconomic people throughout the country-the Freedmen's Bureau Act.2 HEALTH EQUITY AND DEMOCRACY INTERCONNECTED Almost 165 years after the Wide Awakes formed, it is clear that today public health needs a similar movement, a coordinated campaign to increase understanding about public health and underscore how it is a cornerstone of our democracy. [...]successive administrations have worked and succeeded in closing some of those health and health care gaps, including child vaccines, and have even secured limited health rights from the judicial branch, including the right to privacy, the right to make reproductive decisions such as the right to use contraception and the right to an abortion, and the right to health care for incarcerated individuals.3 However, we have rarely been afforded a robust opportunity to engage in the development of comprehensive health equity-focused multilevel policy interventions targeting the root causes of chronic diseases in the United States, interventions that would rise to the level of monumental proportions and significantly improve population health. Consider for example the evidence regarding equity-focused policies such as the 19th Amendment to the US Constitution, which afforded women the right to vote; the Civil Rights Act of 1964, which ended segregated health care; and the Voting Rights Act of 1965, which enabled African Americans to vote in jurisdictions that had limited their right to do so. Research has shown that infant mortality rates improved by up to 15% right after 19th Amendment was ratified,6 38 600 Black infant deaths were prevented because of Title VI of the civil rights law,7 and jurisdictions required to comply with the Voting Rights Act saw reductions of up to 17.5% in infant deaths in their communities.8 Since 2016, life expectancy in the United States has fallen from 34th to 60th in ranking among all nations-a trend that is expected to continue unless we take bold steps to reinvest in public health.9 Additional insights from a study led by Meharrys School of Global Health projects the costs and economic impact owing to disparate and inequitable differences in mental and physical health treatment and outcomes among various populations across the United States at a staggering $1 trillion expenditure in the next 5 years.10 TOO CLOSE TO FAIL:
