Part 3-DEISJ (Diversity, Equity, Inclusion, Social Justice) and Health

The field of health and wellness is intertwined with (diversity, equity, inclusion and social justice) DEISJ. Diversity, equity, inclusion, and social justice significantly impact various domains of individual health and population-based health. The health status of an individual can also have an impact on DEISJ and whether or not someone is treated equitably and with inclusion.

The Impact of Health on DEISJ

There are many examples of how DEISJ issues impact the health of people and populations. Discrimination, inequities, and exclusion can clearly result in negative consequences in health status for individuals and populations. The idea of health status as a cause of DEISJ issues is not as clear to some, however, the literature demonstrates cause and effect in this direction as well. The section on the Social Construction of Health illustrates examples of how health status impacts areas of DEISJ.

Research has documented the mistreatment of individuals based on health issues such as body weight and mental health and the impact on DEISJ via how these individuals are treated. Hiring and healthcare discrimination takes place based on mental health status, as well as body weight.^[1]

People who have the health risk of higher body weight are vulnerable to bias and discrimination in and outside of the workplace. Larger individuals face weight discrimination in the workplace, biased attitudes from health care professionals, negative stereotypes in the media, barriers in education, and weight stigma in relationships. These stigmatizing experiences are harmful, leading to both immediate and long-term consequences for emotional and physical health, reducing quality of life.^[2]

Research has shown the impact of workplace stigma and discrimination on people with mental health challenges including work avoidance, reluctance to disclose mental health conditions to employers, work-related stress, and reduced length of employment. Although there is a multitude of documentation of individuals being discriminated against and treated unfairly due to health status, health status is not a protected class unless there is a documented disability.^[3]

Health disparities continue to be an issue and are monitored by governments and international agencies on a continual basis.

A health disparity/inequality is a particular type of difference in health (or in the most important influences on health that could potentially be shaped by policies); it is a difference in which disadvantaged social groups—such as the poor, racial/ethnic minorities, women, or other groups who have persistently experienced social disadvantage or discrimination—systematically experience worse health or greater health risks than more advantaged social groups. (“Social advantage” refers to one’s relative position in a social hierarchy determined by wealth, power, and/or prestige.) Health disparities/inequalities include differences between the most advantaged group in a given category—e.g., the wealthiest, the most powerful racial/ethnic group—and all others, not only between the best- and worst-off groups. Pursuing health equity means pursuing the elimination of such health disparities/inequalities.^[4]

The impact of the Social Determinants of Health on health disparities and health status continues to be studied. According to the CDC, social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

Social Determinants of Health can be grouped into 5 domains:

Economic Stability

Education Access and Quality

Health Care Access and Quality

Neighborhood and Built Environment

Social and Community Context^[5]