Inequality—in both opportunity and outcome—is becoming the defining zeitgeist of our era. We typically think about inequality in the context of income, but equity and health also go hand-in-hand. Alonzo Plough, PhD, MPH, chief science officer and vice president of Research, Evaluation, and Learning at the Robert Wood Johnson Foundation, for example, recently described how extreme weather events can have a disproportionate impact on “children, the elderly, people with chronic health conditions, the economically marginalized and communities of color.”[11] And others have raised concerns about the disproportionate vulnerability of lower-income Americans to the Zika virus.[12] While there are many ways in which this relationship can manifest itself, research and analysis confirm what common sense suggests: the less-advantaged are affected differently by disease outbreaks, disasters, and large-scale emergencies.
We illustrate here how lower levels of education and income are associated with a decreased likelihood (both in terms of gross and net percentages) that one will enjoy the benefits of PTO, have household broadband access, or telecommute. Understanding the root causes of these differences and addressing the inequities will enhance health security, preparedness, and community resilience. However, understanding the root causes is not sufficient—community leaders from the private, public, and nonprofit sectors must work together to tackle the root causes of these inequities. By doing so, the health security of the entire community will be enhanced.
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