Hi, my name is Piri Ackerman-Barger. I serve as the Associate Dean for health equity, diversity and inclusion, in the Betty Irene Moore School of Nursing. It's my pleasure to be here with you today. We're going to be talking about telehealth and understanding health equity. In this session, we're going to focus on the concept of health equity and what that means for telehealth. The learning objectives will be to define health equity and to discuss the components of health equity. Let's start with this first concept which I call the paradox of health. This really refers to the idea of why people generally get into health care. Why do they choose health care as a career option? Usually when I ask a room full of people why they've made this decision, they'll say something about, they wanted to be in service to other people or they wanted to help other people. What we know is that, that ideal that people come into health care with is not necessarily the ideal, that is the outcome of our health care system. We know that there are a lot of disparities that exist. Those disparities are counter to the notion of health equity. Let's spend a little bit of time exploring what I mean by that. The first thing that we need to talk about is the concept of equality versus equity. Equality is this ideal that has been fundamental to who we are in the United States of America. We see it in some of the early documents. Really when they were talking about equality, they were talking about rights that people should have equal access to the rights that are imbued by the Constitution of the United States. That absolutely remains true today, we want everybody to have equal rights. But in order for equality to exist, we need to understand equity and make sure that things are equitable. Equity really is more about access to the services, the resources, the opportunities within a society that would allow for people to experience this thing called equality. Under the equality notion, if you look at that top diagram of the bicycles, with equality, that means that everybody is treated the same and is given the same resources. In this notion, everyone gets the exact same bicycle. But as you can see, there are multiple people for whom that bicycle is not particularly helpful. It's too small for one person, too large for another person and doesn't meet the needs of a person who is in a wheelchair. Under the equity model, everyone would get a bicycle, but they would get the bicycle that they, as an individual or if we're going to talk about a broader scope, a community needs. The bicycle is designed to meet the needs of each person and that is both equitable and fair. Let's focus on a paradigm shift in the way that we use the terms health disparities and health equity. Health disparities are a really important metric, for understanding the problem. It is database at some of the most robust data that we have in health care. What it's showing is that there are groups of people who are not experiencing access to the same resources, services, and opportunities as other people. That there are these big gaps in the health outcomes of communities because of that. The idea of health equity is that yes, we continue to gather that data. Understanding that simply looking at that data is not enough, that we need to use that data to focus on solutions that will help individuals, families and communities experience the highest level of health that's possible. Let's spend a moment defining the concept of health equity. I'm going to read a quote to you from Camara Jones, a public health expert, who said the following. "Health equity is assurance of the conditions of optimal health for all people. Achieving health equity requires valuing all individuals and populations equally, recognizing and rectifying historical injustices and providing resources according to need. Health disparities will be eliminated when health equity is achieved". Here's another definition from Paula Braveman and her colleagues. They say that, 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 healthcare.