Communities in Action: Pathways to Health Equity

A Report from the National Academies of Sciences, Engineering, and Medicine

coh-report-coverCommunities in Action: Pathways to Health Equity is the first in a series of consensus reports to emerge from the National Academy of Medicine’s Culture of Health Program.

Health equity is the state in which everyone has the opportunity to attain full health potential and no one is disadvantaged from achieving this potential because of social position or any other socially defined circumstance. Currently in the United States, the burdens of disease and poor health and the benefits of well-being and good health are inequitably distributed with negative consequences for the nation’s well-being, prosperity, and economic competitiveness. Although some aspects of a person’s health status depend on individual behaviors and choice, health is also shaped by community-wide factors, and research shows that problems like poverty, unemployment, low educational attainment, inadequate housing, lack of public transportation, exposure to violence, and neighborhood deterioration (social or physical) shape health and contribute to health inequities.

With support from the Robert Wood Johnson Foundation, the National Academies of Sciences, Engineering, and Medicine convened an ad hoc, expert committee to consider solutions that could be identified, developed, and implemented at the local or community level to advance health equity. In the resulting report, Communities in Action: Pathways to Health Equity, the committee identifies the major elements of effective or promising solutions and their key levers, policies, stakeholders, and other elements needed to be successful.

Key Messages from the Report

Health equity is crucial. Health equity is fundamental to the idea of living a good life and building a vibrant society because of its practical, economic, and civic implications. Promoting health equity could afford considerable economic, national security, social, and other benefits. Yet recent research demonstrates that worsening social, economic, and environmental factors are affecting the public’s health in serious ways that compromise opportunity for all.

Health inequity is costly. Beyond significant costs in direct medical care expenditures, health inequity has consequences for the U.S. economy, national security, business viability, and public finances, considering the impact of poor health on one’s ability to participate in the workforce, military service, or society. Addressing health inequities is a critical need that requires this issue to be among our nation’s foremost priorities.

Download the Report | Report Highlights | Recommendations | Press Release | Committee Homepage

Video from the Report Release

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To learn more information about the National Academy of Medicine’s Culture of Health program, please visit

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