Health Equity 101 for Providers Achieving health equity in prostate cancer requires a fundamental transformation of our existing healthcare system. Foundations of healthHealthcare professionals and policymakers have increasingly started to acknowledge the effects of social and environmental circumstances have on health.Investigations by the Robert Wood Johnson Foundation indicate that genetics, individual choices, and health behaviors account for between 10 and 20 percent of the likelihood of positive health outcomes. However, educational, social, financial, environmental, and healthcare-related factors account for 80 to 90 percent. These external factors – known as the social determinants of health – are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems that impact our health and well-being, functioning, and quality of life. Health equity 101 Expand All Social determinants of health The social determinants of health can be grouped into five main aspects of our lives. Research indicates that they are associated with our health, health behaviors, and how we navigate healthcare. These social determinants are shaped by the distribution of money, power, and resources at global, national, and local levels. Education access & quality People with higher levels of education have been shown to be healthier and to live longer. There are many barriers to high quality education and several factors can limit our educational opportunities, such as poverty and social discrimination (e.g. bullying). Low quality education and limited education opportunities can impact our ability to get safe, well-paying jobs which then can limit our ability to protect our health and pay for needed healthcare. Healthcare access and quality Since the implementation of the Affordable Care Act (ACA), the uninsured rate for Black/African American people under age 65 decreased from 20 percent in 2011 to 12 percent in 2019. The uninsured rate for Black Americans, however, is still higher than that for White Americans: 12 percent compared to 9 percent. Health insurance is not the only barrier to healthcare; some of us can’t get the healthcare we need when we need it because of issues related to additional out-of-pocket costs (over and above what insurance covers) and because of where we live and the lack of healthcare providers in our area. Neighborhoods and the built environment The neighborhoods where we live can have a substantial influence on our health, health behaviors, and well-being. In particular, the quality of the air, water, and other resources we have in our neighborhoods, how safe we feel in our neighborhoods, even the physical and social characteristics (e.g. presence of litter, graffiti, abandoned building) have all been shown to be associated with the health, health behaviors, and well-being of the residents. Social and community context The quality and the quantity of our relationships and interactions with family, friends, co-workers, and community members can have a major impact on our health and well-being. Strong social connections have been shown to be associated with lower levels of anxiety and depression and even to how long we live. Economic stability In the United States 1 in 10 people live in poverty, with many of us (approximately 4 out of 10) lacking the financial resources to cover basic expenses for three months if we experienced a sudden job loss, a medical emergency or another financial crisis leading to a loss of stable income. Core competencies for health equity: Addressing the social determinants of healthProstate cancer, much like numerous other health conditions, serves as a stark reminder that our prevailing healthcare system includes substantial disparities. These differences manifest in aspects such as screening and diagnosis rates, available treatment options, accessibility to advanced therapies, and rates of survival. It is crucial to recognize that these disparities are not solely the result of individual choices or medical interventions; they are deeply intertwined with broader social systems.The path toward rectifying these differences require a direct and unwavering confrontation of multifaceted challenges while simultaneously reshaping our healthcare system. Achieving equity in prostate cancer care calls for strategies that not only attend to medical interventions but also grapple with the larger social systems that perpetuate inequality.Eradicating disparities in prostate cancer care mandates the dismantling of access barriers that disproportionately hinder historically underserved communities. This endeavor entails policy reform aimed at rectifying systemic injustices and increased community engagement that includes the voices of those most affected. By fostering a patient and community population that is not only better informed but also empowered to take charge of their health journey, we can begin to disrupt the cycle of disparity and disempowerment.At the core of this transformative journey lies the cultivation of a healthcare workforce that is not just racially/ethnically diverse but also characterized by cultural humility. Healthcare providers need to be armed with the skills and insights necessary to navigate the distinct challenges faced by various patient demographic groups. Bridging the gap in prostate cancer disparities requires healthcare professionals to introspectively address and challenge their own biases and preconceptions about patients. This paves the way for the assurance that each patient, regardless of their background, receives dignified and respectful care, embodying the principles of equity that underscore this transformative initiative. By integrating an understanding of social drivers of health into the fabric of care provision, we can pave the way toward a more equitable future for the prostate cancer journey for all patients/families. Advancing trustworthiness and building trust Fundamentally, achieving health equity in prostate cancer demands a profound transformation of our healthcare system. This endeavor goes beyond minor adjustments; it necessitates a complete rethinking of how our healthcare ecosystem operates. As a result, there are ongoing efforts by various stakeholders within the health and medical community to enhance education, broaden access, foster partnerships, and offer support to those at risk of prostate cancer, individuals already diagnosed, their care partners, and families. However, the significance of these efforts is diminished if they are not coupled with actions that cultivate trust within these communities.Furthermore, the establishment of trust is a critical component of progress. In many marginalized and underserved communities, a history of injustices, discriminatory practices, and a lack of representation has sown deep-rooted skepticism regarding the healthcare system. Acknowledging and addressing this skepticism is a prerequisite for meaningful advancement. Building trust requires healthcare providers and medical professionals to serve as trustworthy partners in the communities they aim to serve.For healthcare providers, it's pivotal to embody trustworthiness in order to lay a solid foundation of trust. This entails a sustained and authentic commitment to principles such as accountability, integrity, consistency, benevolence, and justice. Once trust is established, it can be fortified through continuous actions, transparent communication, and sincere empathy.By acknowledging the systemic nature of disparities, proactively addressing trust concerns, and positioning themselves as steadfast allies, healthcare providers and healthcare systems have the potential to bring about significant and meaningful change. In the quest for health equity, these actions are not only vital but also transformative, promising a future where access to care, treatment, and support for prostate cancer is just and equitable for all.