At Caracole, our vision is to be a relentless force for
We believe everyone deserves to be healthy—no matter who we are,
what we do, where we come from, what we earn, how we look or who we love.
Equity = Quality of Life
Health equity is ensuring everyone can live the
healthiest life possible. That requires high-quality
living conditions and universal access to competent, affordable and culturally
Our health is often based on social, economic and
environmental conditions. Stable housing, healthy
food, adequate employment, transportation, access to medical care and being
treated with dignity and respect are all factors we need to stay healthy.
People are marginalized when they
experience unjust differences in how they are treated or services they can
access. Major risk
factors for health inequalities include:
Gender and sexual orientation discrimination
Stigma, shame and disrespect
Racial, sexual, ethnic and
transportation, technology and education barriers
Neighborhoods and communities
that are neglected, polluted or violent
Achieving health equity requires valuing everyone.
requires actively acknowledging and reckoning with historical and contemporary
injustices, prioritizing the needs of marginalized people, envisioning new ways
of creating a shared sense of community, distributing resources and creating conditions that allow
everyone to thrive. It requires structural changes in programs, services and
governments. It is challenging, but it is not impossible.
Inequities and HIV
HIV prevention and treatment are better and more
accessible than ever before. Also, medical case management and safe and affordable housing assists marginalized individuals with HIV to live long and healthy lives. But improved outcomes are not evenly distributed:
- — Men who have sex with men
- — People who inject drugs
- — People involved in sex work
- — People who are transgender
- — In 2018, Black/African American people accounted for 13% of the US population but 42% of the approximately 38,000 new HIV diagnoses in the United States and dependent areas.
- — Hispanic/Latino people accounted for 27% of all new HIV diagnoses.
Homelessness and HIV are tightly linked. People who are homeless experience higher rates of HIV infection, have a more difficult time staying in HIV care and adhering to HIV medications, and experience worse health outcomes as a result of HIV infection.
- — Black/African American people accounted for 40% of all people experiencing homelessness in 2019 and 52% of people experiencing homelessness as members of families with
children, despite being 13 percent of the US population.
- — People identifying as Hispanic
or Latino are about 22 percent of the homeless population but only 18 percent
of the population overall.
In 2010, the rate of diagnosed HIV among inmates in state and federal prisons was more than five times greater
than the rate among people who were not incarcerated.
People who inject drugs accounted for 7% of new HIV infections in the US and 6 dependent areas in 2018.
In 2015, the American Psychological Association reported that rural communities have HIV prevalence rates approaching those of urban areas. Rural residents have higher rates of poverty, less access to general and specialized health care, and are less likely to have health insurance than city residents.
Individuals with a late HIV diagnosis are at increased risk for HIV-related morbidity and mortality and may have poorer response to antiretroviral treatment. This means they may get sicker, have more infections, and are more likely to die from an AIDS-related disease. Late diagnosis increases the risk that individuals unaware of their status may transmit HIV to others.
Most new HIV diagnoses are now highly concentrated in certain geographic areas. Of the total 3,006 counties in the US—Hamilton County along with 47 others accounted for more than 50% of the new HIV diagnoses in 2016 and 2017. These jurisdictions are prioritized in Phase I of Ending the HIV Epidemic in the U.S., along with Washington, DC; San Juan, Puerto Rico; and seven states with a disproportionate occurrence of HIV in rural areas.
a fact that the people who are marginalized in our communities are also most
impacted by HIV.
Caracole’s passion for equity is woven into who we are
and what we stand for. Here are some of the practices we uphold in order to
create a more equitable community:
Accountability: We challenge our biases and empower each other to do better. We measure what we do, we evaluate the data, and we continue to ask what— and who—are we missing?
Learning: We proactively seek
out what works best for different people, recognizing and affirming their individuality
and difference of experience.
Education: We help others
understand what factors produce health, how to be more culturally humble and
accessible, and why health inequities hurt us all.
Advocacy: We campaign for health care
access, affordable housing, public transportation, harm reduction,
decriminalization and anti-discrimination policies.
Communication: We look for
opportunities for authentic dialogue and messaging to change the biased beliefs
driving policies and practices that create disadvantaged communities.
Social Justice: We challenge racism,
sexism, homophobia, stigma and wealth inequality where they occur and address
them through dialogue and action.
When it comes to supporting communities, we all have a role
to play. You, too, can learn, educate, advocate,
communicate and seek justice.
Join with us. Be relentless.
Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.
Harmful, inequitable and unjust outcomes created and perpetuated for specific groups of people, thru historical and contemporary discrimination in policies and practices.
Social Determinants of Health:
Conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.
A system in which public policies, institutional practices, cultural representations, and other norms work in various, often reinforcing ways to perpetuate racial group inequity.
Morbidity refers to being diseased or unhealthy. Higher morbidity means being sicker or having more adverse symptoms than others with a similar diagnosis. In HIV, this means more opportunistic infections, more organ failure, lower CD4 counts, etc.
Mortality is death rate in a population. In HIV this refers to how many people die of AIDS- or HIV-related disease.