Concepts and Terms for Addressing Disparities in Public Health Emergencies: Accounting for the COVID-19 Pandemic and the Social Determinants of Health in the United States

Public health emergencies, including the coronavirus disease 2019 (COVID-19) pandemic, highlight disproportionate impacts faced by populations with existing disparities. Concepts and terms used to describe populations disproportionately impacted in emergencies vary over time and across disciplines, but United States (US) federal guidance and law require equal access to our nation's emergency resources. At all levels of emergency planning, public health and their partners must be accountable to populations with existing inequities, which requires a conceptual shift toward using the data-driven social determinants of health (SDOH). SDOH are conditions in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks. This article reviews the historic use of concepts and terms to describe populations disproportionately impacted by emergencies. It also recommends a shift in emergency activities toward interventions that target the SDOH to adequately address long-standing systemic health disparities and socioeconomic inequities in the United States.