Module 1: Health Equity
Health Equity is defined as attaining the highest level of health for all people, regardless of cultural, demographic or socio-economic factors.
The concepts of health equity and health disparity are inseparable in their practical implementation. Policies and practices aimed at promoting the goal of health equity will not immediately eliminate all health disparities, but will provide a foundation for dismantling the systemic factors that create and maintain health inequity. Use of the national Culturally and Linguistically Appropriate Services (CLAS) standards is a way to improve the quality of services provided to all individuals and will ultimately help reduce health disparities and achieve health equity. The CLAS Standards aim to improve health care quality and advance health equity by establishing a framework for organizations to serve the nation’s increasingly diverse communities.
Module Objectives
- Define health equity.
- Acquire additional resources about health equity for your toolbox.
- Apply the skills and tools acquired in this module to a case vignette.
Step 1: Let’s Get Started
Step 2: Time to Engage
A general introduction to health equity, the information in this step is accessible, which means that you can listen to a podcast on your morning walk, download a resource to help your client or get a short audio summary of an article that caught your eye before fully engaging with the reading.
Interactive Virtual Learning
To learn more about health equity and ways that it exists in the U.S., start by watching the American Psychological Association’s (APA) webinar, The Case for Advancing Health Equity: Eliminating Racial and Ethnic Health Inequities. In this 54-minute webinar, Dr. Brian Smedley discusses health equity as a process rather than an outcome. He also provides important definitions and a timeline with key historical facts that help to understand the multiple systems where health inequities exist. Dr. Smedley presents on the causes and effects of health disparities in vulnerable populations and provides action steps for eliminating health inequities within health care settings.
Here are some key topics:
- Racism and Health Inequity
- Implicit Bias and Stereotyping
- Anti-Black and Pro-White Biases
In the CDC Webinar COVID-19 Response Promising Practices in Health Equity Webinar (64 min), the presenters, Dr. Nafissa Cisse Egbuonye (Public Health Director Black Hawk County Health Department), Dr. Jarvis Chen (Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health), Dr. Thomas LaViest (School of Public Health and Tropical Medicine Dean, Tulane University), and T. Benicio Gonzales, MSW (Louisville Metro Department of Public Health & Wellness Director, Center for Health Equity), discuss the actions their cities are taking to mitigate the disproportionate impact of COVID-19 on racial/ethnic minorities.
For additional webinars, we recommend that you consider engaging with some of the materials provided by the Center of Excellence (CoE) for Integrated Health Solutions. In our Past Events tab, there are multiple webinar recordings available to watch on-demand as well as webinar slides which include additional resources.
Step 3: Creating a Stronger Foundation
A list of materials and resources designed to give you a more detailed description of the application of the tools introduced in Step 2. This step requires you to engage in deeper analysis of the topic through documentaries, research articles, trainings and books. Some of the tools (e.g., research articles, books) in this step may have a cost attached and we recommend that your organization provide these tools and share the with other team members. These tools may require you to engage for longer periods of time (e.g., trainings) than initial resources.
Step 4: Your Turn
This step encourages you to apply what you have learned through a case vignette. We recommend that you explore the gaps present within the vignette and implement any new skills acquired through this module. We encourage you to consult with others on your team given that there are multiple ways to go about addressing a case vignette especially as you take your role within your organization and your experience, skills and worldview into account. We provide reflection questions from the following perspectives: individual learning and beliefs, organizational learning and systemic. You can use the questions to have discussions with others and think through all the facets of the case vignette that are relevant to your work.
Case Vignette
Dr. Prieto straightened his tie as he nervously awaited the interview. He was the director of a community health agency that was being recognized as an exemplar of striving towards health equity by the national accrediting body and was being interviewed on television for this honor. His health agency served a community with a rapidly growing Latinx population. Under his guidance, the agency began to address many of the issues that had plagued the community: poor health outcomes, high mortality, a lack of bilingual and bicultural providers and a lack of infrastructure to address community health.
Dr. Prieto recruited new bilingual and bicultural staff and retained them through progressive policies that addressed the unique challenges that bilingual and bicultural health providers faced. For example, he paid a bonus for being bilingual, assigned lower caseloads, provided more time to write notes when dealing with language issues and invested heavily in culturally sensitive prevention. Dr. Prieto was intentional in addressing the stigma against getting help in the Latino community by sponsoring youth dance and sport teams.
The community immediately responded positively and the health of the community improved in almost every metric. Dr. Prieto’s efforts were being recognized as a national model for service and he had been asked to serve on the governor’s mental health task force. It was an exciting time to be working in the Latino community. As the lights came on, he gave his tie one more tug and the interview began.
Reflection questions
- What stigmas are you aware of regarding mental health and substance use challenges in your own culture? (individual learning and change)
- What policies and procedures might have to change at your workplace to remove barriers to health equity? (organizational learning and change)
- How are prevention and youth programs related to health equity? (systemic change)