Identify A Health Equity Focus
Identifying a health equity focus can be a detailed and nuanced process, particularly in a multi-organization collaborative where each organization has its own perspectives and motivations that influence their preferences about which inequities the initiative should address. One way to start is by identifying what data is available to the team and where in the healthcare system they would like to focus their initiative.
Initiative focus areas can include changes in policies and procedures at care provider organizations, health plans, state agencies, and community-based organizations. Initiatives can have multi-faceted care and payment transformations that involve some or all of these organization types.
There are many options for choosing a focus area. AHE partners have chosen to focus on:
- Social drivers of health upstream for the health system, such as housing
- Specific health and healthcare inequities such as differences rates in blood pressure control for patients diagnosed with high blood pressure
Stratifying quality data by patient race, ethnicity, language and other demographic variables such as age, sex, health literacy, sexual orientation, gender identity, disability, socio-economic status, and geography is an important tool for uncovering and responding to health and healthcare inequities. Interpreting the data requires utilizing concepts related to health equity and health disparities that can be challenging even for those with years of experience in healthcare.
Reducing and ultimately eliminating health and health care disparities experienced by groups systematically afforded less power and resources is one way you can measure progress toward achieving health equity. It is important to keep in mind the distinction between health equity and health disparities.
The following AHE resources were created to help teams identify a health equity focus:
- Chapter 1 and the appendices of Using Data to Reduce Disparities and Improve Quality guides users through key considerations about how to define and identify health and healthcare inequities.
- Identify A Health Equity Focus Key Data Considerations and Recommendations describes the processes and challenges related to obtaining, sharing, and analyzing data and makes many recommendations to facilitate your work.
The Power of Qualitative Data and External Information
Don’t limit your sources of information to quantitative data that’s internal to your partner organizations. There is a wealth of external and qualitative data that can be accessed to inform your health equity focus. Qualitative data will add important contextual information that will improve your understanding of quantitative data. It may also reveal new information not available in quantitative data and can be especially helpful when quantitative data is lacking or low quality. You can also gather anecdotal, survey, or focus group information from team members on the front-lines of your partner organizations. All of them will have important experiences and perspectives that can inform your decision.
Community-based Data | Value Added |
Meetings with local business leaders, cultural or religious figures, social service directors, school superintendents, consumer advocacy groups, and neighborhood coalition members | Community leaders have their ear to the ground and are often the first to gain awareness of, and address, issues facing the community. They may be best suited to access community-specific data and gain community buy-in for your initiative. |
Regional or culturally specific news media, neighborhood newsletters, and public bulletin boards in libraries, community centers, and businesses | Locally focused news media will reflect the needs, issues, and desires of the community it serves. Producers of that media may also be a good source of guidance and information. |
Community colleges, local universities, public education programs, public libraries | Educational institutions are formal and informal community gathering spaces. Students and professors often create projects that address inequities in the surrounding neighborhoods. Librarians often create educational materials that speak to the issues most important to the community it serves. Healthcare-focused training programs (i.e. nursing, lab tech, etc.) often have access to information about the community that may prove valuable. |
Community needs assessments and health improvement plans developed by local organizations and authorities | Identify community priority issues that can inform your deliberations regarding identification of a health equity focus (e.g. the prevalence of disease, environmental hazards, and behavioral risk factors such as smoking rates). Collaborate with public health entities that can help refine and support your thinking. |