Health Equity

Health Equity

The Grey Bruce Health Unit is committed to actions that work towards reducing health inequities, removing barriers and creating equitable opportunities that support health and well-being for all members of our community. We work towards health equity in many ways including;

  • Strengthening meaningful partnerships with Indigenous and non-Indigenous community members and various organizations to support action;
  • Monitoring and reporting on the relationship between social factors, like income, and health outcomes in Grey Bruce; and
  • Participating in policy development to address the social determinants of health.

 

What is Health Equity?

Health Equity means that ALL members of the community have opportunities to be healthy and receive quality care that is fair and appropriate to their needs, no matter where they live, what they have or who they are (Health Quality Ontario, 2018).

 

Equity doesn’t mean Equality

Equality means that everyone is treated the same regardless of their needs or circumstances. However, treating everyone equally doesn’t mean that every person has the same opportunities to maintain optimal health.

 

Equity takes into consideration that some groups in our community face additional obstacles and barriers and require more supports to achieve the same level of health as others. Barriers may include low income, low literacy skills, limited access to healthy food, unsafe housing or limited access to reliable transportation.

 

In order to improve health and well-being for all people, we must first ensure everyone has the basics to be healthy. Thinking that the same approach will work universally to improve health is assuming everyone has those basics. Equity involves trying to understand and give people what they need – so that people are able to reach higher levels of health and live full, healthy lives. Equality in contrast, aims to ensure that everyone gets the same things. 

 

If we compare both equality and equity side-by-side, you will notice on the right side of the graphic that the people haven’t changed. Instead, what has changed are the resources, approaches, policies, or practices that have an impact on the conditions in which community members live.

 

Equality visual

Equity Visual

 

 

What Things Influence Health?

We know that health is influenced by much more than just the healthcare system. The Determinants of Health Model lists many of the factors that affect health. We refer to these factors as the Social Determinants of Health. Social determinants affect the conditions and circumstances in which individuals and communities live, learn, work, and play. It is also important to note that the Social Determinants of Health interact across the life span, and can affect families over the life course and across generations.

Determinants of Health Model

Source: Dahlgreen, G. and Whitehead, M. (1991). Policies and Strategies to Promote Social Equity in Health. Stockholm: Institute for Future Studies.

 

The Grey Bruce Health Equity Tool!

Using a health equity lens is foundational to providing quality care and improving the health of residents in Grey and Bruce. To support the application of a health equity lens at the individual and systems level, a health equity resource tool was developed. The tool was developed collaboratively with system leaders, service providers and community stakeholders across sectors and agencies within Grey Bruce.

 

Click on each section of the wheel to learn more about the social determinants of health that contribute to the health of individuals and communities. The Health Equity tool guides you in planning and implementing your programs, services, and activities to be more equitable by considering the specific needs of populations. 

Need more information or support, but aren’t sure where to start? Visit https://211ontario.ca or call 211 to learn more about programs and services available in the County of Bruce, Grey County and across the province.

Health Equity Wheel

People with Disabilities Health Equity Tool People With Low Literacy First Nations Inuit and Metis Youth Refugees Older Adults Ethno-Cultural Groups Residents of Rural Areas People with Low Income Immigrants and Newcomers Lesbian/Gay Bisexual Transgender Women Education Money Language Food Housing Affordability Social Justice Availability Community Behaviour Transportation

The Health Equity Tool and training video was developed by the Moving Health Equity Forward Committee, an action group of the Bruce Grey Poverty Task Force.

 

How Can the Tool be Used?

When designing or making changes to policies and programs, or when working with your clients, consider these 5 key questions to ensure that you are using a health equity perspective.

If you are making changes for a group or organization, consider the system perspective. If you are making changes in the work you do directly with clients, patients, or other individuals, consider the individual perspective.

Have we included everyone?

System Perspective
a) Are all who may be impacted engaged in the planning process?
b) What are the roles of each stakeholder?
c) Have we used a broad lens to ensure perspectives cross sectors/silos?
d) Have we engaged patients, clients, or others who will experience the impact?

Individual Perspective
a) Were you included in the discussion?
b) Is everyone included that you want (e.g., personally, professionally)

Do we understand what is important?

System Perspective
a) What do the organization and community consider the critical factors for success?
b) Have we completed the Health Equity Impact Assessment to identify possible negative impacts and plan for mitigation?

Individual Perspective
a) Have you asked the stories of people with lived experience? Do you understand what is important to those you serve?
b) What is the goal that you want to achieve? What is most important to individuals you serve?
c) What steps are important to getting to that goal?
d) What is important to providers? Is it the same as what the individual(s) wants to achieve?
e) What screening tools can be used to better understand someone’s current situation?

What impact will this change have?

System Perspective
a) What is the immediate impact to core agencies and system users?
b) What are the ripple effects to other agencies and the community?
c) Have we clearly identified the positive and negative impacts? Do we have a plan to mitigate negative impacts?

Individual Perspective
a) How will this affect you?
b) How will this impact those immediately around you?
c) What are the positive impacts that we can leverage to help you drive the change?
d) What are the negative impacts and how can we reduce them?

Is it achievable?

System Perspective
a) Are all the players willing to move this ahead?
b) What are the barriers?
c) Are there funding or other systems (political, social) that need to be overcome to make this achievable?

Individual Perspective
a) Is it a realistic goal or set of goals?
b) Do you have what you need to achieve it?
c) What things or people do you need to support you to achieve it?
d) How confident are you that you can achieve your goal?

What are our next steps?

System Perspective
a) What other key players do we have to engage before we can move ahead (political, funders, etc.)?
b) Are there data or supportive information that we need before moving ahead?
C) What does implementation look like?

Individual Perspective
a) What actions do you need to take to move toward your change goal(s)?
b) What do you need to help you move ahead with your change goal(s)?
c) Do you feel ready to work toward your change goal(s)?

 

Additional Health Equity Resources

 

Within a System

Organizations striving for health equity among the populations they work with can make changes to systems within their control. The following selection of resources can support you in moving your organization toward health equity:

Health Equity Impact Assessment Tool & Guide

Achieving Health Equity: A Guide for Health Care Organizations

Fact Sheet: Supporting Health Equity Through the Built Environment

Toward Health Equity: A Tool for Developing Equity-Sensitive Public Health Interventions

Advancing Equity and Inclusion: A Guide for Municipalities

“Let’s Talk” Universal and Targeted Approaches to Health Equity

EQUIP Health Care Easy-to-use tools to support health care providers and organizations in adopting equity-oriented practices!

As an Individual

When working with individuals, small steps toward health equity can be achieved. Consider the factors displayed on the tool (above) as a starting point for learning about barriers that community members may face, as well as how to reduce those barriers. The following resources can be used as tools for equity-informed practice at the individual level:  

Measuring Health Equity: Demographic Data Collection in Health Care

From the Margins to the Middle: D.I.Y. Health Equity Kit

Additional Resources

“Let’s Talk” Health Equity

Health Equity Impact Assessment (Ministry of Health & Long Term Care)

Health Equity Impact Assessment (Wellesley Institute)

“While leadership at the top of an organization is needed to support health equity action, champions in other parts of the organization need to be supported when they assume leadership in their management of health equity projects and programs” Public Health Speaks: Leadership for Health Equity [video]

Awareness of the Social Determinants of Health in Grey Bruce

 

Health Equity Impact Assessment (HEIA)

Using the Health Equity Impact Assessment (HEIA) by the Ministry of Health and Long Term Care is an excellent tool to support health equity. HEIA is a tool that helps identify and address any unintended health impacts that a plan, policy or program might have on vulnerable or marginalized groups within a general population. The overall goal of HEIA is to achieve health equity and eliminate disparities. 

 

Examples of the Health Equity Impact Assessment Tool

CMHA Grey Bruce Mental Health and Addiction Services Integration

HEIA CMHA Detailed Final

HEIA CMHA Summary Final

CMHA HEIA Monitoring Activities

 

Tools & Training

Would you like a hard copy of the Health Equity Tool?

Send us an e-mail and a member of the Moving Health Equity Forward Action Group will be in touch.

 

Grey Bruce Health Equity Tool: Training Videos

The following three video modules are intended to increase awareness of health equity and build capacity for health equity-focused decision-making at all levels of health, social and community service organizations.
Please Note: For optimal quality, please download the videos prior to projecting to an external device.
 

Video 1: Provides an introduction to health equity and the determinants of health.

Video 2: Explains the Grey Bruce Health Equity Tool and components of the tool.

 

Video 3: Demonstrates how to use the tool online.

 

The Health Equity Tool and Training Videos were developed with support from Health Link Grey Bruce through a collaborative of the Bruce Grey Poverty Task Force.

 

 

References

Health LinkBruce Grey Poverty Task Force

 

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