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.
- Step 1: Let's Get Started
- Step 2: Time to Engage
- Step 3: Creating a Stronger Foundation
- Step 4: Your Turn
A brief introduction to the topic that provides you with objectives specific to health equity that will move you closer to your goals.
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.
- Comprehensive and Equitable Access to OUD Care and Treatment (59:27 min)
- Adolescent Mental Health During COVID-19 (59:08 min)
- The Rise of Stimulant Overdoses and Harm Reduction (61 min)
- The Trends of Overdose Data During COVID-19 (58:05 min)
- Expanded PFAS Exposure Assessments in Pennsylvania Communities (21:50 min)
- 10 Building Blocks of Early Childhood Nutrition: Strategies to Promote Breastfeeding (58:36 min)
- Innovative State Strategies for Diabetes Prevention (79 min)
- Use of Telehealth for Substance Use Disorder Treatment in Maternal and Child Populations (52:09 min)
- OMNI Learning Community: Engaging Primary Care Associations and Federally Qualified Health Centers (52:36 min)
- ASTHOConnects Session #2: Working Across Boundaries to Incorporate an Equity Lens to Breastfeeding Initiatives (46:34 min)
- OMNI Learning Community ASTHOConnect: Successful Models Integrating Maternal Care and Substance Use Treatment (57:48 min)
- Social Determinants of Health: Financing Interventions and Strategies for States (54:25 min)
- ASTHOConnects Session #1: ASTHO Breastfeeding Learning Community (62 min)
- School discipline as a social determinant of health and reframe school-based restorative justice (23 min)
- LGBT teens facing bullying (35 min)
- Neoliberal ideology and its impact on youth sexuality (33 min)
- Mental Health Disparities among Gay Youth: A Developmental Interpretation and Application of the Minority Stress Hypothesis (95 min)
- Session 21: How Racism Impacts Our Mental Health (15:15 min)
- Session 27: Mental Health and Terrorism (18:22 min)
- Session 42: Race-Related Stress (33:04 min)
- Session 46: Mental Health Needs of Activists (43:19 min)
- Session 49: Angry Black Women (34:43 min)
- Session 134: Impact of Racial Trauma (38:27 min)
- Session 148: Talking to Kids About Race (28:58 min)
- Session 161: Parenting in a Pandemic (42:25 min)
- Session 162: Processing Our Collective Grief (38:56 min)
- Session 165: Let’s Chill with the Quarantine 15 Jokes (39:24 min)
- Session 183: Seasonal Depression During the Pandemic (44:43 min)
- Addressing Housing Challenges and Economic Insecurity During COVID-19 (34:45 min)
- Using Prevention Strategies to Help Families Thrive (27 min)
- Improving Care to Address Maternal and Child Lead Exposure (30:26 min)
- Addressing Rural Health Disparities in a Pandemic (32:22 min)
- Fostering Equitable Change During COVID-19 (31:46 min)
- How COVID-19 Exposed the Gaps in Substance Use Care (29:45 min)
- The Next Surge: The Behavioral Health Crisis Following COVID-19 (36:11 min)
- Promoting Well-Being and Reducing Risk Post-COVID-19 (28:13 min)
- Lessons from the Trenches: Leading During a Public Health Crisis (33:57 min)
- The Importance of Public Health Surveillance in Responding to Overdoses (27:59 min)
- COVID-19 Highlights Urgent Need for Increased Public Health Funding (23:27 min)
- Tobacco 21 and Flavor Restrictions: What Actually Happened? (34:45 min)
- Ecosystem of Care: Providing Behavioral Health Services to Pregnant Women (24:39 min)
- In the American Psychological Association (APA) COVID-19 Special Report Fighting inequity in the face of COVID-19: Psychologists are working to combat the systemic disparities that have led the virus to disproportionately affect people of color and other groups, Stephanie Pappas delves into topics of fear and discrimination, Native communities, Race and the socioeconomic divide.
- In another article, Combating bias and stigma relations to COVID-19 APA examines action steps that can be taken to stop the xenophobia, biases, and stigma that are spreading as it is related to COVID-19. Some of the action steps include: (1) Promote ethical journalism (2) Correct myths, rumors and stereotypes, and challenge those whose language promotes bias, and (3) Portray different ethnic groups in public information materials
- APA has developed a Bias, Discrimination, and Equity Resources page to support behavioral and social scientists, advocates, activists and community serving practitioners during COVID-19.
- How COVID-19 impacts sexual and gender minorities
- How Psychologists can combat the racial inequities of the COVID-19 crisis
- How to help vulnerable populations now
- Ageism and COVID-19 fact sheet
- Serious mental illness and COVID-19: How to help your patients right now
- · Innovations in Health Equity and Health Philanthropy: By Faith Mitchell
- · Illuminating the Health Equity Challenge: By Garth Graham, MaryLynn Ostrowski, & Alyse Sabina
- · Partnering with Philanthropy in Native America: By Nick Tilsen
- · Building Power, Building Health: By Doran Schrantz
- · Philanthropy on the Frontlines of Ferguson: By Rev. Starsky D. Wilson
- · Promoting Health Impact Assessments: By Lili Farhang & Jonathan Heller
- · Building a Healthier Nail Salon Industry: By Susan McQuade, Mónica Novoa, & Charlene Obernauer
- · Embracing Healing Justice in California: By Samuel Nuñez, Alejandra Gutierrez, & Emily Borg
- · Ending LGBT Health Inequities: By Samantha Franklin & Andrew Lane
- · Achieving Healthy Communities Through Transit Equity: By Dace West
- · Using Fair Housing to Achieve Health Equity: By Kellee White & George Lipsitz
- · Reducing Health Disparities in Atlanta: By Karen Minyard, Kathryn Lawler, Elizabeth Fuller, Mary Wilson, & Etha Henry
- Capitalize on Tax Credits for Families
- Afford Access to paid Family Medical Leave
- Prioritize Justice System Reform
- What is Health Equity?
- Building a Culture of Health by Creating Opportunities for Boys and Young Men of Color
- ARCHE Culture of Health Institute for Leadership Development (CHILD) Online Training titled “Essential Tools for Health Equity Practice.”
- Getting to Equity in Obesity Prevention: A New Framework
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.
- In the APA Special Issue: Racial Trauma: Theory, Research, and Healing, Comas-Díaz, Hall, and Neville (2019) the authors introduce new conceptual models of racial, ethnics and Indigenous trauma that is present in People of Color and Indigenous (POCI) communities.
- Comas-Díaz, L., Hall, G. N., & Neville, H. A. (2019). Racial trauma: Theory, research, and healing: Introduction to the special issue. American Psychologist, 74(1), 1-5. http://dx.doi.org/10.1037/amp0000442
- Toward a Psychological Framework of Radical Healing in Communities of Color article, French and colleagues (2020) Provide context of race and racism in the United States and ways in which this impacts People of Color and Indigenous Individuals (POCI). The authors discuss healing as it integrates liberation psychology, Black psychology, ethnopolitical psychology and intersectionality theory.
- French, B. H., Lewis, J. A., Mosley, D. V., Adames, H. Y., Chavez-Dueñas, N. Y., Chen, G. A., & Neville, H. A. (2020). Toward a psychological framework of radical healing in communities of color. The Counseling Psychologist, 48(1), 14–46. https://doi-org.proxy-remote.galib.uga.edu/10.1177/0011000019843506
- One Size Does Not Fit All: Taking Diversity, Culture and Context Seriously
- Alegria, M., Atkins, M., Farmer, E., Slaton, E., & Stelk, W. (2010). One size does not fit all: taking diversity, culture and context seriously. Administration and policy in mental health, 37(1-2), 48–60. https://doi.org/10.1007/s10488-010-0283-2
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.
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.
- 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)