The second release in our Let’s Talk series, Let's Talk: Public health roles for improving health equity, offers public health organizations a framework for reflection and action.
The public health roles speak to four categories of action that can guide an organization’s efforts to reduce disparities in health. They are a health equity framework that can help you set priorities and make decisions:
Role 1: Assess and report
Role 2: Modify and orient interventions
Role 3: Partner with other sectors
Assess and report on a) the existence and impact of health inequities, and b) effective strategies to reduce these inequities.
Assess and report includes public health surveillance activities, specifically “the ongoing systematic collection, analysis, interpretation and dissemination of health data for the planning, implementation and evaluation of public health action” (Choi, 2012). It also includes assessing and reporting effective strategies to reduce inequities.
Four of the promising practices, identified to guide local public health practice to reduce social inequities in health, are related to assessment and reporting: purposeful reporting, health equity target setting, equity-focused health impact assessment and contributing to the evidence base.
Highlights from projects
Population health status reporting is a vital tool for addressing the social determinants of health and advancing health equity. The way that health data is collected, analyzed and shared shapes our perceptions of population health and influences our ability to act. Public health practitioners and organizations from across Canada have identified the need for resources, tools and collaborative learning on population health status reporting. In 2012, we hosted a national learning circle of practitioners and academics engaged in knowledge exchange and synthesis. Capital Health (Halifax) served as an applied practice site, as they integrated a health equity lens into their first population health status report. Evidence and knowledge gathered over the learning circle process were disseminated to our audience through nine synthesis documents, four videos and numerous events.
Equity-integrated population health status reporting: Action framework
The NCCDH, with contributions from each of the National Collaborating Centres for Public Health, has completed a Population Health Status Reporting – Toolkit Project.
This resource presents an accessible action framework for people who are creating community health status reports, as well as people interested in learning how to use PHSR to drive action on improving health equity.
For more information, click here.
Modify and orient interventions and services to help reduce inequities, with an understanding of the unique needs of populations that experience marginalization.
It is essential for public health programs to reach populations that experience marginalization. Programs and services must be planned, implemented and evaluated with a consideration of equity.
Three of the promising practices, identified to guide local public health practice to reduce social inequities in health, are related to modify and orient: targeting with universalism, equity-focused health impact assessment, and early childhood development.
Highlights from projects
Let’s Talk… Universal and targeted approaches to health equity, part of the Let’s talk series, explored targeted, universal and blended approaches to public health interventions. In Let’ talk …Universal and targeted approaches to health equity a number of conceptual examples were given to help clarify the theory.
Real-world examples are in development to help public health staff better understand how targeted and universal approaches can be blended to achieve better population health outcomes. The first, Learning from practice: Targeting within universalism at Capital Health, can be found here.
Because most of the social determinants of health lie outside of the health sector, working with multiple partners - including government, community organizations, communities, and specific populations - is an essential part of public health practice, especially considering that differences in our health are influenced by economic and societal factors.
Two promising practices, identified to guide local public health practice to reduce social inequities in health, are related to partner with other sectors: intersectoral action and community engagement.
Highlights from projects
In 2012, we released an expedited systematic review as part of our effort to explore “what works” to improve health equity through action on the social determinants of health. This review examines the question, “What is the impact and effectiveness of intersectoral action as a public health practice for health equity through action on the social determinants of health?” In 2013, we published an article about this study.
In 2013, a reference guide that describes 16 community engagement frameworks was created, as public health practitioners are increasingly using community engagement strategies.
Upcoming – stay tuned!
The NCCDH will release additional case examples that will highlight the role of partnering with other sectors and the community.
In early 2014, we dropped work on a review of reviews about the effectiveness of community engagement by public health to address determinants of health because a substantive, multi-faceted U.K. study was released that researched similar questions. We are summarizing and analyzing this new U.K. study – you’ll see our findings in products and events in 2014.
Lead, support and participate with other organizations in policy analysis and development, and in advocacy for improvements in health determinants and inequities.
Participating in policy development and advocacy is a key role for public health to improve health equity because policies that promote health improve conditions where people live, work and play.
Three of the promising practices, identified to guide local public health practice to reduce social inequities in health, are related to policy development and advocacy: health equity target setting, intersectoral action and community engagement.
The NCCPH program has an NCC that is fully focused on healthy public policy. Because of this, the NCCDH doesn’t emphasize this role. At the NCCDH we partner with the National Collaborating Centre for Healthy Public Policy and other NCCs on resources that look at policy development and advocacy with a view that critically considers the social determinants of health and health equity. Visit the NCC for healthy public policy for more resources related to policy development and advocacy.
Highlights from projects are:
Tools and approaches for assessing and supporting public health action on the social determinants of health and health equity is a joint NCCDH and NCCHPP document that offers analysis of various tools including the capacity og each to create policy recommendations.
Health Equity Tools for Policy Change is a powerpoint presentation given by NCCDH staff to a gathering of 400 people at THRIVE! The tools is describes, from Alberta, Australia and the European Union, have been used widely to improve the equity outcome of policies and programs.