Values are not enough: Qualitative study identifying critical elements for prioritization of health equity in health systems
This resource is available in English only
Backgrounded by British Columbia’s efforts to prioritize health equity through policy changes, including a requirement to apply an equity lens across all public health programs in regional health authorities, this study is part of the Equity Lens in Public Health Program of Research.
The authors, guided by complexity theory, explore what is needed to prioritize health equity within complex health system. They focus their inquiry on six British Columbia (BC) health authorities and the BC Ministry of Health, engaging senior public health actors through semi-structured interviews and focus groups.
Creating a systems value for health equity and engaging health equity champions
Their analysis reveals that both creating a ‘systems value’ for health equity and engaging health equity champions are critical to prioritizing health equity in the informal organization of the BC health system.
The authors underscore the importance of assessing the system as a whole and identifying areas where health equity is strongly valued, and, in contrast, where it lacks support.
They note that health equity is often a core value among senior public health leaders, and that this supports its prioritization within the health system. In contrast, health equity is inconsistently valued and understood in other parts of the health system.
Embedding health equity in the formal organization of the health system
The authors also found that to embed health equity in the formal organization of the health system, it was necessary to name health equity as an explicit priority at all levels (e.g., in strategic plans and goals).
Other critical elements include:
- requiring health equity in decision-making;
- dedicating resources to health equity efforts;
- building capacity to engage in health equity work; and
- ensuring a coordinated, comprehensive approach to prioritizing health equity within the health system.
Use this resource to
- reflect on the factors necessary to prioritize health equity in complex health systems;
- spark a conversation with colleagues about how the concept of health equity is and is not valued and understood; and
- inform health equity change efforts within your region’s health system.
van Roode, T., Pauly, B.M., Marcellus, L. et al. (2020). Values are not enough: qualitative study identifying critical elements for prioritization of health equity in health systems. International Journal for Equity in Health, 19 (162). https://doi.org/10.1186/s12939-020-01276-3
- Let’s Talk: Values and health equity (2020)
- Living health equity values in public health organizations: a review and dialogue-based tool (2021)
- Let’s Talk: Ethical foundations of health equity (2020)
- Webinar recording: Living health equity values within public health organizations (2019)