Key Strategies to Pursue Health Equity
Systems change efforts sometimes grapple with a tension between: a) urgency to address brokenness that continues to do harm, and b) patience to gather enough resources and the right leaders to be effective and successful. Strategies to reduce health disparities and promote health equity can address both sides of this tension.
No one has a greater sense of urgency to improve health outcomes than those who are directly impacted by health disparities. Participatory designs in which marginalized communities identify their own health challenges, help design interventions, and assist in assessing the success of those interventions benefit from the urgency of and accountability provided by their participants.
Along those same lines, urgency is enhanced in coalitions and collective impact initiatives when non-professional community members are clearly and deeply involved in decision-making processes and equity is established as a primary goal from the outset.
The chart below from the Centers for Disease Control and Prevention (CDC) is a helpful tool to assess community participation and involvement. As work shifts more to the right, stronger partnerships and more ambitious outcomes become possible – equity becomes not only an end, but also a means to that same end.
(Source: American Association of American Medical Colleges)
Practical recommendation 1: Abide by the phrase “with, not for” – do things with the people you are serving, not for them
On the other hand, a long-term approach (patience) is strengthened by perpetual efforts to build trust and deepen relationships, not only to generate resources (i.e., sustainable funding) but also to identify and develop leaders from and within marginalized communities. For example, training and hiring community members as promotores de salud (community health workers) increases leadership capacity and enhances collective efficacy. Similarly, organizations can implement programs providing training and real opportunities for patients and community members to exercise leadership in the promotion of community health.
Developing long-term community leadership for health equity – whether through community-based organizations, churches, or other associations – means that leaders rooted in the community will be prepared and in place when the time is right to move into action. Outside (or even inside) professionals should never be the first, last, and only line of defense!
Practical recommendation 2: Working towards health equity includes ensuring the people you serve have the resources and abilities necessary to continue the work – how you can develop leadership and capacity among the people you serve? How can you strengthen the human assets of the community?
As we strive for the highest level of health for all people, let us remember that this is everyone’s business. As a society, health equity is in our best interest socially and economically; for Methodist Healthcare Ministries, it is also a moral and theological imperative as we provide leadership to improve the wellness of the least served.
Tim Barr is the Collective Impact Strategy Manager for Methodist Healthcare Ministries. He supports, develops, and facilitates collaborative efforts in South Texas. Tim is also a member of the Climate Equity workgroup for the City of San Antonio’s Climate Action and Adaptation Plan.
To see part 1 of this blog series, click here.
To see part 2 of this blog series, click here.