The health system plays an important role in coordinating the design, organization, and management of programs and services to achieve more equitable health outcomes for people. With this in mind, the BC Provincial Health Services Authority (PHSA) initiated the Reducing Health Inequities Project to identify actions the health system could take to reduce health inequities.
The Reducing Health Inequities project team pulled together a wide range of stakeholders from across BC. This group represented health authorities, government ministries, academia, and community organizations. They worked to identify issues and barriers across the health system that may contribute to inequities, with a focus on three underserved populations: immigrants, refugees, and individuals transitioning into and out of the corrections system.
The project team learned that the system-level barriers and their recommendations were particularly pertinent to people currently underserved by the health care system. After much consultation, a number of recommendations for action were identified, including: 1) develop health equity targets and plans in consultation with communities, and 2) monitor and measure the impact of their interventions on health inequities.
Paola Ardiles (Past Chair of the Reducing Health Inequities Steering Committee) describes the PHSA initiative as effective because it used two promising practices, intersectoral action and target setting as key strategies to drive action.
Health equity targets help ensure that resources are dedicated to reducing health inequities. A health system that incorporates equity throughout its activities will better meet the health needs of underserved populations and lead to improved quality of life for the wider population. Ardiles noted that the province could see that health system barriers and issues were inadvertently creating or perpetuating health inequities; improving the responsiveness of the health system could reduce the burden and economic costs of chronic disease and health inequities.
Contributions from multi-sectoral partners from across the province added richness to the policy recommendations, making them more relevant and practical. According to Ardiles, the approach was effective in supporting community engagement that truly considers the needs and capacity of the communities being served. The process also involved champions in leadership positions, internal and external to public health, which is critical to advancing system level changes.
The Reducing Health Inequities project is a good example of intersectoral action: partners identified the need to develop health equity targets that would make the health system accountable for responding to the needs of underserved populations.
Please visit the NCCDH Resource Library for related materials, including:
- Assessing the impact and effectiveness of intersectoral action on the social determinants of health, NCCDH 2012
- VIDEO: Public health speaks: Intersectoral action for health equity, NCCDH 2013
- Promoting action on equity issues: A knowledge-to-action handbook, University of Alberta 2011
We would like to hear from you! What have your successes been in using target setting and intersectoral action as practices to improve health equity? What resources do you find helpful? Please send your ideas and examples to Lesley Dyck, Knowledge Translation Specialist.
With thanks to Helena Wall and Paola Ardiles for their help in preparing this story.