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Advancing health equity through frameworks
Many organizations and systems are committed to advancing health equity, but the strategic, tactical and practical work required can be challenging. Frameworks are a useful tool to help translate equity commitments into action.
While the literature includes numerous health equity frameworks, it provides little direction on how to use them to implement and strengthen health equity action in organizations and systems. To help fill this gap, the NCCDH, guided by an advisory group, convened an online workshop with approximately 50 participants.
The purpose of the workshop was to listen, learn and build on participants’ practice-based knowledge, experience and expertise to co-create guidance on using frameworks to strengthen health equity efforts across organizations and systems.
Foundational health equity approaches
The workshop discussion focused on four key areas:
- advantages and pitfalls of frameworks
- co-creating, selecting and adapting frameworks
- organizational and system supports
- critical evaluation questions
Across these areas, four themes emerged as foundational to all health equity work, whether using frameworks or not:
- How we work together matters. Use anti-oppressive, equity-oriented approaches at all stages of health equity work.
- Create space for people and communities to exercise their power at all levels and stages. Address inequitable power relations and centre the voices of equity-denied communities in health equity work. Adopt non-hierarchical leadership approaches, diversify who holds formal leadership roles and ensure health equity roles have decision-making power.
- Establish supportive, enabling structures and environments at system and organizational levels. Enabling factors include legislation; embedding accountability for health equity in organizations; integrating equity-aligned policies and practices; and fostering organizational transparency, creativity and space to learn.
- Commit required resources. Resources that enable health equity work include dedicated funding and time; recruiting, retaining, promoting and appropriately compensating people doing this work; and ongoing support to monitor and evaluate health equity work.
Use this resource to
- Explore practice-based insights from workshop participants on advancing health equity, whether using frameworks or not
- Facilitate discussion to identify concrete strategies to disrupt systems of oppression and advance health equity in organizations
- Guide action on the co-creation, use and evaluation of health equity frameworks
Related resources:
Health equity frameworks as a tool to support public health action: A rapid review of the literature
Health equity frameworks as a tool to support public health action: A curated list
Let’s Talk: Redistributing power to advance health equity
Let’s Talk: Determinants of health
The coin model of privilege and critical allyship: Implications for health
Reference
National Collaborating Centre for Determinants of Health. (2025). Using health equity frameworks to advance health equity in organizational and system contexts: Learnings from the field. Antigonish, NS: NCCDH, St. Francis Xavier University.