scholarly journals Sidebar: Time, Talent, and Treasure: Health Systems and the Anchor Mission Strategy for Advancing Health Equity

2022 ◽  
Vol 83 (1) ◽  
pp. 13-15
Author(s):  
Crystal W. Cené ◽  
Randi J. Towns
Keyword(s):  
Health Systems ◽  
Health Equity ◽  
Mission Strategy

scholarly journals Enhanced skills in global health and health equity: Guidelines for curriculum development

2017 ◽  
Vol 8 (2) ◽  
pp. e48-60 ◽  
Author(s):  
Russell Eric Dawe ◽  
Andrea Pike ◽  
Monica Kidd ◽  
Praseedha Janakiram ◽  
Eileen Nicolle ◽  
...  
Keyword(s):  
Family Medicine ◽  
Global Health ◽  
Health Systems ◽  
Health Equity ◽  
Underserved Populations ◽  
Cultural Humility ◽  
Global Health Education ◽  
Essential Components ◽  
Competency Based ◽  
Program Components

Introduction: Global health addresses health inequities in the care of underserved populations, both domestic and international. Given that health systems with a strong primary care foundation are the most equitable, effective and efficient, family medicine is uniquely positioned to engage in global health. However, there are no nationally recognized standards in Canada for postgraduate family medicine training in global health.Objective: To generate consensus on the essential components of a Global Health/Health Equity Enhanced Skills Program in family medicine.Methods: A panel comprised of 34 experts in global health education and practice completed three rounds of a Delphi small group process.Results: Consensus (defined as ≥ 75% agreement) was achieved on program length (12 months), inclusion of both domestic and international components, importance of mentorship, methods of learner assessment (in-training evaluation report, portfolio), four program objectives (advocacy, sustainability, social justice, and an inclusive view of global health), importance of core content, and six specific core topics (social determinants of health, principles and ethics of health equity/global health, cultural humility and competency, pre and post-departure training, health systems, policy, and advocacy for change, and community engagement).Conclusion: Panellists agreed on a number of program components forming the initial foundation for an evidence-informed, competency-based Global Health/Health Equity Enhanced Skills Program in family medicine.

Measuring and Combatting Health-Related Inequalities

2021 ◽  
pp. 184-204
Author(s):  
James Wilson
Keyword(s):  
Public Health ◽  
Lived Experience ◽  
Health Systems ◽  
Health Equity ◽  
Power Structures ◽  
Health Related ◽  
Break Up ◽  
Pluralist Approach

This chapter examines how health systems should measure, and respond to, health-related inequalities. Health equity is often taken to be a core goal of public health, but what exactly health equity requires is more difficult to specify. There are indefinitely many health-related variables that can be measured, and variation in each of these variables can be measured in a number of different ways. Given the systemic interconnections between variables, making a situation more equal in some respects will tend to make it less equal in others. The chapter argues for a pluralist approach to health equity measurement, which takes its cue from the lived experience of individuals’ lives. Reflection on the deepest and most resilient causes of health-related inequalities shows that they are often the result of intersecting structural concentrations of power—structures which it is vital, but very difficult, to break up.

scholarly journals “The health equity curse”: ethical tensions in promoting health equity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bernie Pauly ◽  
Tina Revai ◽  
Lenora Marcellus ◽  
Wanda Martin ◽  
Kathy Easton ◽  
...  
Keyword(s):  
Public Health ◽  
Health Systems ◽  
Health Equity ◽  
Ethical Challenges ◽  
Services Research ◽  
Ethical Concerns ◽  
Ethical Frameworks ◽  
Ph Values ◽  
Constant Comparative Analysis ◽  
Health Agenda

Abstract Background Public health (PH) practitioners have a strong moral commitment to health equity and social justice. However, PH values often do not align with health systems values, making it challenging for PH practitioners to promote health equity. In spite of a growing range of PH ethics frameworks and theories, little is known about ethical concerns related to promotion of health equity in PH practice. The purpose of this paper is to examine the ethical concerns of PH practitioners in promoting health equity in the context of mental health promotion and prevention of harms of substance use. Methods As part of a broader program of public health systems and services research, we interviewed 32 PH practitioners. Results Using constant comparative analysis, we identified four systemic ethical tensions: [1] biomedical versus social determinants of health agenda; [2] systems driven agendas versus situational care; [3] stigma and discrimination versus respect for persons; and [4] trust and autonomy versus surveillance and social control. Conclusions Naming these tensions provides insights into the daily ethical challenges of PH practitioners and an opportunity to reflect on the relevance of PH frameworks. These findings highlight the value of relational ethics as a promising approach for developing ethical frameworks for PH practice.

scholarly journals “The Health Equity Curse”: Ethical Tensions in Promoting Health Equity

2020 ◽  
Author(s):  
Bernie Pauly ◽  
Tina Revai ◽  
Lenora Marcellus ◽  
Wanda Martin ◽  
Kathy Easton ◽  
...  
Keyword(s):  
Public Health ◽  
Health Systems ◽  
Health Equity ◽  
Ethical Challenges ◽  
Services Research ◽  
Ethical Concerns ◽  
Ethical Frameworks ◽  
Ph Values ◽  
Constant Comparative Analysis ◽  
Health Agenda

Abstract Background: Public health (PH) practitioners have a strong moral commitment to health equity and social justice. However, PH values often do not align with health systems values, making it challenging for PH practitioners to promote health equity. In spite of a growing range of PH ethics frameworks and theories, little is known about ethical concerns related to promotion of health equity in PH practice. The purpose of this paper is to examine the ethical concerns of PH practitioners in promoting health equity in the context of mental health promotion and prevention of harms of substance use.Methods: As part of a broader program of public health systems and services research, we interviewed 32 PH practitioners. Results: Using constant comparative analysis, we identified four systemic ethical tensions: [1] biomedical versus social determinants of health agenda; [2] systems driven agendas versus situational care; [3] stigma and discrimination versus respect for persons; and [4] trust and autonomy versus surveillance and social control.Conclusions: Naming these tensions provides insights into the daily ethical challenges of PH practitioners and an opportunity to reflect on the relevance of PH frameworks. These findings highlight the value of relational ethics as a promising approach for developing ethical frameworks for PH practice.

Health systems and health equity: The challenge of the decade

2012 ◽  
Vol 7 (sup1) ◽  
pp. S63-S72 ◽  
Author(s):  
Marian Jacobs ◽  
Wafaa M. El-Sadr
Keyword(s):  
Health Systems ◽  
Health Equity

scholarly journals Daniel Lopez-Acuña

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D Lopez-Acuña
Keyword(s):  
Health Systems ◽  
Health Equity

Abstract Dr Lopez-Acuña will present opportunities to advance health equity by making health systems more accessible for people in situations of heightened vulnerability, including due to irregular status, through actions at the local, regional and international levels.

scholarly journals Values are not enough: qualitative study identifying critical elements for prioritization of health equity in health systems

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Thea van Roode ◽  
Bernadette M. Pauly ◽  
Lenora Marcellus ◽  
Heather Wilson Strosher ◽  
Sana Shahram ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Systems ◽  
Health Equity ◽  
Health Inequities ◽  
System Capacity ◽  
Comparative Approach ◽  
Structural Level ◽  
Critical Elements ◽  
Health Authorities

Abstract Background Health system policies and programs that reduce health inequities and improve health outcomes are essential to address unjust social gradients in health. Prioritization of health equity is fundamental to addressing health inequities but challenging to enact in health systems. Strategies are needed to support effective prioritization of health equity. Methods Following provincial policy recommendations to apply a health equity lens in all public health programs, we examined health equity prioritization within British Columbia health authorities during early implementation. We conducted semi-structured qualitative interviews and focus groups with 55 senior executives, public health directors, regional directors, and medical health officers from six health authorities and the Ministry of Health. We used an inductive constant comparative approach to analysis guided by complexity theory to determine critical elements for prioritization. Results We identified seven critical elements necessary for two fundamental shifts within health systems. 1) Prioritization through informal organization includes creating a systems value for health equity and engaging health equity champions. 2) Prioritization through formal organization requires explicit naming of health equity as a priority, designating resources for health equity, requiring health equity in decision making, building capacity and competency, and coordinating a comprehensive approach across levels of the health system and government. Conclusions Although creating a shared value for health equity is essential, health equity - underpinned by social justice - needs to be embedded at the structural level to support effective prioritization. Prioritization within government and ministries is necessary to facilitate prioritization at other levels. All levels within health systems should be accountable for explicitly including health equity in strategic plans and goals. Dedicated resources are needed for health equity initiatives including adequate resourcing of public health infrastructure, training, and hiring of staff with equity expertise to develop competencies and system capacity.

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