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Health equity

Why health equity?

Equity as a key component of quality care that extends into all approaches of client care. Health equity refers to people's ability to attain their optimum level of health, regardless of gender, age, ethnicity, social class and other circumstances. Equity-based approaches recognize that care for disadvantaged populations needs to be designed to:

  • soften the harsh impact of wider social exclusion and inequality
  • take account of the long-standing, deep-seated nature of social and economic inequalities experienced by marginalized individuals and communities
  • meet the unique health needs and challenges of marginalized individuals and communities.

Definition

Health equity involves creating equal opportunities for good health for everyone and reducing avoidable and unjust differences in health among population groups.

Members of marginalized groups experience disparities in health status rooted in unequal social power and discrimination. Significant inequities exist in how people access and experience health care services. Factors such as gender, race, sexual orientation, immigration status, income and education can influence a person's access to timely, appropriate, high-quality care.

Equitable access to health services that is based on need, fair distribution of resources and culturally competent care, and that focuses on the most health-disadvantaged groups can reduce disparities in health outcomes and enhance the well-being of members of marginalized groups.

Health equity includes developing affordable health care systems. In Ontario, health equity action priorities include:

  • collecting equity data and developing equity indicators
  • developing shared interpretation and translation services
  • improving access for non-insured clients.

Principles of health equity

Health care systems can address health disparities in various ways. They can:

  • identify and reduce barriers to accessing services
  • ensure that all people receive the high-quality, responsive care they need
  • target investments and interventions toward the most health-disadvantaged groups
  • build equity, diversity and gender analysis into all service delivery and planning
  • enhance equity-focused primary, chronic and preventive care, and make other health care investments that will have the most impact in reducing disparities
  • build cross-sectoral collaborations beyond the health care system to address the wider determinants of health.

Collaboration

The Ontario Ministry of Health and Long-Term Care (MOHLTC) developed the Health Equity Impact Assessment (HEIA) tool to advance quality and equity in health care service design and delivery. HEIA is a decision-support tool that guides users through the steps of identifying how a program or policy will affect different population groups. The goal is to maximize positive impacts and reduce negative impacts that could widen health disparities.

Between 2009 and 2010, MOHLTC partnered with the North East, Toronto Central and Waterloo Wellington Local Health Integration Networks (LHINs) to conduct regional HEIA pilots. The feedback was used to further refine the tool. The refined tool better integrates the social determinants of health and provides an improved HEIA implementation plan.

The feedback also identified the types of support and ongoing collaboration that are necessary to integrate HEIA. MOHLTC continues to work with all LHINs to advance regional implementation and support provincial and local HEIA communities of practice.

Related approaches

  • client-centred approach
  • integrative care.

Evidence summary

Ontario Ministry of Health and Long-Term Care. (2012). Health Equity Impact Assessment. Toronto, ON: Author.

Toronto Central Local Health Integration Network. (2008). Health Equity Discussion Paper. Toronto, ON: Author.

Toronto Central Local Health Integration Network. (2014). Health Equity. Toronto, ON: Author.

Resources

Online resources

  • The Health Equity Office at the Centre for Addiction and Mental Health offers various health equity resources for addiction and mental health professionals, primary care providers, allied professionals and people involved in program and policy development.

For your clients and their families

  • Face to Face: Understanding Mental Illness was created by the Canadian Mental Health Association. Learn the signs and symptoms of mental illness, and develop the skills and tools for how to best engage with those experiencing mental health challenges.
  • The Hospital for Sick Children in Toronto created the film Journey to Cultural Competence to facilitate awareness and experiential learning relating to culture and health care. The film features families who immigrated to Canada from different parts of the world and the stressors they experience while navigating the health care system.
  • Multilingual Resources. The Centre for Addiction and Mental Health provides multi-language information about mental health and addiction for people whose first language is not English. It also provides resources for professionals who work with clients from culturally and linguistically diverse backgrounds.
  • The Refugee Mental Health Course for Settlement Workers is offered by the Centre for Addiction and Mental Health (CAMH) as part of its Refugee Mental Health Project. CAMH received funding from Citizenship and Immigration Canada to create these free online resources for settlement workers and health care professionals who work with refugees in Ontario.

Training

  • The Opening Doors Project, developed by the Canadian Mental Health Association, is a free workshop series for newcomer communities, mental health survivors and mental health agencies and institutions.
  • Professional Education and Training (PET) is offered by the Ontario Council of Agencies Serving Immigrants. It provides individual and in-house group training for staff at immigrant service agencies whose positions are funded by Citizenship and Immigration Canada and the Ontario Ministry of Citizenship and Immigration.

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