The System exChange The Sytem exChange provides powerful tips and ideas for transforming your local community.

Part 1 in the series on Equity

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What is Equity?

America has some of the biggest differences in health and wellbeing outcomes across groups of people ( Robert Wood Johnson Foundation, 2016 ). These differences matter because they impact what possibilities a community can achieve and whether people can reach their full potential. Every community has these types of disparities. Fortunately, a focus on equity can help to tackle them. Equity involves creating conditions in which everyone has a fair and just opportunity for health and wellbeing (Blackwell, 2017; Robert Wood Johnson Foundation, 2016).  Unfortunately, some groups experience more obstacles to this opportunity than others, such as a lack of access to good jobs with fair pay, quality education, housing, safe environments, and healthcare. Often, these obstacles accumulate because of discrimination related to socioeconomic status, race/ethnicity, sexual orientation, gender, disability status, geographic location, or a combination of these characteristics (Annie E. Casey Foundation, 2014).  A focus on equity requires communities to simultaneously:

Address Inequities

by removing the obstacles (e.g., policies and systems) preventing some groups from having the opportunity for health and well-being.

Promote Equity

by supporting the social, economic, political, and learning power and capacity of groups experiencing inequities.

What is the difference between equity and equality? People often misunderstand these two terms, even though they have very different implications for the work. Below are some descriptions of each term and an example:

Equality  Assumes everyone starts from the same place and has equal access to resources and opportunities.  Says everyone should be treated the same and given the same things. EXAMPLE: All public schools in a community have computer labs with the same number of computers and hours of operation during the school day.

Equity  Acknowledges neighborhoods and systems are structured in ways that give some groups more access to resources and opportunities than others.  Says people should have access to resources and opportunities based on their unique needs and circumstances. EXAMPLE: Each school provides adequate computers and hours of operation to meet the specific needs of students within their building - especially those who don’t have access to computers, printers, or the internet at home. 

Equity vs. Equality Checklist  Check out this checklist to help understand whether a plan, policy, or strategy is equity focused vs. equality focused. Additional Resources Annie E. Casey Foundation Equity Resources Reports, tools, guides, and assessments to help organizations and change efforts pursue equity. Prevention Institute Health Equity Tools Practical tools to help practitioners, advocates, community groups, and policymakers promote equity with their efforts. Race Forward Website Reports, tools, and training opportunities around how to promote racial equity within change efforts.

 Practical Tips:  Talking about Equity

How do you bring people into the conversation about tackling local inequities in your community? It comes down to how you talk about it. Unfortunately, it can be challenging to talk about equity with others in authentic dialogue. The good news is that there are many resources out there to help build a shared understanding and value for equity in the community. Check out the following resources to help support your conversations about equity.

Visualizing Equity vs. Equality Check out this image comparing equity and equality from the Robert Wood Johnson Foundation, 2017. NOTE : equity involves not only giving people what they need (e.g., right type of bike), but also putting conditions in place to ensure inclusion and access for everyone (e.g., adding curb cuts to sidewalks) Visualizing Equity vs. Equality Check out this image comparing equity and equality from CAMH Provincial System Support Program, 2015. Click here to access their guide with additional resources.

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Statisticks Lottery The video describes why some children experience worse outcomes related to success in school and life than others. Helpful for illustrating the types of obstacles often leading to inequities. Source: The Campaign for Grade-level Reading, 2014

 Talking about equity and inequity can be difficult. The Robert Wood Johnson Foundation and the Annie E. Casey Foundation have funded research looking at how various ways to talk about equity resonate with different Americans (see first two resources linked below). The research suggests avoiding language that triggers negative reactions given people’s current political paradigms, and instead using language that better resonates with diverse audiences such as:

Words to Avoid “Equal, equality or equalizing” “Leveling the playing field” “Creating balance” ‘Unjust/injustice”

Words to Use “Raising the bar for everyone” “Giving everyone an opportunity to live a healthy life” “Not right” 

Framing to Avoid Who is to blame for current inequities Focus on fairness (risks people getting into debates about what this means)

Framing to Use What (policies, practices, etc.) is to blame for current inequities Focus on results of using an equity approach (e.g., all children graduating) Focus on opportunity for all 

New Way to Talk about the Social Determinants of Health This report by the Robert Wood Johnson Foundation (2010) provides some research-based suggestions for how to talk about equity and the social determinants of health. Race Matters: How to Talk about Race This report by the Annie E. Casey Foundation (2006) provides practical tips and recommendations for how to talk with others about racial equity.

Framing Public Issues This report (especially pages 33-34) by the Frameworks Institute (2002) provides research-based recommendations for how to frame and talk about sensitive issues like equity.

CHIR Connection

Reach out to your local CHIR to share ideas and take action around promoting equity in your region.

Join CHIRs across the state in discussing these ideas on MICHIRLearning.org Current Discussion Topic: What resources are you using to help talk with others about equity?

Equity Q&A Q: How can we start bringing a focus on equity into our CHIR discussions? A: There are lots of ways to embed an equity focus into your local discussions, such as: Add agenda items to help groups consider equity within planning and decision-making Use an Equity Impact Assessment tool to help groups consider equity questions in their planning Have one person per meeting volunteer to listen for (and then highlight) opportunities where the group could consider equity in the discussion Submit your questions on the Contact Us page of the MICHIRLearning website .

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July 2019 Have an idea for a future System exChange publications? Email us at: [email protected]

References Annie E Casey Foundation (2006). Race matters: How to talk about race. Retrieved from https://www.aecf.org/resources/race-matters-2/ Annie E. Casey Foundation. (2014). Race equity and inclusion action guide. Retrieved from https://www.aecf.org/m/resourcedoc/AECF_EmbracingEquity7Steps-2014.pdf   Blackwell, A. G. (2017). The Curb-Cut Effect. Stanford Innovation Review , Winter 2017. Retrieved from https://ssir.org/articles/entry/the_curb_cut_effect john powell, Stephen Menendian & Jason Reece. (2009). The Importance of targeted universalism. Poverty & Race. 18(2). Just Health Action (n.d.) Introduction to environmental justice, equity, and health. Retrieved from http://justhealthaction.org/wp-content/uploads/2010/05/JHA-Lesson-Plan-3-How-are-equity-and-equality-different-final.pdf Robert Wood Johnson Foundation. (2010) A new way to talk about the social determinants of health. Retrieved from  https://societyforhealthpsychology.org/wp content/uploads/2016/08/rwjf63023.pdf  Robert Wood Johnson Foundation. (2016). From vision to action: A framework and measures to mobilize a culture of health. Retrieved from https://www.rwjf.org/content/dam/COH/RWJ000_COH-Update_CoH_Report_1b.pdf Robert Wood Johnson Foundation (2017) Everett culture of health story. Retrieved from https://www.rwjf.org/en/library/articles-and-news/2015/10/coh-prize-everett-ma-story.html  Thomas, S. P., Quinn, S. C., Butler, J., Fryer, C. S., & Garza, M. A. (2011) Towards a fourth generation of disparities research to achieve health equity. Annual Review of Public Health 32(3), 399-416.