A tool to assess alignment between knowledge and action for health equity

Abstract

Advancing health equity is a central goal and ethical imperative in public and global health. Though the commitment to health equity in these fields and among the health professions is clear, alignment between good equity intentions and action remains a challenge. This work regularly encounters the same power structures that are known to cause health inequities. Despite consensus about causes, health inequities persist-illustrating an uncomfortable paradox: good intentions and good evidence do not necessarily lead to meaningful action. This article describes a theoretically informed, reflective tool for assessing alignment between knowledge and action for health equity. It is grounded in an assumption that progressively more productive action toward health inequities is justified and desired and an explicit acceptance of the evidence about the socioeconomic, political, and powerrelated root causes of health inequities. Intentionally simple, the tool presents six possible actions that describe ways in which health equity work could respond to causes of health inequities: discredit, distract, disregard, acknowledge, illuminate, or disrupt. The tool can be used to assess or inform any kind of health equity work, in different settings and at different levels of intervention. It is a practical resource against which practice, policy, or research can be held to account, encouraging steps toward equity-and evidence-informed action. It is meant to complement other tools and training resources to build capacity for allyship, de-colonization, and cultural safety in the field of health equity, ultimately contributing to growing awareness of how to advance meaningful health equity action.

Assessing researchers’ capabilities, opportunities, and motivation to conduct equity-oriented dissemination and implementation research, an exploratory cross-sectional study

“…These barriers have been reported by other D&I researchers [ 9 ]. Specific examples of barriers for funding opportunity include inequalities in research funding for non-white, non-male researchers [ 41 – 44 ], limited opportunities to strengthen understanding of social determinants of health, systemic racism and discrimination in research and practice [ 4 , 45 – 48 ], and unfavorable institutional rankings towards health disparities research compared to what is perceived as more innovative “-omics” research [ 45 ].…”

Large-scale infectious disease testing programs have little consideration for equity: findings from a scoping review

“…Numerous tools exist to support incorporating equity values within public health interventions and programs [40] , [41] , [42] . These tools should be used both during the design, implementation, and evaluation process, as the link between equity intention and action remains challenging [43] . TIDieR-PHP was developed to enable consistent reporting of Population Health and Policy (PHP) interventions to promote transparency and transferability of findings to diverse settings.…”

A rapid review of equity considerations in large-scale testing campaigns during infectious disease epidemics

“…Numerous tools exist to support incorporating equity values within public health interventions and programs (80–82). These tools should be used both during the design, implementation, and evaluation process, as the link between equity intention and action remains challenging (83). TIDieR-PHP was developed to enable consistent reporting of Population Health and Policy (PHP) interventions to promote transparency and transferability of findings to diverse settings.…”