From local adaptation to activism and global solidarity: framing a research and innovation agenda towards true health equity

Abstract

The proposal for a global health treaty aimed at health equity, the Framework Convention on Global Health, raises the fundamental question of whether we can achieve true health equity, globally and domestically, and if not, how close we can come. Considerable knowledge currently exists about the measures required to, at the least, greatly improve health equity. Why, then, do immense inequities remain? Building on this basic question, we propose four areas that could help drive the health equity research and innovation agenda over the coming years.First, recognizing that local contexts will often affect the success of policies aimed at health equity, local research will be critical to adapt strategies to particular settings. This part of the research agenda would be well-served by directly engaging intended beneficiaries for their insights, including through participatory action research, where the research contributes to action towards greater health equity.Second, even with the need for more local knowledge, why is the copious knowledge on how to reduce inequities not more frequently acted upon? What are the best strategies to close policymakers' knowledge gaps and to generate the political will to apply existing knowledge about improving health equity, developing the policies and devoting the resources required? Linked to this is the need to continue to build our understanding of how to empower the activism that can reshape power dynamics.Today’s unequal power dynamics contribute significantly to disparities in a third area of focus, the social determinants of health, which are the primary drivers of today’s health inequities. Continuing to improve our understanding of the pathways through which they operate can help in developing strategies to change these determinants and disrupt harmful pathways.And fourth, we return to the motivating question of whether we can achieve health equity. For example, can all countries have universal health coverage that comprehensively meets all of people’s health needs? How to foster the national and global solidarity to achieve such equity? The answers to questions such as these can help point the way to measures, often well outside the narrow realm of technical solutions, to realize the right to health, and to achieve and sustain substantive health equality.

Subnational health management and the advancement of health equity: a case study of Ethiopia

“…However, the meaning of "health equity" is likely to evolve over time as its three constructs noted above shift to reflect changing contexts and priorities. Pragmatic approaches have been developed to help governments navigate the practical integration of health equity considerations into national health policies and/or policy-making processes, using participatory approaches to ensure that diverse stakeholder perspectives are captured [57,58]. Interestingly, our findings suggest subnational health managers to be very familiar with government messaging around health equity, and therefore policy documents and strategies are promising opportunities to harmonize understandings and establish norms surrounding the advancement of health equity.…”

Diversity and inclusion for the All of Us research program: A scoping review

“…Based on the work presented, and in conjunction with community partners, All of Us has developed resources for engaging diverse communities (https://www.joinallofus.org/en/ community/community-resources). These provide a springboard for researchers to more readily incorporate diversity and inclusion strategies to local settings [45,71] or disease specific contexts, or to use the https://www.researchallofus.org/ platform to build diverse cohorts. Within All of Us, the attention paid to these important factors can help surface the intersectionality of these barriers to research participation and help the research community to be better equipped to engage diverse populations.…”

Nursing and Global Health: social determinants of health in the training of nurses

“…In addition, 86.9% of the participants strongly agreed or agreed on the importance of describing the relationship between access to clean water, sanitation, food and air quality on individual and population health. In this perspective, evidence shows that public health interventions aiming to supply clean water and proper sanitation provide considerable health improvements for underprivileged populations (21) . The resources that affect people's quality of life, such as access to clean water, healthy food and to an environment free of toxins interfere with individual and population health in general.…”