Defining Health Equity

1. PolicyLink: Health Equity: Moving Beyond "Health Disparities" (PDF)
   • This PolicyLink paper provides a definition of health equity and highlights the need for public health to move beyond a disparities framework. It also lifts up solutions that are grounded in strengthening communities, engaging non-health sectors, lifting up promising practices, advancing progressive policy options, and identifying research gaps that can make the case for prioritizing health equity strategies. 
2. National Association of County and City Health Officials (NACCHO) and Learning Collaborative Roots of Health Inequity Web Course
   • This course considers the root causes of inequity in the distribution of illness, disease, and death. It is based on a social justice framework and is a conceptual introduction that grounds practitioners in strategies for taking action in everyday practice.
3. Prevention Institute Health Equity and Prevention Primer: Modules 1, 2, 3:
   • The Health Equity and Prevention Primer (HEPP) is a web-based training series for public health practitioners and advocates interested in policy advocacy, community change, and multisector engagement to achieve health equity.
   • Module 1: Achieving Equity in Health and Safety through Primary Prevention
     This module sets the stage for the overall Primer. It describes how a primary prevention approach leads to the goal of equity in health and safety.l
   • Module 2: Take Two Steps to Prevention
     This module introduces the Two Steps to Prevention framework, and illustrates the Trajectory of Health Inequities. It explains how inequities are created and where prevention efforts are most effective.
   • Module 3: Community Factors and How They Influence Health Equity
     This module explores 18 community factors and demonstrates their links to health equity. It provides tangible opportunities to address inequities in the community environment.
4. Unnatural Causes Action Toolkit (for screening the film)
   • Full Toolkit (PDF): This toolkit provides facilitation tips, background, sample agendas, and guidelines for planning an effective screening of the Unnatural Causes film — one that not only deepens understanding of issues but serves as a step towards further involvement.
   • Discussion Guide (PDF)
     This discussion guide includes suggested pre- and post-viewing activities, comprehension and discussion questions for each program, and activities to encourage audience participation.
   • Handouts
     Includes handouts, background source material, event planning tools, and publicity materials that can be used for an event designed to increase understanding of the social determinants of health.
5. The California Endowment: A Tale of Two Zip Codes
   • This four-minute video describes the large role that our zip code plays in determining how long we'll live, and how manmade differences in neighborhoods can be unmade to improve health across our nation. It is part of The California Endowment's 10-year Building Healthy Communities initiative, which seeks to bring equity to all neighborhoods so that all Californians can enjoy the benefits of healthy communities and live long and productive lives.
6. San Francisco State University Health Equity Institute: What is Health Equity?
   • This three-minute motion graphic video explains how social, economic, and environmental conditions can create health inequities and how these inequities can affect health disparities.
7. Centers for Disease Control and Prevention: Equity Infographic
   • This visual illustrates the difference between health equity and health disparity, including examples of health equity programs and strategies.
8. PolicyLink: Why Place & Race Matter (Full Report, PDF)
   • Dynamic groups and initiatives are featured to illuminate action at the intersection of health, place, and race. This report aims to further inspire creative thinking, new partnerships, innovative strategies to achieve sustainable change, and continued momentum in the movement to build healthy, opportunity-rich communities.
9. PolicyLink: Regional Planning for Health Equity (PDF)
   • This brief introduces strategies for planning for health equity at a regional scale. It provides a summary of how the field of building healthy communities has evolved, specifically focusing on regional drivers of change.

Building Leadership for Health Equity

1. Association for State and Territorial Health Officials (ASTHO): The Role of the State and Territorial Health Official in Promoting Health Equity (PDF)
   • This document highlights the leadership role of State and Territorial Health Officials in advancing health equity and outlines five key strategies for leaders within government health agencies.
2. The Colorado Trust: Health Equity and Leadership (PDF)
   • This document presents five actions that health-care organizational leaders can take to promote health equity, with a focus on organizational cultural competency development. The broad strategies presented can be used to focus specifically on institutionalizing health equity, and a brief bibliography is included for further reading.
3. American Public Human Services Association: Adaptive Leadership Toolkit (PDF)
   • This toolkit is a complement to the "The Art of the Possible" article published in the June 2012 issue of Policy & Practice, and provides additional information and resources to support the identification and development of adaptive leadership skills.  The toolkit considers multiple levels where change processes and leadership development can occur.
4. The University of Kansas: Community Tool Box Building Leadership
   • This online toolkit includes 11 actions to help in developing a plan for enhancing leadership and its core tasks. Content areas include: individual and group competence assessments, establishing leadership development goals and methods, and collaboration methods. Content-specific supplemental resources are also provided.
5. Hispanic Health Equity: Leadership Unity Knowledge Action (LUKA) Toolkit
   • This online toolkit is based on the LUKA Principle, an iterative process of gathering information, engaging leaders, and taking actions to advocate for services and policies to reduce the impact of HIV/AIDS on the Latino community. The leadership section includes lessons regarding leadership, conflict management, personal style assessments, and case studies.

Organizational Capacity Building for Health Equity

1. Centers for Disease Control and Prevention (CDC): A Practitioner's Guide for Advancing Health Equity: Building Organizational Capacity to Advance Health Equity(PDF)
   • This module provides a set of considerations for how organizations can improve hiring decisions, resource distribution, and staff training to increase organizational capacity to advance health equity.  Self-assessment questions and a case example are included.
2. Bay Area Regional Health Inequities Initiative (BARHII): Local Health Department Organizational Self-Assessment for Addressing Health Inequities (PDF)
   • This toolkit provides local health departments with tools and guidelines to identify the skills, organizational practices, and infrastructure needed to address health equity, and provides insight into the steps local health departments can take to ensure their impact.
3. Bay Area Regional Health Inequities Initiative (BARHII): State Health Department Organizational Self-Assessment for Achieving Health Equity (PDF)
   • This toolkit provides state health departments with tools and guidance to help identify the skills, organizational practices, and infrastructure necessary to achieve health equity.  Included are six instruments to support establishing baseline measures for capacity skills, as well as improvement areas focused on equity; conducting strategic planning; and monitoring progress towards achieving goals.
4. Seattle Race and Social Justice Initiative: Racial Equity Toolkit to Assess Policies, Initiatives, Programs, and Budget Issues (PDF)
   • This toolkit provides a process and set of questions to guide the development, implementation and evaluation of policies, initiatives, programs, and budget issues to advance racial equity.  An assessment worksheet, data resources, and a glossary are included.
5. Multnomah County: Equity and Empowerment Lens
   • The Equity and Empowerment Lens (with a racial justice focus) is a transformative quality improvement tool used to improve planning, decision making, and resource allocation for achieving more racially equitable policies and programs. Sample materials, handouts, and a logic model describing its core principles and processes are included.
6. Association of State and Territory Health Officers (ASTHO)
   • This resource provides a visual representation of the three strategic areas to advance health equity, with specific actions to support each area. Various activities to enhance organizational capacity to achieve health equity are included.
7. Alameda County Public Health Department: Planning for Change: ACPHD's Journey to Build Social & Health Equity 2006-2013 (PDF)
   • This two-page infographic outlines Alameda County Public Health Department's journey to build social and health equity, including its strategic direction, planning phases, planning outcomes, and health equity vision.

Leveraging Institutional Capital for Health Equity Sustainability

1. Bay Area Justice Funders Network: The Choir Book: A Framework for Social Justice Philanthropy
   • The Choir Book provides a comprehensive framework for effective social justice philanthropy, made up of core values, individual competencies, and best practices in the field. Organized according to a six-step grant cycle, this funding tool also includes assessment questions and transformational practice opportunities.
2. Directors of Health Promotion and Education: RFA Health Equity Language Checklist (PDF)
   • The RFA (Request for Applications) Health Equity Language Checklist can be used to assist funding agencies with incorporating health equity concepts into their request for applications.
3. National Collaborative for Health Equity: Local Government Budgeting and Racial Equity (webinar)
   • This two-part 30-minute webinar focuses on budgeting basics, and integrates racial equity into government budgeting.  Part One includes information on the financial realities of municipal budgeting, budget development, and budget approval considerations. Part Two presents tools and processes used to apply an equity analysis in budgeting to avoid disproportionate impacts.
4. City of Portland Office of Equity and Human Rights: Budget Equity Assessment Tool Template   
   • The Budget Equity Assessment Tool includes a general set of questions to guide you and your Budget Advisory Committee in assessing how current budget requests or decisions benefit and/or burden communities, specifically communities of color and people with disabilities.
5. Participatory Budget Project: Organizing for Participatory Budgeting: How to Start Participatory Budgeting in Your Community (video)
   • The video provides an overview of participatory budgeting, and how it works to promote democratic and equitable budget decision making. The downloadable toolkit provides tools and tips for starting the process, including how to build support and make the case for participatory budgeting at the city level.
6. Government Alliance on Race and Equity: Contracting for Equity: Best Local Government Practices that Advance Racial Equity in Government Contracting and Procurement (PDF)
   • This issue brief presents an overview of equitable contracting, as well as seven strategies to address structural barriers to equitable procurement practices. 
7. Government Alliance on Race and Equity: Human Impact Partners HealthEquityGuide.org: A Human Impact Partners Project
   • This health equity guide highlights strategic practices in the following areas: (1) mobilizing data, research, and evaluation, (2) building government alliances, (3) sharing power with communities, and (4) confronting the root causes.

Coalition Building and Partnerships for Health Equity

1. CDC A Practitioner's Guide for Advancing Health Equity: Developing Partnerships and Coalitions to Advance Health Equity:
   • This guide's section provides an overview of ideas and strategies to develop diverse and effective partnerships and coalitions to advance health equity. Includes a checklist of questions for self-assessment and case examples.
2. CDC A Practitioner's Guide for Advancing Health Equity:Meaningful Community Engagement for Health and Equity:  
   • This guide's section has an overview of ideas and strategies to meaningfully engage with communities to advance health equity. Includes checklist of questions for self-assessment and case examples.
3. The Praxis Project Tips on Base Building: There Are No Short Cuts! (PDF):
   • This tool gives individuals guidance on effective base building and leadership development within their organizations.
4. The Praxis Project Building Diverse Community Based Coalitions (PDF):
   • This tool gives practical and critical guidance on building diverse coalitions.
5. Prevention Institute Collaboration Multiplier:
   • Collaboration Multiplier is an interactive framework and tool for analyzing collaborative efforts across fields. It is designed to provide organizations with a better understanding of which partners they need and how to engage them, or to facilitate organizations that already work together in identifying activities to achieve a common goal, identify missing sectors that can contribute to a solution, delineate partner perspectives and contributions, and leverage expertise and resources.
6. Prevention Institute Health Equity and Prevention Primer Module 5: Enhancing Effective Partnerships for Health Equity
   • This module explores the power of partnerships for improving equity. It introduces the Eight Steps to Coalition Building, which can be used to develop a successful collaborative health equity effort.
7. PolicyLink Engagement Checklist
   • This tool is designed to offer an opportunity for reflection on a common process for achieving authentic community engagement and participation. It should be used to help assess the extent to which you are integrating community input and involvement into your project.
8. Minnesota Department of Health Resource Library for Advancing Health Equity in Public Health
   • This library contains resources for public health departments to further their capacity to advance health equity. Resources address aligning programs, improving data collection systems, developing organizational knowledge, and working at the policy level.

Research and Evaluation for Health Equity

1. Association of State and Territorial Health Officials (ASTHO): Health Equity State Snapshots
   • This map-based tool provides summaries of data collected through ASTHO's 2014 Health Equity/Minority Health Survey. Information on health equity infrastructure, funding allocation and expenditures, and strategic plans and partnerships is available for most U.S. states and territories.
2. Robert Wood Johnson Foundation & The University of Wisconsin Population Health Institute: County Health Rankings & Roadmaps
   • This online resource measures important health factors and provides a revealing snapshot of how health is influenced by where people live, learn, work, and play.  The Roadmaps complement the heath data to provide guidance and tools that support the effective use of data for action.
3. Centers for Disease Control and Prevention, CDC Foundation, and Robert Wood Johnson Foundation: The 500 Cities Project
   • The purpose of the 500 Cities Project is to provide city- and census tract-level small area estimates for chronic disease risk factors, health outcomes, and clinical preventive service use for the largest 500 cities in the United States. These smal area estimates will allow cities and local health departments to better understand the burden and geographic distribution of health-related variables in their jurisdictions, and assist them in planning public health interventions.
4. PolicyLink and the Program for Environmental and Regional Equity (PERE): National Equity Atlas
   • This tool supports the growing movement to create more equitable economies by providing comprehensive data to track, measure, and make the case for inclusive growth and health equity. Data indicators, summaries, and reports are provided, along with examples of actions made using data from the National Equity Atlas.  
5. Sustainable Communities Index
   • This tool is a system of indicators for livable, equitable, and prosperous cities. It provides the methods and data sources required for collecting indicators in your city or region and resources for applying these metrics to planning, policy making, and civic engagement.
6. CDC: A Practitioner's Guide to Advancing Health Equity: Understanding and Identifying Health Inequities
   • This is an overview of ideas and strategies to collect, analyze, and interpret data to identify and act on health inequities. Includes checklist of questions for self-assessment and case examples.
7. World Health Organization: Health Equity Assessment Toolkit (software and manual)
   • This toolkit includes a software application that enables users to assess within-country health inequities using disaggregated data and summary measures, which are visualized in tables and graphs. Customized results can be exported and saved in different formats, and a user's manual is included.
8. Seattle King County: Equity Impact Review Tool
   • The Equity Impact Review Tool is a process and tool to identify, evaluate, and communicate the potential impact — both positive and negative — of a policy or program on equity.
9. Human Impact Partners: A Health Impact Assessment Toolkit: A Handbook to Conducting HIA (PDF)
   • A comprehensive guide to conducting HIA for health equity, including instructional materials, worksheets, and examples.
10. CDC: A Practitioner's Guide: Addressing Health Equity in Evaluation Efforts
    • Overview of ideas and strategies for designing, implementing, and interpreting equity-focused evaluations. Includes checklist of questions for self-assessment and case example.
11. Prevention Institute: Health Equity and Prevention Primer Module 7: Good Health Counts: Measurement and Evaluation for Health Equity
    • This module describes how community health indicators can be used in community assessments to improve health and safety outcomes, as well as reduce inequities.
12. Community Campus Partnerships for Health: Developing and Sustaining Community-Based Participatory Research Partnerships: A Skill-Building Curriculum
    • This is a seven-unit online curriculum for community-institutional partnerships to use a CBPR approach to improving health.  Recommended resources in the form of organizational websites, reports, partnership agreements, policies, and training materials are included.
13. The Engage 2020 Action Catalogue
    • This online decision support tool enables those wanting to conduct inclusive research to find the best method for their specific needs.  It includes 57 research methods focused on involvement and inclusion, and 32 different criteria that can be weighed according to the importance of each criterion.

Framing and Communications for Health Equity

1. CDC: A Practitioner's Guide for Advancing Health Equity: Making the Case for Health Equity (PDF)
   • Overview of ideas and strategies to effectively frame and support messages about health equity. Includes checklist of questions for self-assessment and case examples.
2. Berkeley Media Studies Group
   1. Communicating About Health Equity: Showing the Bigger Picture to Build Healthier Communities
      • In this webinar, Berkeley Media Studies Group reviews tools to help groups that are working to reframe and effectively communicate the importance of their efforts.
   2. Social Norms Change and Health Equity
      • In this webinar, BMSG Director Lori Dorfman and UC Berkeley doctoral candidate Katherine Schaff discuss lessons learned from advocates working to develop health-related media campaigns in Alameda County, California.
   3. Communicating to Create Healthy Communities: More than a Message:
      • Berkeley Media Studies Group's Lori Dorfman discusses how advocates can use media advocacy to help amplify and accelerate community organizing efforts and advance policies that improve health. She explains why message is never first, discusses the limits of counter-marketing, and shares insights on framing.
   4. Framing 101
      • A brief explanatory piece on the importance of communications framing for health equity efforts.
   5. Media Advocacy 101
      • An overview of the definition and purpose of media advocacy, and strategies to use it effectively.
3. The Praxis Project: A Good Framing Strategy
   • This tool is designed to help advocates develop a framing strategy that is tailored to specific audiences.
4. The Praxis Project: Communicating for Health Justice: A Curriculum for Developing a Health Equity Communications Strategy (PDF)
   • This tool is designed to help health justice advocates make the shift from the dominant, "portrait" frame (characterized by individual choices like what we choose to eat), to a "landscape" perspective that includes how policies and historical issues continue to shape health outcomes.
5. The Society of Practitioners of Health Impact Assessment's (SOPHIA) Equity Workgroup: Communicating About Equity in Health Impact Assessment: A Guide for Practitioners (PDF)
   • This document presents nine strategies for effectively communicating about health impact assessment processes and policy successes including: developing a communications plan; effective framing and messages; and other important considerations. Examples and additional resources are included.

Policy Advocacy to Institutionalize Health Equity

1. Directors of Health Promotion and Education: The Policy Scan in 10 Steps
   • This tool provides a systemic process to conduct a policy scan. A policy scan can serve as a planning tool, eliminate duplication of efforts, prevent unintended consequences for vulnerable populations, and move toward health equity.
2. The Praxis Project: Toolkit for a Winning Policy Strategy   
   • This publication is designed to support organizers, health workers, and others to engage in community organizing and policy advocacy to build healthier communities. It provides analytical frameworks, tools, and concepts to support policy advocacy to hold the institutions that affect our health and health care accountable.
3. Human Impact Partners Blog: Using an Inside-Outside Strategy to Build Power and Advance Equity 
   • A blog post from Human Impact Partners explaining the utility of an inside-outside strategy to advance health equity and policy change. 
4. Prevention Institute: Health Equity and Prevention Primer Module 6: The Importance of Local Policy for Achieving Equitable Outcomes  
   • This module looks at why policy — at the city and county levels, in particular — is important to health equity efforts. It provides an overview of four key strategies in the policy development process.
5. Washington State Department of Public Health: Health Equity Review Planning Tool (PDF)
   • This tool was developed to help organizations assess the potential impact of their public health programs and policies, with a focus on equity and community engagement.  Multiple assessment worksheets are included, along with key definitions and a description of the determinants of health equity.  
6. CDC National Center for Chronic Disease Prevention and Health Promotion: Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities (PDF)
   • This toolkit provides a conceptual framework, and list of resources, to increase the capacity of organizations working with communities to implement effective responses to obesity-related health disparities. The focus is on the policy, systems, and environmental changes needed to reduce obesity disparities and achieve health equity. Examples of strategies and surveillance data to inform obesity prevention initiatives are provided.
7. The State of Washington Governor's Interagency Council on Health Disparities: Promoting Equity in State Policy and Program Development (PDF)  
   • This guide provides sample language that can be adapted and inserted into state policies, plans, programs, budgets, rules, grants, contracts, and solicitation documents to promote health equity. Integrated frameworks are included to promote a more holistic approach to addressing equity in government institutions, policies, and situations.
8. Association of State and Territorial Health Officers (ASTHO): Health in All Policies: Strategies to Promote Innovative Leadership
   • This resource was developed to support the public health sector adopt Health in All Policies as a collaborative approach that incorporates and articulates health considerations into policymaking across sectors, and at all levels, to improve the health of all communities and people. A series of case studies are provided to illustrate five fundamental approaches: identifying shared goals; engaging partners early and developing partnerships; defining a common language; activating the community; and leveraging funding. Additional resources for implementing Health in All Policies are provided.
9. ChangeLab Solutions: Model Health in All Policies Ordinance:
   • This document provides background information, instructions, and sample language from the efforts of previous Health in All Policies to support local governments adopting their own ordinance.  Modifiable versions of the document are available upon request for editing.
10. PolicyLink: GEAR- Getting Equity Advocacy Results
    • This interactive tool provides useful benchmarks, frameworks, and tools for measuring progress in equity efforts for policy change across a range of issues.