Grant: Travel Awards - Institute Community Support

Health equity is the absence of avoidable or remediable differences in health between groups. The development of health inequities can be understood as a consequence of multiple social, political, and cultural factors that give disproportionate benefit to some people, while disadvantaging others. Although the causes of health inequities extend well beyond the health system, reducing health inequity is nevertheless a key and growing policy focus in health systems particularly public health. This study explores the views of British Columbian (BC) health system decision makers and public health practitioners on health equity as a priority in their work. We conducted 29 individual interviews and 25 focus groups with 171 participants from six BC health authorities and the Ministry of Health. The participants represented two exemplar programs: mental health promotion and preventing the harms of substance use. Participants included senior executives, public health directors, regional directors, medical health officers, managers, and public health practitioners. The study design was case study and we used critical discourse and situational analysis to develop an understanding of how public health decision makers and practitioners in each health authority and the Ministry of Health talk about, value, and act on health equity. We paid particular attention to whether or not health equity is a priority. Preliminary findings fall into three areas: (1) Health Equity Talk, (2) Health Equity as a Priority, and (3) Health Equity Strategies. Decision makers valued health equity, but did not necessarily see it as a major goal of the health system in BC. At the same time, public health practitioners engaged in a wide range of health equity strategies. Definitions of health equity varied, reflecting different understandings of vulnerability, justice, and appropriate health system responses.