This document summarizes a webinar on applying a health equity lens to program planning. The webinar introduced a community planning tool developed by Fraser Health to help incorporate equity considerations into public health program design. It provided an overview of the tool's 7 steps and 2 case studies of the tool in use. City of Delta and Fraser Health's South Asian Health Institute discussed how using the tool surfaced inequities and engaged partners and community. Key themes were serving disadvantaged groups, acknowledging strengths, building community capacity, and eliminating barriers. The tool is meant to supplement existing processes and support learning to apply an equity lens.

1. Applying a health equity lens to
program planning
March 18, 2020
1:30-2:30pm (EDT)
SPOTLIGHT ON METHODS AND TOOLS WEBINAR

2. McMaster University acknowledges that it is located on the
traditional territories of the Mississauga and
Haudenosaunee nations, and within the lands protected by
the “Dish with One Spoon” wampum agreement.
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3. 3
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4. 4
After Today
The PowerPoint presentation (in English and
French) and English audio recording will be made
available.
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5. 5
Poll Question #1
How many people are watching
today’s session with you?
A. Just me
B. 2-3
C. 4-5
D. 6-10
E. >10
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SPOTLIGHT ON METHODS AND TOOLS WEBINAR
Local Health
Issues and
Context
Public
Health
Expertise
Community
and Political
Preferences
and Actions
Research Resources
National Collaborating Centre for Methods and To
ols (NCCMT)
https://www.nccmt.ca/

8. National Collaborating Centre for
Determinants of Health
Our focus: Social conditions that influence
health & narrowing the gap between the least
and most healthy
Our audience: Canadian public health
organizations & practitioners.
Our work: Explain and share what’s known to
help public health positively influence health
for EVERYone through their work.
http://nccdh.ca/

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Community Planning
tool: Applying a health
equity lens to program
planning
SPOTLIGHT ON METHODS AND TOOLS WEBINAR

10. Today’s facilitators
Dianne Oickle
Knowledge Translation Specialist​
doickle@stfx.ca

11. SPOTLIGHT ON METHODS AND TOOLS WEBINAR
The NCCDH is in Mi’kma’ki, the ancestral and unceded territory of the Mi’kmaq
People. This territory is covered by the “Treaties of Peace and Friendship” which
Mi’kmaq and Wolastoqiyik (Maliseet) peoples first signed with the British Crown in
1725. The treaties did not deal with surrender of lands and resources but in fact
recognized Mi’kmaq and Wolastoqiyik (Maliseet) title and established the rules for
what was to be an ongoing relationship between nations.

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Presenters
Meghan Martin
Regional Immunization Leader, Fraser Health
Authority
Samantha Tong
Team Lead, Health Equity and Population
Health Unit, Fraser Health Authority
SPOTLIGHT ON METHODS AND TOOLS WEBINAR

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Community Planning Tool
Applying a Health Equity Lens to Program Planning
March 18, 2020
Samantha Tong
Team Lead, Health Equity and Population Health Unit
Meghan Martin
Regional Immunizations Leader
Fraser Health Authority

14. 14
Acknowledgement

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Presentation Overview
1. Background on Health Equity and Health
Equity Impact Assessments
2. Overview of Community Planning Tool
3. Case studies

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What is a Health Equity?
Treating everyone
the same
Providing everyone
with what they
need to succeed
Image source: Interaction Institute for Social Change (interactioninstitute.org)
Artist: Angus Maguire (madewithangus.com)
Removing the
barrier altogether

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Health Equity Impact Assessments
 HEIAs analyze the potential impact of service,
program or policy changes on health disparities
and/or health-disadvantaged populations
 WHO Commission on SDOH has called for use
of health equity impact assessments as
standard practice in all major policy-making
 Fraser Health staff requested that a similar tool
be developed that they could use in community

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Polling Question
 How many are currently using HEIAs in their
work?
 Yes
 No
 Don’t know
 Not currently, but have in the past
 Not currently, but have plans to use in the future

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The Starting Point
You have identified a health issue you
want to address in your community
Do you need to apply a health equity lens?
People in our
community aren’t
getting enough
physical activity.
Anxiety is on the rise
among high school
students.
The latest data shows
we need to eat more
fruits and vegetables.

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Polling Question
 What barriers do you see in your
community to planning with an equity
lens?
 Hard to identify the inequities/lack of data
 Finding appropriate partners
 Engaging community
 Planning an equity-focused program
 Implementing an equity-focused program
 Assessing what difference we’ve made
 Maintaining momentum

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Download the tool: https://www.fraserhealth.ca/health-topics-a-to-z/healthier-communities

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7 Steps in Program Planning
Assess
Inequities &
Define Scope
Identify &
Assemble
Partnerships
Assess
Capacity &
Engage
Community
Select
Approach to
Change & Plan
for Action
Implement &
Monitor
Assess Your
Progress
Maintain
Momentum
Health Equity

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Workbook Layout

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Appendices
Appendix A: Guide to Assessing Inequities and Defining Scope
1. Who is most advantaged or disadvantaged in relation to this issue?
To answer this question you will need to find data or information on the outcomes that interest
you. Rather than looking at outcomes for the whole population, you will need to explore how
outcomes vary between different groups within the population and determine which groups fare
better or worse.
You can separate the population into sub-populations based on the social determinants of health.
In some cases it may be relevant to look at how outcomes differ based on race or gender while at
other times it may be more relevant to look at how outcomes differ across different income levels.
Consult with colleagues or key informants in your community to identify which social determinants
may be related to a difference in the health outcome you are interested in affecting.
Potential sources of data on health differences between population groups include: Statistics
Canada; Fraser Health Reports; and the My Health, My Community Atlas. Local agencies, including
municipal governments, school districts, and not-for-profit agencies, may also collect data on local
health issues.
2. What social structures or practices might have led to these inequities being created,
maintained, or increased?
To answer this question it is helpful to carry out a “root cause analysis”. Information on the root
cause(s) of your issue of interest may be available from academic research, gray literature, or key
informants and stakeholders in the community. When there is not a clear answer, you may need to
explore the root cause yourself. One simple way of doing this is to apply the “But Why?”
technique.

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Case Study
Applying the Community
Planning Tool
City of Delta

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Step 1:
Assess Inequities and Define Scope
Questions
1. Who is most advantaged or disadvantaged in relation to this issue?
2. What social structures or practices might have led to these inequities
being created, maintained, or increased?
3. Which of the populations facing disadvantage do you want to serve
with your program?
4. Which social structures or practices need to be addressed to create
the change you want to make?
5. What does the evidence say is effective in changing these social
structures or practices? Is the evidence applicable to your community?
(See Appendix A)

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Questions
1. Your target population is always a key stakeholder. How will you
involve them in program planning and implementation?
2. Who are the other stakeholders that may share your goal or agenda
(e.g., levels of government, organizations, private sector and local
communities)? How will you engage these groups?
3. What opportunities exist to work co-operatively with other sectors for
support and increased effectiveness?
4. Is there a common vision and mission for your work which is shared
by all partners in your initiative? What is the vision/mission?
5. What role will each partner play in your initiative?
Step 2:
Identify & Assemble Partnership
(See Appendix B)

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Questions
1. Think about what barriers your target population might face in
engaging with your planning process. How will you create low-barrier
opportunities for your target population to participate?
2. What social structures or practices does the community believe are
leading to the health inequity? Is this the same as your understanding
of the issue?
3. What strengths does the community identify within themselves to
address the issue?
4. What new skills or resources does the community feel need to be
developed to address the issue?
5. What existing community strengths can your program build on? What
new skills or resources can your program help to develop that will
empower the community to take the lead on addressing this issue?
Step 3:
Assess Community Capacity & Engage
Community
(See Appendix C)

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Step 4:
Select Approach to Change & Plan for Action
Questions
1. What approaches or strategies will you combine to create your
desired change?
2. How will your proposed initiative build the capacity of the
community and remove the barriers that cause inequities?
3. How will you involve your target population in the design of your
initiative?
4. How will you measure whether your program is effective and if
inequities have been reduced? What indicators will you collect?
5. What are the potential unintended negative consequences of your
actions? How will you mitigate these?
(See Appendix D)

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Step 5:
Implement & Monitor
Questions
1. Do you have the resources to deliver what has been promised to the
community in your plan? If not, how will you obtain the resources or
change your action plan to match existing resources?
2. How will you document your progress? How will you monitor when
your actions are deviating from your plan?
3. How will you document the obstacles you encounter when
implementing your action plan and your response to them?
4. What participatory methods are you using to engage your target
population / community as you implement and monitor progress on
your action plan?
(See Appendix E)

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Key Takeaways for City of Delta
 This tool helps us check our assumptions
 Provides a structure to apply an equity
lens, even if conceptually you understand
 It surfaces the systems and structures
that are contributing to inequities
 It empowers decision-makers to see the
tangible changes they can make to their
own systems and structures

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Case Study
Applying the Community
Planning Tool
Fraser Health
South Asian Health Institute

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Step 1:
Assess Inequities and Define Scope
Questions
1. Who is most advantaged or disadvantaged in relation to this issue?
2. What social structures or practices might have led to these inequities
being created, maintained, or increased?
3. Which of the populations facing disadvantage do you want to serve
with your program?
4. Which social structures or practices need to be addressed to create
the change you want to make?
5. What does the evidence say is effective in changing these social
structures or practices? Is the evidence applicable to your community?
(See Appendix A)

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Questions
1. Think about what barriers your target population might face in
engaging with your planning process. How will you create low-barrier
opportunities for your target population to participate?
2. What social structures or practices does the community believe are
leading to the health inequity? Is this the same as your understanding
of the issue?
3. What strengths does the community identify within themselves to
address the issue?
4. What new skills or resources does the community feel need to be
developed to address the issue?
5. What existing community strengths can your program build on? What
new skills or resources can your program help to develop that will
empower the community to take the lead on addressing this issue?
Step 3:
Assess Community Capacity & Engage
Community
(See Appendix C)

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Step 4:
Select Approach to Change & Plan for Action
Questions
1. What approaches or strategies will you combine to create your
desired change?
2. How will your proposed initiative build the capacity of the
community and remove the barriers that cause inequities?
3. How will you involve your target population in the design of your
initiative?
4. How will you measure whether your program is effective and if
inequities have been reduced? What indicators will you collect?
5. What are the potential unintended negative consequences of your
actions? How will you mitigate these?
(See Appendix D)

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Key Takeaways for SAHI
 A good way to check-in with how we’re doing and a
reminder of whether we have done something or not
 A framework of steps/considerations at the start of
planning (e.g., community input, evidence,
evaluation) and before any strategies/interventions
are developed
 Having a better understanding of where we are at
with desired level of engagement with existing
partners helps to plan for where we want to be with
our partners
 With community input and identifying where gaps
may be would help with where we focus our
efforts/resources to meet the population’s needs

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Summary: Overarching Themes
 Serve those facing the greatest barriers
 Engage the prioritized population as a
partner (as opposed to a “target”)
 Acknowledge and build on strengths
 Build capacity within the community to
meet their own needs
 Elimination of barriers is the end goal

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Closing Thoughts
 This tool is designed as a supplement to your
current program planning process – use part or
all of the tool as needed
 Use this tool when addressing a health issue in
your community
 Fill out the worksheets as a planning team
 Give yourself enough time to consider all of the
questions and gather the information needed
 This is a learning process – the more you use an
equity lens the easier it will become!

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Polling Question
 How would a tool like this be used in COVID19
planning and response?

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Polling Question
 Who is most advantaged or disadvantaged in
relation to this issue?

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Polling Question
 What opportunities exist to work co-operatively
with other sectors to address inequities in
COVID19 planning/response?

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Thank You!
Acknowledgements:
Cheyanne Stones (SFU MPH Practicum Student)
City of Surrey Healthy Communities Department
City of Delta Social Planning
Fraser Health South Asian Health Institute
Fraser Health’s Health Equity Working Group
Questions or Feedback?
Samantha Tong
Samantha.Tong@fraserhealth.ca
Download the tool:
https://www.fraserhealth.ca/health-topics-a-to-z/healthier-communities

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Your Comments/Questions
• Use Chat to post comments
and/or questions
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privately to ‘Host’)
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46. 46
Your Feedback is important!
Your responses will be completely anonymous to other Webinar participants.
Please indicate your level of agreement with the following:
1. Participating in this webinar increased my knowledge and understanding of this tool.
2. How likely are you to use the tool/method from today’s webinar in your own practice.
3. Which of the following statements apply to your experience with the webinar today (select all that
apply):
 The webinar was relevant to me and my public health practice.
 The webinar was effectively facilitated
 The webinar had opportunities to participate
 The webinar was easy to follow along
 The webinar met my expectations
4. Would you recommend this webinar to others?
 Yes
 No
 Maybe
5. How did you hear about the event?
Strongly agree Agree Undecided Disagree Strongly Disagree
Strongly agree Agree Undecided Disagree Strongly Disagree
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47. For more information about the National
Collaborating Centre for Methods and Tools:
• NCCMT website www.nccmt.ca
• Contact: nccmt@mcmaster.ca
For more information about the
National Collaborating Determinants of Health:
• NCCDH website www.nccdh.ca
• Contact: nccdh@stfx.ca
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