The document defines health equity and discusses the work of Oregon's Health Equity Committee (HEC). The HEC was established to promote the elimination of health disparities and achieve health equity for all Oregonians. It adopted a definition of health equity as a state where all people can reach their full health potential and are not disadvantaged by factors such as race, class, gender or other social determinants. The committee seeks to operationalize this definition through collaborative efforts that address inequitable distributions of resources and power, as well as historical and current injustices.

1. Health Equity Definition
Maria E. Castro
OHA Equity and Inclusion Division

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What?

3. Health Equity Committee
Committee purpose – coordinate and develop policy that
proactively promotes the elimination of health disparities and
the achievement of health equity for all people in Oregon.
The HEC was established by the Oregon Health Policy Board in
2017.
Achieving health equity, including a healthcare workforce that
the demographics of the communities it serves, is a priority for the
the Oregon Health Authority (OHA) and the Governor.
The Health Equity Committee is responsible for reviewing health
and leading efforts to develop best-practice policies which improve
health equity.
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4. Who?
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West Livaudais, MPH Ashley Harding
Connie Sherrard, MSW Carly Hood-Ronick, MPH
Michael Anderson-Nathe KateWells
AnnieValtierra-Sanchez Derick DuVivier, MD
Jorge Ramirez, Ph.D JoAnn Miller
Deb Morrow Amela Blekic, MD
Rakesh Gadde, DDS Stick Crosby
Clarice Amorim Freitas

5. Demographic Composition
Race/Ethnicity
46% white non-Hispanic; 13% Asian or
Pacific Islander; 13% African
American/Black; 7% American
Indian/Alaskan Native; 20% members
identify as Hispanic/Latino.
Geography
33% from Portland area; 27% Willamette
Valley; 13% Southern OR; 7% Central
OR; 7% OR Coast; 13% Eastern Oregon.
Disability: 7%
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6. The need for a health equity
definition
HEC is tasked with
making
recommendations to
OHPB, OHA, and the
broader health systems
in Oregon using an
equity lens (HEC Charter,
2017)
Development of an
equity framework
starts from a
common working
definition of health
equity.
Consensus around a
definition of health
equity helps foster
dialogue and bridge
divides.
Lack of clarity on the
definition can pose a
barrier for effective
engagement and
action
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7. Definition adopted by OHA and
OHPB
• In October 2019, the Oregon Health Policy Board and
the Oregon Health Authority adopted the heath equity
definition developed by the Health Equity Committee.
• HEC Co-Chairs and Equity and Inclusion Division
Director planned a series of presentations to OHPB
Committees to introduce the definition.
• The Health Equity Committee is currently developing a
definition framework aimed to support the
operationalization and the development of metrics.
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8. Definition Vetting and
Feedback
•Tribes
•Community Advisory Councils
•Community Based Organizations
•Oregon Health Policy Board (OHPB)
•OHPB Committees
•Coordinated Care Organizations
•Regional Health Equity Coalitions
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9. Assumptions and Values
Health is broadly
defined as a
positive state of
physical, mental,
and social well-
being and not
merely the absence
of disease.
Everyone has the
right to a standard
of living adequate
for health, including
nutrition,
education, housing,
medical care, and
necessary social
services.
Rural racial/ethnic
minority populations
have substantial
health, access to care,
and social
determinants of health
challenges that can be
overlooked when
considering
aggregated population
data.
Inequities in
population health
outcomes are
primarily the result
of social and
political injustice,
not lifestyles,
behaviors, or genes.
Addressing health
inequities means
addressing
differences that are
not only
unnecessary and
avoidable but also,
unjust and unfair.
Equity must be
intentionally
pursued as a
strategy; it will not
necessarily happen
as a byproduct of
other development
efforts.
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10. Health Equity
Definition
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11. Oregon will have established a health system that creates
health equity when all people can reach their full health
and well-being and are not disadvantaged by their race,
language, disability, gender, gender identity, sexual orientation,
social class, intersections among these communities or
or other socially determined circumstances.
Achieving health equity requires the ongoing collaboration of
all regions and sectors of the state, including tribal
to address:
• The equitable distribution or redistribution of resources and
power; and
• Recognizing, reconciling and rectifying historical and
contemporary injustices.
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12. Health Equity Definition
Framework
The Health Equity Committee definition framework draws
attention to the concepts of fairness and justice in the
distribution of resources. Furthermore, it highlights the idea that
that social inequities in health are avoidable through collective
action and that inaction is no longer acceptable.
Identifying and implementing effective solutions to move the dial
on health equity demands:
• Recognition of the role of historical and contemporary
oppression and structural barriers facing Oregon communities.
• Engagement of a wide range of partners representing diverse
constituencies and points of view.
• Direct involvement of affected communities as partners and
leaders in change efforts.
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13. Principles guiding Health Equity
definition operationalization
• Historical forces have left a legacy of racism and segregation.
• We must acknowledge the cumulative impact of stressful
experiences and environments on particular populations.
• We must recognize the role of privilege in contributing to
inequity in health outcomes and acknowledge that policies have
afforded privilege to some groups at the expense of others.
• We must encourage meaningful community engagement and we
must build capacity to engage.
• We must recognize the cumulative impact of multiple stressors
and focus on changing community determinants, not blaming
individuals or groups.
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14. Committee opportunities to
advance health equity
The HEC and Equity and Inclusion division see opportunities to
build structures that advance health equity through the
following:
• Breaking down current silos and considering health equity in
every policy and business decision.
• Aiming for greater alignment and amplification of existing
efforts to advance health equity.
• Building collective capacity and infrastructure at the
organization and committee level for change.
• Creating and advancing systems changes and policies that
result in reallocation of resources and power.
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15. Examples for the HCWFC
• Committee must start by building the capacity and infrastructure.
• Change will not occur if just one person, division or committee is
assigned the duties of advancing equity.
• Achieving health equity requires more than identifying and addressing
overt discrimination. It also requires addressing unconscious and
implicit bias and the discriminatory effects—intended and unintended—
of systemic structures and policies created by historical injustices.
• Adoption of a Health Equity Impact Assessment (HEIA).
• A HEIA is a tool for building policy coherence for health equity. It is used
to assess the potential health equity consequences of policy, which
feeds back into the decision-making process (Douglas & Scott-Samuel
2001).
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16. Questions?
• You can always visit the OHA Equity and Inclusion division
webpage at https://www.oregon.gov/oha/OEI/Pages/index.aspx
• The Health Equity Committee webpage at
https://www.oregon.gov/oha/OEI/Pages/Health-Equity-
Committee.aspx
Maria Elena Castro, M.Ed.
Health Equity Program Analyst
OHA Equity and Inclusion Division
Equity Unit
Maria.castro@dhsoha.state.or.us
503.884.4448
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