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.
Spotlight Webinar: Applying a health equity lens to program planning
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.
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
3. 3
Housekeeping
Use Chat to post comments and/or
questions during the webinar
• ‘Send’ questions to All (not
privately to ‘Host’)
Connection issues
• Recommend using a wired
Internet connection (vs.
wireless),
• WebEx 24/7 help line
• 1-866-229-3239
Participant Side
Panel in WebEx
Chat
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
4. 4
After Today
The PowerPoint presentation (in English and
French) and English audio recording will be made
available.
These resources will be available at:
http://www.nccmt.ca/previous-webinars
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
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
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
6.
7. 77
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/
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.
12. 12
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
13. 13
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
16. 16
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
17. 17
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
18. 18
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
19. 19
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.
20. 20
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
21. 21
Download the tool: https://www.fraserhealth.ca/health-topics-a-to-z/healthier-communities
22. 22
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
25. 25
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.
28. 28
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)
29. 29
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)
30. 30
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)
31. 31
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)
32. 32
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)
33. 33
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
35. 35
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)
36. 36
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)
37. 37
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)
38. 38
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
39. 39
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
40. 40
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!
43. 43
Polling Question
What opportunities exist to work co-operatively
with other sectors to address inequities in
COVID19 planning/response?
44. 44
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
45. 45
Your Comments/Questions
• Use Chat to post comments
and/or questions
• ‘Send’ questions to All (not
privately to ‘Host’)
Chat
Participant Side
Panel in WebEx
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
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
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
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
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
48. Housekeeping
• Recently, we have been experiencing
connection issues during our webinars.
• To reconnect:
1. Hoover over the bottom of the screen
until a toolbar appears
2. Click on the audio button
3. Click play (button should now be blue)
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
Editor's Notes
Hello everyone and thank you so much for taking the time to be virtually here with us today. I would like to welcome you to the next installmaent of our Spotlight on Methods and Tools webinar series. My name is Kristin Read, I am a research coordinator at the NCCMT and I, along with support from two members of the NCCMT team, Bandna & Leah are here to help you with any issues that may pop up so please let us know if you need our help with anything!
Today we will be exploring Fraser Health’s Community Planning Tool: Applying a health equity lens to program planning and given current events, hopefully have a bit of an opportunity to consider how this type of tool can help us in thinking about the planning and response to COVID19.
I’d like to start by taking some time to recognize that The NCCMT, which is hosted by McMaster University, is situated on the traditional territories of the Mississauga and Haudenosaunee nations, which are acknowledged in the Dish with One Spoon Wampum belt. This wampum uses the symbolism of a dish to represent the territory, and one spoon to represent that the people are to share the resources of the land and only take what they need. I want to share this with you as something that truly resonates with me and encourage everyone joining us today to take this opportunity time to reflect on these teachings.
With this in mind, I would like to thank you for taking time today to learn with us and wish a very warm welcome to those who have joined us this afternoon.
I know we are all eager to get to the presentation so please bear with me as I share a few housekeeping items.
Please use the chat box on the bottom right of your screen to post throughout the webinar. We will also be having polling questions to get your thoughts. Both of these functions should be found along the right hand side of your screen. If not, you should be able to open the panels using the icons along the bottom. Also a quick heads up that we have a few short evaluation questions at the end of the webinar. It is important for us to get your feedback on the day so if you can please stay tuned at the end of the webinar.
When using the chat, please make sure you are sending to all participants so that everyone can join in the conversation.
If you are having connection or technical issues we are here to help. You can also contact the WebEx help line. The number is posted on the slide & in the chatbox.
The slides and recording of this webinar will be made available shortly after the presentation. We will try to get them up as soon as possible for those who are unable to join us today. You can access them through the NCCMT webinars page on our website OR on our YouTube and SlideShare accounts.
We have our first polling question of the day. We are hoping to get a sense of who’s joining us today…
You can answer using the panel on the right hand side. Please make sure to press submit after selecting your response. We would also like to encourage you to share where your from the in chatbox!
As we leave this open for a bit… I wanted to share a little information about our hosts for todays webinar…
This webinar today is brought to you from the NCCMT and NCCDH. We are part of the National Collaborating Centre for Public Health.
For those of you who are unfamiliar
NCCs are funded by the PHAC and each hosted in different academic (and non-academic) institutions across the country
Part of why the NCCs exist in the KT field = to reduce duplication, share learning across jurisdictions, and help identify gaps in knowledge and practice
ALSO a large part of what we all do is act as a resource for training, professional development, and capacity building for knowledge translation & EIDM for PH in Canada.
As you can see here each NCC works in a different domain of PH and we are located across the country.
The NCCMT champions the use of different types of evidence in public health decision making and offers methods and tools for using evidence when making these types of decisions. We use the models displayed here to guide our thinking around EIDM in PH. For more information we encourage you to check out our website!
The NCCDH focuses on the social determinants of health and is particularly interested in how we can help public health practitioners address health inequities. You can check out their website to access the tool we will be discussing today as well as a wealth of information on health equity and public health.
With that I would like to officially welcome everyone to this installment of the Spotlight on Methods and Tool webinar series featuring a wonderful planning tool from Fraser Health and introduce your facilitator for the day…
Today’s facilitator is my friend and colleague Dianne Oickle who is a knowledge translation specialist at the NCCDH. Dianne’s background is in nutrition and she has an abundance of experience working with communities in public health particularly focusing on reproductive and child health in rural settings. I would like to welcome Dianne ‘to the stage’ and pass it off to you to introduce our presenters!
Introduce presenters
- Meghan Martin is a Regional Immunization Leader with Fraser Health, one of BC’s five regional health authorities. In this role, and in her previous role as a Policy Analyst for Population and Public Health, Meghan supports evidence-based planning, implementation and evaluation of programs and policies with an equity lens.
- Samantha Tong is the Team Lead of the Health Equity and Population Health Unit within the Population and Public Health Program at Fraser Health Authority. The unit supports a broad range of strategic and priority population and public health initiatives with a focus on multi‐level health system policies and initiatives to improve overall population health.
Thank you so much for joining us today to share your experience
Meghan
Meghan
“I acknowledge that Fraser Health provides services within the unceded and traditional lands of the Coast Salish and Nlaka’pamux (ent-la-cap-um) Nations. We’re grateful for the care that’s been given to these lands over millennia and for the opportunity we have today to live, work, and play in this part of the world.”
Meghan
Meghan
Equity isn’t a term we hear every day. More often we talk about equality. Equality means treating everyone the same. This seems fair, on the surface, but as the picture shows sometimes treating everyone equally still leaves someone out.
This is where equity comes in. Equity means providing everyone with what they need to succeed. Equity may actually mean that we treat people differently, but we do this so that they can all achieve the same positive outcome.
Applying a health equity lens to program planning means taking a hard look at the health issue we want to address and considering whether certain groups of people in our community are facing greater barriers to achieving good health. Applying a health equity lens can help us see opportunities to deliver our programs and distribute program resources in a way that is equitable, rather than equal, so that everyone in our community can achieve the positive health outcomes.
I also want to note that while this kind of redistribution can have a positive impact on groups in our communities, we always want to remember that the goal should not be continuous adaptation and accommodation. Ultimately we need to remove the barriers that are causing the inequities in the first place. This requires significant social change, but we can start those conversations just by acknowledging where barriers exist and the impact they have on people.
Meghan
In order to identify who may be facing significant barriers, and what kind of supports would be most helpful to overcome those barriers, we can use a Health Equity Impact Assessment. HEIAs help us to analyze the potential impact of services, programs or policies on health disadvantaged populations. In 2008 the World Health Organization’s Commission on the SDOH called for the use of HEIAs in all major policy-making.
Fraser Health developed a health equity assessment tool for our own internal use. This tool is used to look at what barriers clients might encounter when trying to access our health programs and services.
It was as this internal tool was being launched, some of our Community Health Specialists began to ask whether a similar tool was available to apply a health equity lens to community program planning. Our CHS were working in communities in a lot of programs related to health and wellbeing and they always brought a health equity lens to their work, but there wasn’t a consistent way to build health equity into the program planning process.
There were several health equity program planning tools already out there, but when we met with community partners we found that they didn’t quite hit the mark. Some were overly complicated and 150 pages long while others were so minimal that they provided too little direction for staff who may not be experienced in completing health equity impact assessments. Our CHSs and our community partners told us that they needed something in between.
Meghan
Meghan
Let’s start by establishing when you would use this tool.
Communities come to this tool because they have identified a health issue that they want to address. For example, your community may be concerned about mental health among high school students, physical activity levels across the population, or healthy eating habits in your community.
The health issue that you have identified may be physical, mental, emotional, or social but the key is that it is an important health issue and your community wants to take action to change the situation.
The next question is: do you need to apply a health equity lens to your program planning?
Applying a health equity lens to program planning means taking a hard look at the health issue we want to address and considering whether certain groups of people in our community are facing greater barriers. Applying this lens can help us see opportunities to deliver our programs and distribute program resources in a way that is equitable, rather than equal, so that everyone in our community can achieve positive health outcomes.
Meghan
Meghan
The Health Equity and Population Health Unit worked with a MPH student as well as community partners to develop the Community Planning Tool. This tool is intended to be used in a community context to apply a health equity lens to program planning.
The tool is free to use and can downloaded in pdf form from the Healthier Communities page of the Fraser Health website.
Meghan
It’s important to note that this particular tool is not a comprehensive program planning tool. What we heard is that several different planning processes are used in different communities and it would be difficult to find one process that worked for everyone. Instead, the tool helps you apply a health equity lens to whichever program planning process works best for your community and we divided it into seven steps which seemed to be common across several different models of program planning.
They are:
Defining the scope of your program
Identifying key stakeholders with an interest in the health issue you have identified
Engaging the Community and Assessing Community Capacity to take action on this health issue
Selecting your Approach to Change and creating a Plan for Action
Implementing your program and monitoring your progress
Carrying out an evaluation to assess your Progress
And finally, maintaining the momentum that has been created by your program
Meghan
When you open the tool, you will see that each step is laid out like a workbook.
On the left is a simple visual reminder of the key activities in this step.
On the right is a worksheet for you to work through with your planning team.
Meghan
For each step in program planning, there is a worksheet for you to work through with your program planning team. The worksheet is divided into three sections.
The first section of each worksheet provides a description of what is happening at this stage of program planning. This will help you determine which stage your planning group is in.
Following the description, each worksheet has a checklist to demonstrate what you will have accomplished after applying a health equity lens to this stage of your planning. This can be a useful guide to check your progress when using the tool.
The third section of the worksheet is a table of4 to 5 questions which you will use to apply a health equity lens to your program planning.
Some of these questions may seem easy for your planning group to answer, for example people who have worked on a health issue for a while may have good sense of which populations are more or less advantaged in relation to a health issue. But if you’re less familiar with the issue, or if you’re starting work on an emerging issue, some of these questions could be more challenging to answer.
If you’re having trouble responding to a question on the worksheet, you can turn to the back of the Tool to find an Appendix for each step in the tool.
Meghan
The Appendices give more information on what the question is asking and provide some guidance on how you might answer the question by directing you to resources or suggesting processes that your planning group could use to answer the question.
Meghan
These three pages – the visual summary, the worksheet, and the Appendix – are consistent for every step of the Tool.
By working through the worksheets for each Step, your planning team will be prompted to deepen your understanding of the health issue you are trying to address and how it affects population groups differently. The information your planning team gathers in each step of the tool will help you adjust your program so that it is focused on serving those who face the greatest barriers to good health in your community.
Meghan
We will walk through the first few steps of the tool to give you a sense of what kinds of questions are asked in the worksheets and how they have been applied to program planning in our organization and local communities.
Meghan
DELTA EXAMPLE: When social planner arrived in Delta, there was a sense that poverty and homelessness was not a significant issue in their community. She felt that the issue was underrepresented and wanted to make the case that more action was needed, so she started with Step 1 of this tool: assessing inequities and defining the scope of the problem. She dug into the data and spoke to people with lived experience to get a fuller picture of the issue in her community and the social practices that were preventing those living with homelessness from accessing the services they needed. This helped her make the case to key decision makers that this was an issue that needed attention.
Meghan
DELTA EXAMPLE: With the scope of the issue established, the Social Planner set out to find the partners that could help. In Step 2, she identified who those people would be, how they approached the issue and what they could contribute. This led to collaboration between the City planning department, policy and bylaw officers, faith communities, and not for profits who had outreach programs.
Meghan
DELTA EXAMPLE: This next step of assessing community capacity gave the newly formed partnership an opportunity to take stock of all of the skills and resources that were already available in the community. In some cases, Bylaw or Police officers weren’t aware of social services that could help the people they encountered and social service agencies didn’t appreciate the extent to which law enforcement could help them identify who these people were and where they could be found. Question two “Which social structures or practices does the community believe are leading to the health inequity?” was identified as particularly impactful in this conversation. It gave all of the partners the opportunity to question what structures or processes were contributing to homelessness in their community and explore how their own practices could be altered to break down those barriers.
Meghan
DELTA EXAMPLE: Now that partners had come together and better understood the issue of homelessness in their community, they needed to create a plan for how they would change the system. They recognized that lack of trust between agencies and the siloed approach to practice was a major contributor to why people experiencing homelessness were not getting connected with the services they needed. The group needed a connector to help the partners communicate and build relationship with one another. A regular weekly phone call was established which would be facilitated by the Social Planner. This helped ease communication between the different agencies and, over time, build trust directly between the agencies so that they could share information and set up systems for referral in their community. This relationship building project had the potential to fundamentally shift the patterns in the community that were contributing to homelessness.
An important component of this stage of planning was question 5: considering the potential unintended negative consequences of their actions. With increased collaboration between the partners, there were potential consequences to the agencies themselves as well as the people they were trying to serve. It was helpful to identify these up front and plan to mitigate the risks.
Meghan
DELTA EXAMPLE: Delta is currently at the stage of implementing and monitoring this initiative. One of the most important measures was the annual homeless count. With improvements in engagement and monitoring, their homeless numbers went up for several years, because the count was now more effective. Then they started to turn around and at the last count Delta achieved an important milestone: 0 people were found to be functionally homeless. There are still issues with people living in RVs and transient populations that need support, but the regular, street-entrenched people are now being engaged and connecting with services more quickly. The Social Planner also shared that there have been positive spillover effects. By changing the structures and relationships in the community, the agencies involved are now communicating more quickly on a number of social issues and have widened the scope of their partnership beyond meeting the needs of people experiencing homelessness.
Meghan
DELTA EXAMPLE: Key takeaways are…
Sam
Sam
SAHI Example: The South Asian Health Institute within Fraser Health was created to advance understanding of the key health issues affecting the South Asian population and to support the development of culturally appropriate strategies for improving the health of the diverse South Asian community in Fraser Health. For the last 5 years, the team has focussed efforts on health promotion activities to prevent chronic disease in the SA community in settings where the community frequently visited, such as places of worship, schools, and SA businesses. The program is currently undergoing a review of some of the work and the Community Planning Tool was used to reflect, at a high level, how the current work applied health equity considerations. The team was asked to complete Steps 1, 3 and 4, with consideration to desired level of engagement with the identified populations the team wanted to focus their efforts with.
Step 1 of this tool highlighted for the team that during the early stages of the program development, the focus of the work was on the SA community broadly. Now that the program has developed further, there was opportunity to look at whether specific sub-groups within the SA community experienced greater inequities. The team identified new SA immigrants as a population to focus further work on. However, they also recognized that they needed to find out more information about the new immigrant journey and what services/programs existed for these clients. Because the intent was to use the tool to reflect at a high level, the team did not review the evidence at the time. This would be done at a later date.
Sam
SAHI Example: This Step of the tool helped the team to consider the social determinants of health
Sam
SAHI Example:
Sam
SAHI EXAMPLE: Key takeaways are…
Sam
Throughout the tool, you will find there are some overarching themes that make up the core of a health equity lens.
The focus is always on serving those who face the greatest barriers, rather than designing a program for the general population
The prioritized population is a partner, not a “target” and their views and preferences are given equal or greater weight to those of other partners
It starts from a place of strength and aims to build on existing strengths, recognizing marginalized populations as resilient rather than needy
Not just building programs for communities, but building capacity within the community to meet their own needs by including them in the process of program planning and implementation
The ultimate goal should be the elimination of barriers, not the delivery of a program
Sam
To conclude this tutorial, here are a few final points which will help to ensure success when using this tool.
The first thing to remember is that this is not a comprehensive program planning tool. It is designed to supplement your existing program planning process and can be used as a helpful guide in whichever process fits best for your community.
Second, it is best to use this tool when addressing a health issue in your community. The tool could be applied to help identify equity considerations for programs not related to health, but some of the questions in the worksheet won’t be a good fit.
Third, the worksheets are meant to be filled out as a planning team, rather than through individual reflection. This allows for a broader range of ideas and input and also helps to ensure that the entire planning team is on the same page in regards to the equity considerations for your program.
Fourth, it’s important to give yourself enough time to fully consider all of the questions and gather the information needed to answer the questions. Many of the steps will have questions that can’t be answered in a single meeting, especially those that ask you to review the available evidence or gather information from the community. The tool will be most effective when there is adequate time given to the process to fully answer the questions.
Finally, it’s important to remember that this is a learning process. Members of your planning group may have different levels of knowledge or experience when it comes to applying an equity lens to program planning. Be open to learning as you go and remember that the more you practice using an equity lens the easier it will become!
What inequities are you observing in the COVID19 response in your area and how would a tool like this help to address those inequities early in planning?
What would you need to have in place in your agency to use this tool?
Who in your organization or community would be best placed to apply this tool in practice?
Sam
We would like to thank Cheyanne Stones, a former practicum student with Fraser Health Authority, and the City of Surrey’s Healthy Communities Department for their contributions to the creation of this tool.
And if you have any questions or if you have used the tool and would like to provide us with feedback from your experience, please contact Sam Tong at Samantha.Tong@fraserhealth.ca
For more information and to download the tool visit the Healthier Communities page at www.fraserhealth.ca
Thanks to presenters
Open it up for questions/comments
Please use the chat box to submit your q’s
As we wrap up…
Please take time to answer evaluation questions
Using the polling question panel on the right hand side of your screen
You feedback is important to us and will be used to continue to improve our webinar series