A tool to assess alignment between knowledge and action for health equity

Abstract

Advancing health equity is a central goal and ethical imperative in public and global health. Though the commitment to health equity in these fields and among the health professions is clear, alignment between good equity intentions and action remains a challenge. This work regularly encounters the same power structures that are known to cause health inequities. Despite consensus about causes, health inequities persist-illustrating an uncomfortable paradox: good intentions and good evidence do not necessarily lead to meaningful action. This article describes a theoretically informed, reflective tool for assessing alignment between knowledge and action for health equity. It is grounded in an assumption that progressively more productive action toward health inequities is justified and desired and an explicit acceptance of the evidence about the socioeconomic, political, and power-related root causes of health inequities. Intentionally simple, the tool presents six possible actions that describe ways in which health equity work could respond to causes of health inequities: discredit, distract, disregard, acknowledge, illuminate, or disrupt. The tool can be used to assess or inform any kind of health equity work, in different settings and at different levels of intervention. It is a practical resource against which practice, policy, or research can be held to account, encouraging steps toward equity- and evidence-informed action. It is meant to complement other tools and training resources to build capacity for allyship, de- colonization, and cultural safety in the field of health equity, ultimately contributing to growing awareness of how to advance meaningful health equity action.

Keywords: Health equity; Health inequities; Knowledge translation; Knowledge-to-action; Praxis.

Fig. 1

Six possible actions in response to evidence about causes of health inequities. This figure is an adaptation of Table 1 from Katrina M. Plamondon, Joan L. Bottorff, C. Susana Caxaj & Ian D. Graham (2018) The integration of evidence from the Commission on Social Determinants of Health in the field of health equity: a scoping review, Critical Public Health, published online 5th December 2018, DOI: 10.1080/09581596.2018.1551613