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  • Health Equity Lens

    To understand health equity, we must figure out what a health equity lens includes. An equity lens means to evaluate an action, policy, or program for disparate or inequitable health impacts on people when they are grouped into categories including, but not limited to:
    • Age
    • Disability
    • Gender, gender identity, sex, sexual orientation, or marital or pregnancy status 
    • Employment, employment status, or access to sustainable job opportunities
    • Housing, housing status, access to safe and affordable housing, or housing location
    • Income level, education level, or socioeconomic status
    • Language preference or English proficiency
    • National origin, citizenship, or immigration status
    • Race, ethnicity, or color
    • Religion or creed
    • Veteran or military status

    The 4 P's

    Racial and Income Equity Lens: The Four P's

    The Office of Health Equity and PCHD take a holistic approach to racial equity. This means addressing health equity in multiple contexts at multiple levels.

    This graphic shows the connectedness of four factors in a racial equity lens:

    People, Process, Power, Place.

    These four factors can be used as a guide to consider the intersectionality of populations being worked with, meaning how these factors relate to each other and how that changes experiences at the individual, organizational, and systemic levels.

    Health Equity Lens: People


    Consider individual identity and lived experience. Race, age, gender, sexuality, disability, age, financial status, and many other descriptors and identifying traits affect how people experience disparities.

    A child who is African American has a different experience learning about history than a child who is white.

    Jamal is one of two Black children in his fourth-grade class. When the teacher told the class, they would be starting a unit on the Civil War, and the abolition of slavery, every head in class turns to Jamal and the other Black child. This only happens to the other children when a character in a book the class is reading has the same first name as that child. Jamal learns that the other students see his race before his name.

    Health Equity Lens: Process


    Consider how procedures and common means of getting things done affect people of different groups and abilities. Processes made under assumptions, such as the assumption that everyone has internet access or understands English, create barriers for groups and individuals.

    A person who does not speak English has a different experience getting medical care than someone who does speak English.

    Camila goes to a nearby clinic for her aching back. When she speaks Spanish to the receptionist, the receptionist provides her with paperwork in Spanish but tells her no doctors there speak Spanish. Camila’s ten-year-old daughter agrees to translate. When Camila and her daughter see the doctor, the doctor uses many words the daughter does not know. The daughter misses some details when she translates into Spanish for her mother.

    Camila does not understand why the doctor did not prescribe her medication for her pain, and she does not know what to do next.

    Health Equity Lens: Power


    Consider who has decision-making power in workplaces, communities, and other environments and how power dynamics can be shifted to include communities often left out of conversations.

    A person who rents their home has a different experience maintaining their home than someone who owns it.

    Antonio reports to his landlord that his oven and stove are broken. The landlord says he will get a contractor and have them replaced. Two weeks pass, and the landlord has stopped picking up Antonio’s calls. According to his lease, Antonio is not allowed to replace the stove. He attempts to do all his cooking in the microwave, as he can not afford to eat out every day. He worries his children aren’t getting enough nutrients from the few kinds of meals he can make for them.

    Health Equity Lens: Place


    Consider the resources available in different geographic locations and environments. Different neighborhoods, workplaces, businesses, and other built environments can be closer or farther from parks, grocery stores, and health services, creating different levels of access to important resources.

    A person living in an area with no sidewalks has a different experience walking around than someone living in an area with sidewalks.

    Rachelle walks home from the bus stop, carrying several bags of groceries. As she walks along the main road, she turns sideways to pass between the street and the brush sticking out from the wash. She reaches a sharp turn and stops for a moment, as she hears a car coming from around the corner. The car passes close to her without slowing down. Rachelle feels thankful she waited until her kids were at school to go grocery shopping, because it would be hard to keep them safe on such a dangerous road.

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