Equity is defined by the World Health Organization as the absence of avoidable or remediable differences among groups of people.
What is health equity?
The definition of health equity by the Ministry of Health is as follows:
“In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes.”
The concept acknowledges that not only are differences in health status unfair and unjust, but they are also the result of differential access to the resources necessary for people to lead healthy lives.
What does this mean?
- equality is treating people the same
- equity is treating people fairly.
- equity is about being prepared to work differently to help people achieve the same outcomes.
In this illustration the first picture shows what happens when everyone gets the same. In the second picture we can see that each person gets the support they need to see the game. The third picture shows everyone being able to watch the game without additional supports because the systemic structures and biases that cause the inequity have been removed.
Addressing inequity in primary care
In this video Susan Reid of Health Literacy NZ talks about addressing inequity in primary care using treatment of gout as an example:
(Health Literacy NZ and Health Navigator NZ, 2020)
Associated guide for clinical teams using the ‘Addressing inequity in primary care’ video
This guide provides some questions and suggestions for how this short video (9 minutes) can be used by practice teams, GP and nurse peer groups or PHO facilitators to stimulate discussion and action.
What is being done about health equity?
There are many examples of affirmative action towards improving equity in healthcare across Aotearoa New Zealand. Here are some of the initiatives that organisations and individuals are doing.
The National Science Challenges examples
He Pikinga Waiora – Making health interventions work for Māori communities
This project focussed on ways to address implementation of health-related programmes and initiatives to reduce health inequalities and achieve health equity for Māori.
Read about the project and see Nina Scott’s presentation at the 2020 Long Term Conditions Forum on the same project.
Mana Tū: A whānau ora approach to long term conditions
The study examined the impact of Mana Tū, a programme co-designed with whānau, clinicians, health service planners and whānau ora providers, on clinical and lifestyle interventions for whānau living with pre-diabetes and people with poorly controlled diabetes.
Read about the study and also see view Taria Tane’s Mana Tū presentation and video at the 2020 Long Term Conditions forum:
(Health Navigator NZ and National Hauora Coalition, 2020)
The work of Dr Debbie Ryan and Dr Api Talemaitoga
Read about the work of Dr Debbie Ryan and Pacific Perspectives. The report Tofa Saili lays out the evidence for health equity for Pacific peoples in Aotearoa New Zealand.
In this video, Dr Ryan talks about some of the findings in the report:
(Health Literacy, NZ & Health Navigator NZ, 2020)
In this video Dr Api Talemaitoga talks about some of the determinants of health inequity in Pacific peoples and provides some ideas for things you can do in your everyday practice.
(Health Literacy, NZ & Health Navigator, NZ, 2020)
Also see Talanoa with Dr Api, a series of videos providing a Pacific perspective on topics such as COVID-19 and vaccinations:
(Prepare Pacific, NZ, 2020)
Health Care Home's Enhanced model of care
The Health Care Home collaborative have recently launched the enhanced model of care. This webinar describes the need for the enhanced model of care, what has been enhanced and some information on how to support practical implementation:
(Health Care Home Collaborative, NZ, 2020)
Mauri Ora Window – The art of breathing life into other's experiences
In this webinar, Hemaima Reihana-Tait describes the Mauri ora window, a toolkit of principles and practice that supports equitable healthcare practices.
(Health Care Home Collaborative, NZ, 2020)
Equity Ministry of Health, NZ
Achieving equity Ministry of Health, NZ
Health equity links Health Quality & Safety Commission, NZ
Equity of health care for Māori – a framework Ministry of Health, NZ
Cultural safety SMS Toolkit, NZ
Te ao Māori framework Health Quality and Safety Commission, NZ
- Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition Int J Equity Health, 2019
- Achieving health equity in Aotearoa New Zealand – the contribution of medicines optimisation Journal of Primary Health Care, RNZCGP, 2018
- Achieving health equity in Aotearoa – strengthening responsiveness to Māori in health research NZ Medical Journal, 2017
- Came H, O'Sullivan D, Kidd J, McCreanor T. The Waitangi Tribunal’s WAI 2575 report: Implications for decolonizing health systems Health and Human Rights Journal. 2020 Jun; 22(1).
- Dalbeth, N., Dowell, T., Gerard, C., Gow, P., Jackson, G., Shuker, C., Te Karu, L. (2018). Gout in Aotearoa New Zealand: the equity crisis continues in plain sight New Zealand Medical Journal. 2018 Nov; 131(1485).