Further resources for health equity sensitive research
General Resources
This page provides information about other useful resources to support researchers to design, undertake and report health equity sensitive research. The list of resources is not exhaustive, with resources selected for their particular relevance to the issues raised on this site. The resources include further readings, videos, inventories, guidance and websites.
Intro
The resources below are grouped into six sections:
- intersectionality and health;
- health equity and structural drivers;
- researching social categories;
- inclusive public involvement;
- equity-focused practice and policy; and,
- other relevant resources.
Intersectionality and health equity
Intersectionality and health explained (Video)
This video – created by a research team in the Department of Sociological Studies at the University of Sheffield in the UK, as part of an Economic and Social Research Council-funded project – considers ‘intersectionality’, a term coined by Kimberlé Crenshaw to describe the discrimination experienced by black women, and how this can lead to differences in health.
The Problem with the phrase women and minorities
Health equity and structural drivers
Structural Intersectionality as a New Direction for Health Disparities Research
This article aims to integrate insights from intersectionality perspectives with the emerging literature on structural racism and structural sexism—which point to promising new ways to measure systems of inequality at a macro level—to introduce a structural intersectionality approach to population health.
Why do some countries do better or worse in life expectancy relative to income? An analysis of Brazil, Ethiopia, and the United States of America
This mixed-method study highlights potential structural determinants driving differential performance in population health outcomes in three countries: Ethiopia, a low-income country with health outcomes exceeding what would be predicted on the basis of its GDP per capita; Brazil, a middle income country also over-performing; and the USA, a high-income country whose health outcomes are worse than those predicted by its economic performance. Structural determinants of cross-national health differences included: greater equity, a more inclusive welfare system, high political participation, strong civil society and access to employment, housing, safe water, a clean environment, and education.
Racism, Culture and Equity in Obstetrics & Gynaecology
This is a US-focussed online resource offering a collection of papers, articles, videos, audio, podcasts, and organizations, and articles on the pervasiveness of racism in matters relating to obstetrics and gynaeoclogy. It is curated by a team of medical doctors and students in the US.
Ivory tower indeed: the many ways racism shapes health research infrastructure and practice
This is a short article that concisely summarises the many, different ways that racism impacts on health research. It focusses on racism in the health research infrastructure rather than in the design and conduct of health research. i.e. in the ethno-racial composition of the leadership teams of research commissioning bodies; the composition of the research workforce, the experiences of racism in academia by minority medical students, the composition of the leadership of medical schools, journal editorial teams, the differential success of minority academics in attracting research funds, in achieving professorships, and in getting their work published. It also touches on the under-representation of racialised minorities in research participation and patient involvement and the consequences for the services they receive.
Researching social categories
What can health inequalities researchers learn from an intersectionality perspective? Understanding social dynamics with an inter-categorical approach?
This paper argues for an inter-categorical conceptualisation of social location that recognises differentiation without reifying social groupings – thus encouraging researchers to focus on social dynamics rather than social categories, recognising that experiences of advantage and disadvantage reflect the exercise of power across social institutions.
How to Embed a Racial and Ethnic Equity Perspective in Research
This report aims to equip researchers with tools and resources to integrate a racial and ethnic perspective in research.
Researching ethnic inequalities
This paper results from a project funded by the Joseph Rowntree Foundation that explored scientific and ethical standards in researching ethnicity.
Lessons for inclusive researchers
The focus of this paper is learning about the practicalities associated with inclusive ways of doing research from the field of learning disability. These practicalities are also of relevance to researchers working in other fields and seeking the participation of different groups in the research process.
Explore the meanings and uses of intersectionality: Intersectionality as a theory of power rather than identity
This short piece speaks to the debate on whether all identities or social categorisations can be called ‘intersectional’. The author cautions against understanding intersectionality only as shorthand for ‘intersectional disadvantaged identities’.
Winer, C. (2021). The Trouble with ‘Intersectional Identities’. Academia Letters, Article 819.
Inclusive public involvement
Public involvement in research: values and principles framework
A framework put together by INVOLVE (renamed as NIHR Centre for Engagement and Dissemination), a national advisory body that is funded by the National Institute for Health Research to support public involvement in NHS, public health and social care research and development.
Centre for Social Justice and Community Action
This website provides useful resources on participatory action research including toolkits, guides, case studies on ethics of community-based participatory research.
NIHR Race Equality Framework
This is a self-assessment tool for organisations/departments to improve racial equality in public involvement in health and social care research by developing their racial competence. Its focus is on organisations/departments and not individual researchers. It raises key issues about how public involvement is organised and supported by an appropriate organisational infrastructure and appropriate institutional practices. Individuals researchers will find many good pointers to ‘best practice’ but they will go through material that is not addressed to them but to their organisation/department.
Equity focused practice and policy
Health Equity Assessment Tool (HEAT)
Resources and e-learning from Public Health England to support systematic action on health inequalities.
https://www.gov.uk/government/publications/health-equity-assessment-tool-heat
Health inequalities portal
The health inequalities portal is managed by EuroHealthNet, the European Partnership for health, equity, and wellbeing. It includes links to a range of available tools (including the HEAT-Plus resource developed by World Health Organization) to support you to measure and understand health inequalities as well as assess how to act, and to analyse how policies and actions can affect health equity.
https://health-inequalities.eu/
Promoting action on equity issues
The toolkit provides guidance on evidence-informed decision making to address health equity issues with a framework and worksheets that can be used to develop an equity-focused knowledge translation strategy.
Reporting and dissemination
Disseminating knowledge products
This paper calls for a strategic approach to the dissemination of knowledge. It lists and considers the main questions a dissemination strategy seeks to address and considers the potential advantages and disadvantages of various dissemination pathways. This paper does not focus on knowledge or research on health inequalities. It offers a generic approach to dissemination.
How to talk about the building blocks of health:
A communications toolkit for people working in public health
The Health Foundation published in July 2022 a toolkit for public health professionals on how to communicate about the wider social determinants of health to a non-specialist audience with the aim to gain support for policies and action. It is a short document containing five recommendations:
1) to illustrate the significance of the wider determinants of health, start your messaging with a focus on inequalities in life expectancy and the fact that lives are being cut short;
2) explain the causes of health inequalities through two strategies: a) using the metaphor of ‘the building blocks of health’ to explore the role of social determinants; b) using specific examples and step-by-step causal chains to illustrate how wider determinants such as job and housing impact on health (e.g. through chronic stress);
3) include specific solutions and show that positive, desirable, feasible change is possible for every problem you bring up;
4) beware of the following because research indicates that they all seem to decrease support for action on the wider determinants: the economic case of tackling social determinants; the case for protecting the NHS, and a focus on the COVID-19 pandemic;
5) do not use data in the place of a story; offer meaning, and make sense of facts and figures through the use of metaphors and step-by-step explanations.
The toolkit is also accompanied by a number of reports on the research that led to these recommendations. One of them is interesting for public health communicator in that it identifies a number of ideas expressed in the public domain that militate against the social determinants of health paradigm i.e. that health is an individual matter of lifestyle choices; that structural racism does not exist in the UK.
You can see how the toolkit has been put to practice in the media campaign by Health Equals.
How to talk about the building blocks of health – The Health Foundation
Other relevant resources
A novel conceptual model and heuristic tool to strengthen understanding and capacities for health inequalities research
This paper develops a conceptual model to increase understanding of how health inequalities research and research capacities are produced using perspectives from the social determinants of health and political economy literatures. The latter highlights the role of power and politics and positions the production of HI research, as a political process.
Cash-Gibson, L., Harris, M., Guerra, G. et al. (2020) A novel conceptual model and heuristic tool to strengthen understanding and capacities for health inequalities research. Health Res Policy Sys 18, 42
Health Equity Tools Inventory
An inventory was developed in 2013 (updated 2016), collating available resources for policy, practice and research that identify improving health equity as a goal.
https://www.uvic.ca/research/projects/elph/
Registry of Knowledge Translation Methods and Tools: a resource to support evidence-informed public health
An online repository of tools to improve the uptake of research evidence in public health policy and practice