National Collaborating Centre for Determinants of Health. (2015). Equity-integrated population health status reporting: Action framework. Antigonish, NS: National Collaborating Centre for Determinants of Health, St. Francis Xavier University.
Relevance for Public Health
The Equity-Integrated PHSR Action Framework was developed specifically for public health and those who partner with public health in collecting and reporting data (e.g., health/public health staff, community organizations, academic researchers). In this document, the Action Framework focuses on a public health audience, with hopes to expand to other audiences in the future (e.g., community organizations, researchers).
The Action Framework is applicable to and can be used by any public health professional conducting community health reporting or interested in producing change through the PHSR process. For example, if your local public health unit is developing a report profiling the health of women in your city, the Action Framework could be used to ensure that important considerations regarding health equity are guiding the conversation and being incorporated throughout the development process.
The Equity-Integrated Population Health Status Reporting Action Framework aims to support the incorporation of health equity into population health status reporting (PHSR), with the goal of improving the ability to address the social determinants of health. The Framework describes the steps in traditional population health status reporting and brings an equity lens to the process. Ultimately, equity-integrated population health status reporting helps to determine where the biggest inequities lie and why, to identify where it is best to allocate resources and the effectiveness of interventions/actions in reducing inequity and increasing equity, and to set targets for advancing health equity.
The Action Framework was informed by three similar frameworks: The Community Toolbox, Chapter 3: Assessing Community Needs and Resources; the NCCMT’s An Introduction to Evidence-Informed Public Health and a Compendium of Critical Appraisal Tools for Public Health Practice; and The Prairie Women’s Health Centre of Excellence: Guidelines for Developing a Population-Based Gender and Health Profile. The Action Framework was developed through consultation using a community collaborative approach.
The action framework includes:
- a description of the roles and expected outcomes for public health actors, researchers and community stakeholders;
- how to communicate, collaborate and apply a health equity values lens, including key questions to ask and examples of promising practices; and
- seven steps to a population health status reporting process and examples of potential actions/promising practices for each.
The document concludes with examples of ways to apply the framework to your own practice and how to use it as a conversation starter. Readers are encouraged to examine the framework through the lens of their own role in the system and think about what they can do within their circle of influence.
Accessing the Method/Tool
Implementing the Method/Tool
Time for Participation/Completion
Information not available
Additional Resources and/or Skills Needed for Implementation
Steps for Using Method/Tool
Each of the three components in the How section and the seven steps in the What section of the Action Framework includes a list of corresponding questions to consider and examples of potential actions/practices to take.
How: The Three Components of the PHSR Process and Potential Actions
Apply a health-equity-values lens:
- How do we ensure that we are thinking about the social, economic and political structures and systems that create these health inequities?
- How do we consider the types of collective action that can more fairly distribute resources for health (including power and money)?
- How do we invite people to be part of our team when we don’t know them?
- How do we build trust?
- How do we move to action?
- How do we make sure everyone knows what stage the process is at?
- How do we share our story so that others are inspired to join us?
What: The Seven Steps of the PHSR Process and Potential Actions
- Who needs to be part of the process?
- What are the key questions and issues/problems?
- In what ways are equity values integrated into our investigation questions?
- What is the best way to find the relevant research evidence?
- What indicators will help us answer the research question?
- What other data are available?
- Do we need to develop a plan to collect additional data?
- What are the data sources and the quality of the data?
- What limitations are inherent in the sources and data?
- Is there evidence available from other quantitative, qualitative or participatory research that can be used to complement the data?
- How do research approaches, data collection and analysis integrate health equity values?
- Do the various indicators adequately measure both assets and deficits?
- How well are population demographics disaggregated by geography, economic and social characteristics?
Synthesize & Adapt:
- How can we synthesize, adapt and integrate different types of evidence to paint a more complete picture of inequities?
- What recommendations can we make for practice based on the available evidence?
- How are health equity values integrated into our recommendations?
- How do the recommendations relate to the local context?
- Who is our audience and what is the best way to communicate what we have learned?
- How can we frame the findings so that they engage everyone?
- What is the best way to explore potential actions, spanning from community mobilization to policy development?
- How can we collaborate to implement these potential actions?
- How well did the PHSR process contribute to achieving our organizational goals for the report, where improved equity is included and integrated among those goals?
- In what ways did increased community capacity to take action on the social determinants of health and health equity result from the process?
Who is involved
The people using the Action Framework are those in the public health sector. This could include everyone from senior leaders, to medical health officers, to epidemiologists, to managers, to front-line staff.
Conditions for Use
Evaluation and Measurement Characteristics
Information not available
National Collaborating Centres for Public Health
Method of Development
The Integrated-Equity Action Framework was the product of a collaborative learning project spearheaded by the National Collaborating Centre for Determinants of Health between 2011 and 2013. The project involved consulting individuals such as managers, directors, researchers, epidemiologists and medical officers of health to identify the ways in which health equity could be effectively incorporated into PHSR. The result of this project, with reference to content from comparable documents, was a draft version of the Action Framework. The draft framework was then reviewed by National Collaborating Centres and public health stakeholders using a community collaborative approach.
National Collaborating Centre for Determinants of Health
St. Francis Xavier University
Antigonish, NS B2G 2W5
Phone: (902) 867-5406
These summaries are written by the NCCMT to condense and to provide an overview of the resources listed in the Registry of Methods and Tools and to give suggestions for their use in a public health context. For more information on individual methods and tools included in the review, please consult the authors/developers of the original resources.