Health Equity

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What Is Health Equity?

Health equity is created when everyone has a fair opportunity to reach their highest level of well-being. Achieving health equity is about addressing and removing systemic barriers, recognizing and responding to systems of power and privilege, addressing disparities (including the voices of those historically and presently living with marginalization), and promoting cultural safety.

Health is not solely determined by medical care or personal choices. It’s also shaped by a wide range of social, economic, political, commercial, and environmental factors, known as the determinants of health. These determinants often reveal deeper patterns of inequality that lead to health differences among groups.

Social determinants of health include, but are not limited to:

  • Culture, race, and ethnicity
  • Food insecurity
  • Gender identity and expression
  • Housing
  • Income and income distribution
  • Indigenous status
  • Sexual orientation and attraction
  • Social inclusion/exclusion
  • Social support networks

Economic determinants of health include, but are not limited to:

  • Income
  • Education
  • Employment
  • Access to healthcare

Political (structural) determinants of health include, but are not limited to:

  • Written and unwritten rules that maintain hierarchies, values, beliefs, worldviews, culture, and norms
  • Power dynamics seen in governance, laws, policies, regulations, budgets, and practices

Commercial determinants of health include, but are not limited to:

  • Product design
  • Marketing
  • Lobbying
  • Working conditions
  • Research and development

Environmental determinants of health include, but are not limited to:

  • Physical environments
  • Chemical environments
  • Biological environments
  • Social and built environments
  • Climate change
  • Limited access to green space

What Is Intersectionality?

Intersectionality is a term coined by Kimberlé Crenshaw, an American civil rights advocate and scholar of critical race theory. It describes how different forms of discrimination combine and affect people’s daily lives. As a framework, it helps us understand how aspects of identity interact to create unique experiences of privilege or oppression.

“Intersectionality is simply about how certain aspects of who you are will increase your access to the good things or your exposure to the bad things in life... It’s basically a lens, a prism, for seeing the way in which various forms of inequality often operate together and exacerbate each other. We tend to talk about race inequality as separate from inequality based on gender, class, sexuality or immigrant status. What’s often missing is how some people are subject to all of these, and the experience is not just the sum of its parts.”
(Crenshaw, 2020, TIME Magazine)

The wheel of privilege and power is a tool that can help identify the different forms power takes, allowing us to design systems in new ways that correct power imbalances.

Click here to view this image in a larger size.

Image source: Government of Canada. https://www.canada.ca/content/dam/ircc/documents/pdf/english/corporate/anti-racism/wheel-privilege-power.pdf

What Is Cultural Safety?

Cultural safety is an outcome defined by the individual or community’s perspective. It considers the social, political, and historical contexts. It embraces anti-racism and anti-oppression through the reduction of power imbalances between minority and dominant groups. It also involves practicing cultural humility through self-reflection to understand one’s own biases, assumptions, and privilege. It recognizes the historical roots of trauma.

By applying culturally safe (anti-racist and anti-oppressive) practices, we create a welcoming and inclusive environment. This could involve using respectful language, actively listening, being open to learning from others, adjusting personal perspectives, and acknowledging and addressing power dynamics.

Here are definitions of the continuum of cultural safety and humility:

  • Cultural awareness is the starting point – it involves recognizing that both similarities and differences exist among individuals and groups.
  • Cultural sensitivity builds on this by acknowledging the influence of our own cultural background and how it shapes our biases. It calls us to act with respect and consideration.
  • Cultural competency involves taking accountability for reducing assumptions based on intentional or unintentional biases. It includes developing practical skills for interacting effectively with diverse groups, without requiring complete knowledge of every culture.
  • Cultural humility is a lifelong process of learning and self-reflection. It means recognizing the role of power and privilege in our actions and language, listening without judgment, and remaining open to growth.
  • Cultural safety happens when people feel respected and safe – spiritually, socially, emotionally, and physically.

Although becoming culturally safe requires time, reflection, and commitment, it is essential to reduce the harms caused by inequity, oppression and racism.

Truth and Reconciliation

The Truth and Reconciliation Commission (TRC) of Canada was created following the Indian Residential Schools Settlement Agreement. The TRC created a historical record of the residential school system and presented a summary of the findings in the report 94 Calls to Action.

This final report is a testament to the courage of survivors and families who shared their stories. It guides a national engagement strategy for developing and implementing a reconciliation framework.

Learn more:

Land Acknowledgment

A land acknowledgment is not a call to action but an opportunity for an individual act of reconciliation. It provides a meaningful way to introduce ourselves. Rooted in traditional protocol, a land acknowledgement serves as an important step toward cultural safety by honouring the connection to land and history.

Learn more:

The EOHU supports each employee in creating a personalized land acknowledgment that reflects their location, event, worldview, and personal journey.

What Is the EOHU Doing to Address Health Equity and Cultural Safety?

To build systems that foster justice, inclusion, and well-being for all, public health must commit to and integrate equity, cultural safety and a deep understanding of health determinants into its base. This will allow public health to develop effective, respectful, and inclusive interventions.

Health equity is at the foundation of public health, as outlined in the Ontario Public Health Standards (OPHS) and the Health Equity Guideline (2018). Public health units are mandated to address inequities by focusing on the determinants of health and applying an equity lens in all aspects of planning, implementation, and evaluation.

Health equity requirements

  1. Assess and Report: Evaluate and share information about the health status of communities, highlight health inequities, and identify effective local strategies to reduce them. Examples of how the EOHU is achieving this requirement include: 
  2. Modify and Orient Public Health Interventions: Adjust public health practices to help reduce inequities, particularly for people who experience greater barriers due to systemic factors. Examples of how the EOHU is achieving this requirement include: 
    • Professional development for staff and community partners
      • Foundations of Cultural Safety
      • Bridges Out of Poverty – Individual Level
        • If your organization is interested in hosting a Bridges Out of Poverty workshop, please contact us at 1-800-267-7120 or email info@eohu.ca.
    • Toward a Culturally Safe EOHU
      • As part of this internal strategy, the EOHU is committed to:
        • Being an anti-oppressive, anti-racist and culturally safe organization
        • Implementing the Prairie Centre for Racial Justice Equity Indicators Framework
        • Engaging staff and adopting a method of engaging voices of people with lived and living experience in EOHU process and actions
        • Being accountable to EOHU staff, partners, and community members.
      • To find out more: Advancing health equity in organizations and systems using frameworks as a tool [Webinar]. National Collaborating Centre for Determinants of Health (February 11, 2025). 
    • The EOHU is a Living Wage Employer: The EOHU is committed to paying all its staff a living wage. A living wage fosters a skilled and healthy workforce that has a higher job satisfaction, greater quality of life, and an increased ability to actively participate in communities to make positive and equitable change. 
  3. Engage in Multi-Sectoral Collaborations: Work with municipalities, community partners, and Indigenous communities to identify, develop and share strategies that improve health and reduce inequities. Examples of how the EOHU is achieving this requirement include: 

    As a proud member of the IDEA Community Coalition, the EOHU is committed to promoting equity, diversity, inclusion, anti-oppression, and Truth and Reconciliation. We collaborate with local organizations and agencies to address systemic barriers and create lasting change. By focusing on community equity, continuous learning, inclusive practices, policy evaluation, and data-driven accountability, we strive to foster an inclusive and just community.

  4. Lead, Support, and Participate: Carry out health equity analysis, policy development, and advocacy to advance healthy public policies. Examples of how the EOHU is achieving this requirement include:
    • Providing support to community partners/strategies.
    • Participating in various provincial working groups and roundtables:
      • Ontario Public Health Association (OPHA) Health Equity Working Group
      • Health Equity Managers Network
      • Social Determinants of Health, Community of Practice

Need support or have an idea you want to discuss?

Contact us by email at info@eohu.ca or call 613-933-1375 or 1-800-267-7120.

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