Moving the Needle on Health Equity

A newly-revised NC Heath Equity Impact Assessment tool helps people reduce health disparities in the communities they serve.

By: Vikki Crouse | November 2021

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Health is essential for everything we do.

Across measures of individual and community health there are persistent health gaps by race, ethnicity, income, and other key factors. Often these differences are preventable. Just as often, these differences can be perpetuated by inequitable programs and practices in public health (however unintentional), as well as the distinct social and economic conditions in the places where people live, learn, work, and age.  

Eliminating health disparities requires intentional efforts to enhance the health and well-being of residents.

Local stakeholders in rural, western North Carolina have been implementing the Health Equity Impact Assessment to improve health outcomes among young children ages 0-5. Since 2016, the High Country Collaborative, a local health department serving five western NC counties, is having success using the HEIA to strengthen its Positive Parenting Program (Triple P). Through the HEIA process, the High Country Collaborative identified barriers to equitable access and participation in the Triple P program. As a result, the group used data and recommendations to implement new strategies for more robust and targeted outreach to community members, including close partnerships with schools and places of worship.  

Launching a newly-updated NC HEIA tool

This week, in collaboration with the NC Division of Public Health and the Office of Minority Health and Health Disparities, NC Child is releasing a newly-updated North Carolina Health Equity Impact Assessment (HEIA). The updates are designed to better support impacted community members in applying the HEIA framework to both program development and policy advocacy.

NC Child and collaborators first released the HEIA tool in 2017. The HEIA provides a structured process to guide the development, implementation and evaluation of policies and programs that impact population health, with a goal of reducing health disparities and inequities. Data and community involvement are central to the tool’s success.

HEIA action steps

The four action steps of the HEIA are completed jointly by a diverse group of stakeholders. The group can include local decision-makers, civic groups, faith leaders, and directly-impacted community members. The success of the HEIA lies in the strong collaboration among these stakeholders, and their work to implement the proposed changes to the policy or program.

The HEIA consists of four primary action steps:

  1. Describe the program or policy to be assessed including the goals and expected outcomes.
  2. Analyze the data profile to determine potential impacts of policies and programs on health and health disparities.
  3. Identify changes to current or proposed policies or programs to ensure they reduce health disparities and not make them worse.
  4. Develop a monitoring plan for measuring the implementation of recommended changes to policies or programs and the impact they have on communities.
    HEIA Action Steps

Local HEIA Success with Public Health Programs

In North Carolina, local health departments participating in the NC Improving Community Outcomes for Maternal and Child Health Initiative (ICO4MCH) use the HEIA annually to evaluate evidence-based programs aimed at improving birth outcomes, reducing infant mortality rates, and improve the health status of children ages 0-5. Local sites are using the HEIA to improve program implementation for the Positive Parenting Program (Triple P), Ten Steps for Successful Breastfeeding, Reproductive Justice, and the Tobacco Cessation and Prevention program.

The NC Health Equity Impact Assessment is a great tool for promoting health equity across all North Carolina communities. Is there a local or statewide initiative that you think would benefit from the HEIA? We invite you to explore the updated tool and share with us how you plan to use it to drive positive health changes in your community.