Understanding Health Equity in Health Care Planning

By: Maxine Arena, MPH, MBA

Health equity is a core principle of health care planning, ensuring that all individuals have equal access to health care resources, irrespective of their socioeconomic status, race, ethnicity, gender, or geographic location. Health care systems can enhance health equity through various strategies, such as developing a comprehensive health equity plan, analyzing social determinants of health (SDOH) data, customizing interventions, providing culturally competent care, fostering interdisciplinary collaboration, advocating for equitable policies, and continuously monitoring their impact. These strategies are essential for designing interventions that tackle the underlying causes of health disparities, which significantly impact health outcomes and health care costs.

Health disparities refer to systematic differences in health outcomes and access to care that adversely impact marginalized populations.¹ If not addressed, health disparities may lead to higher rates of disease burden as well as impact mortality rates. It starts by making health equity a pivotal and central focus in strategic planning. This involves a key understanding of health-related social needs and creating a data-driven strategy backed by community needs assessments as well as engaging stakeholders in the development process. This ensures that the strategic plan is informed by those most affected.

As health systems prioritize health equity, continuously collecting and analyzing SDOH data is essential as the data helps to identify specific community needs and informs the allocation of resources and services. It allows health care systems to identify at-risk populations and can tailor programs and interventions to meet community needs.¹ Health equity is not a one size fits all approach, so creating data-driven interventions centered on prevention and access helps to address the unique needs of different communities. This in turn increases the effectiveness and acceptance of an intervention and leads to improving broader health determinants and overall population health.

Addressing the unique needs of different communities requires health care providers to incorporate cultural component care. This begins by training health care providers to recognize and address their biases and to learn more about the culturally diverse backgrounds of their patients. Investing in health equity training that focuses on communication and skill building over training that may lead to stereotyping is significant to creating a cultural care model². This may mean investing in interpretation services, ensuring education materials are written in culturally and linguistically appropriate manner, incorporating community health workers, recruiting and retaining minority staff, or embedding clinics in geographic areas that are easily accessible for certain populations. Additionally, incorporating advance care planning (ACP) is another critical component of health equity, ensuring that patients can express their health care preferences and make informed decisions about their end-of-life care by aligning treatment with their values.³

When thinking about upstream planning, health care systems should advocate for policies that promote health equity at local, state, and national levels. This includes supporting legislation that addresses health related social needs, improves access to care, develops workforces, reimburses for navigation services, and reduces systemic barriers that perpetuate inequities.⁴ A key to accomplishing this is prioritizing partnerships between health systems and social care organizations. This means a comprehensive and intentional position to interdisciplinary collaboration by mobilizing coalition building and helps to develop holistic approaches to inequities.⁶ Advocating for such policies also has economic implications. Ultimately advocating for such policies not only provides access to preventative care, that if left without intervention leads to more expensive emergency interventions, it helps to improve economic outcomes by reducing health care expenditures and enhancing workforce participation.¹

Lastly, implementing systems to monitor and evaluate the impact of health equity initiatives is essential. Quality of care received is a significant factor that needs to be measured effectively as significant gaps still exist between the quality of care that is delivered to health disparity populations and the care that the health care system can optimally deliver.⁵ Specifically focusing evaluation on overuse in healthcare, which is the provision of health care services for which harms outweigh benefits or that is not necessary, can help to yield to the most effective interventions to meet the evolving needs of communities.^4,5 

Health equity remains a vital component of effective health care planning. By addressing health disparities, improving health outcomes, recognizing economic implications, engaging interdisciplinary collaborations, and formulating equitable policies, health systems can create frameworks that serve all individuals fairly.

As a practical example of this work in action, the Constellation Regional Collaborative, led by Constellation Quality Health and funded by the Centers for Disease Control and Prevention (CDC) through a five-year cooperative agreement, advances equitable care across North Carolina, South Carolina, Georgia, and Florida by improving cardiovascular outcomes and addressing social determinants of health. To learn more, visit The Constellation Regional Collaborative or email regionalcollab@constellationqh.org. We also offer consulting services in areas such as behavioral health, chronic disease management, post-acute care, and workforce development. Leveraging data-driven strategies, Constellation helps health systems and organizations build sustainable, equity-focused care models that improve outcomes and overall system performance. For more information, contact info@constellationqh.org.

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¹ Cunningham, R., et al. (2022). Health systems and health equity: Advancing the agenda. Retrieved from https://www.nursingoutlook.org/article/S0029-6554(22)00097-5/fulltext.

² Ihara, E. (2004, February). Cultural competence in health care: is it important for people with chronic conditions? (Issue Brief No. 5) Georgetown University Health Policy Institute.  Retrieved from https://hpi.georgetown.edu/cultural/.

³MyDirectives. (2023). What does advance care planning have to do with health equity? Retrieved from https://www.mydirectives.com/blog/what-does-advance-care-planning-have-to-do-with-health-equity.

⁴American Medical Association. (2024). AMA’s 2024-2025 strategic plan to advance health equity. Retrieved from https://www.ama-assn.org/about/leadership/ama-s-2024-2025-strategic-plan-advance-health-equity.

⁵Braveman, P., et al. (2011).  “Health Disparities and Health Equity: The Issue Is Justice”, American Journal of Public Health 101, no. S1 (December 1, 2011): pp. S149-S155. Retrieved from https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2010.300062.

⁶National Academy of Medicine. (2020). Community-driven health equity action plans. Retrieved from https://nam.edu/programs/culture-of-health/community-driven-health-equity-action-plans/.