Hannah Lantos, Lisa Kim, Jenita Parekh, Jennifer Manlove, Katherine Cushing, Andrea Shore, & Donnie Greco
The Robert Wood Johnson Foundation (RWJF) defines health equity with the following two components: 1. “everyone has a fair and just opportunity to be as healthy as possible”; and 2. obstacles to health must be removed to ensure equal opportunity. Obstacles may include “poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.” This two-part definition makes clear that equity has an outcome component (everyone can be healthy) and a process component (removing obstacles). Achieving equity requires paying attention to student outcomes and to how inclusive the processes in your clinic are. Improved clinical processes can impact patient care—and focusing on both is essential for school-based health centers (SBHCs) to impact equity. In this foundational approach on equity, outcomes and processes are highlighted throughout different examples.
The strategies in this Foundational Approach focus on equity strategies related to improving systems and processes, tracking clinic improvements, and tracking or improving patient outcomes. Many will help your staff ensure that as many students as possible feel welcome, respected, and safe in your clinic and that systematic policies or procedures that create obstacles to advancing equity are removed. While these strategies were defined as relevant for schools with SBHCs, they could be useful for health care organizations that serve adolescents broadly or those looking to enter schools without a clinic to do outreach, education, or service provision. These strategies include approaches such as equitable communication, clinic and patient safety, or staff training.
Now think about potential next steps to embed equity into sexual health services and set some intentional goals. The following statements can serve as prompts to help you identify next steps.
1. Identify at least one new sexual health equity strategy to implement in your school-based health setting or organization over the next three months.
Think about what you discussed in response to the needs assessment questions and then identify new opportunities for sexual health equity in your SBHC. Ensure that your conversation identifies ways to reach all student populations or that if you narrow to focus on one population, it is intentional. Consider what data can help you identify the strategies on which you should focus.
2. Identify at least one existing sexual health equity strategy in your school-based health setting or organization to improve over the next three months.
Think about what is already happening in your SBHC regarding equity in your sexual health services. Consider what could be done more efficiently or more effectively and what efforts are not having the desired outcomes. Think about smaller changes that you can test and include in SBHC protocols. Ensure that your conversation identifies ways to reach all student populations. Then consider an additional small change. Consider what data can help you identify the strategies on which you should focus.
3. Identify at least one new sexual health equity strategy to implement in the school(s) where you are located over the next three months.
Think about new opportunities for schoolwide equity work related to sexual health services. Ensure that your conversation identifies ways to reach all student populations.
4. Identify at least one existing sexual health equity strategy in the school(s) where you are located to improve over the next three months.
Think about what your SBHC is already doing in the school regarding equity and sexual health that could be done more efficiently or effectively. Think about smaller changes that you can test and include in SBHC protocols. Ensure that your conversation identifies ways to reach all student populations. Then consider an additional small change.
Lantos, H., Kim, L., Parekh, J., Manlove, J, Cushing, K., Shore, A., & Greco, D. (2022). Embedding Equity Approaches into Clinic Processes and Patient Interactions. Child Trends. https://doi.org/10.56417/3031i7003s
This publication is supported by the Office of Population Affairs (OPA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $2,036,999 with 100 percent funded by OPA/OASH/HHS. The contents reflect the views of the authors and do not necessarily represent the official views of, nor an endorsement by, OPA/OASH/HHS, or the U.S. Government. For more information, please visit https://opa.hhs.gov/.
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