Building a Culture of Health means being attentive to biases

We, at County Health Rankings & Roadmaps, like many across the country, are working to deepen our efforts around health equity. We created an internal work group on health equity in early 2015 to further support a foundation for health equity by enriching our understanding of the barriers and opportunities for everyone to be their healthiest, and by growing our confidence in sharing health equity practices with others. We are also holding ourselves responsible to have an intentional commitment to equity as a program, and to continue to reflect on how we are doing.

In November 2015, we released the County Health Rankings Health Gaps Reports to explore what is driving health differences across each state and how those health gaps can be closed. In these Reports, we showed county by county differences in avoidable deaths by shading the counties with the greatest share of avoidable deaths in darker colors compared to those with fewer deaths. What we realized upon releasing these Reports is that we were contributing to the “dark is bad, light is good” narrative – we even originally said healthier counties were shaded white! In fact, our Rankings health factor and health outcome maps also present data using this same color gradient.

Many of the efforts to display data fall into this trap – we do what many organizations across the country do when illustrating differences on a map. What can we do about this? How can we do better? First, recognizing our own implicit bias has helped spur internal discussions within our program. This blog is the start of sharing our program’s journey; in so doing, we join with others who are reflecting, learning and changing practices.

Building a Culture of Health, county by county, means contributing to a national movement where all individuals, especially those most affected by poor health outcomes, have a voice and a role in creating and implementing solutions by sharing stories and lessons learned. It includes having a shared commitment to identifying and addressing gaps in opportunity that tend to disproportionately and negatively affect certain populations. Building this Culture of Health requires us to be attentive to biases, implicit or otherwise, that may undermine health equity. Health equity is a basic principle that all people, respective of sexual orientation, ethnicity, race, ability, language, gender, age, religion, income, educational level, or geographic location have  the opportunities they need to lead healthy lives.

With this in mind, we will continue to challenge ourselves internally, so that we can continue to be action and thought leaders externally.