What’s in a disparity rating? Identifying evidence-informed strategies to advance equity

Collectively we have the power to create communities where everyone has the opportunity to thrive. We’re getting better at identifying what drives inequity; yet, there is no single or simple solution to address inequity. As we strive to create healthier communities for all, we must invest in solutions that dismantle policies and systems that burden some groups while giving other groups unfair advantages. To do this, we need to examine how effective a solution is at achieving expected beneficial outcomes for communities and at addressing differences in health between groups. We must also consider how to implement a strategy to maximize its impact on reducing inequity.  

How do we do that?  

What Works for Health (WWFH) is a database of evidence-informed strategies, including policies, programs, and systems changes, that can improve health. As part of the County Health Rankings & Roadmaps (CHR&R) team, our evidence analysts review and evaluate evidence for each strategy and assign evidence of effectiveness and disparity ratings. The current disparity rating is a tool to understand how policies and programs impact populations across racial or ethnic groups, socioeconomic groups, and geographic locations.  

Evidence analysts are experts in assessing and synthesizing the best information to determine potential implications of a given strategy and are always seeking ways to advance their analysis and the WWFH database. For example, analysts are working to enhance the rating to reflect how a strategy might influence disparities between other characteristics such as age, gender, and disability. Analysts are also exploring how a strategy can be implemented to ensure that everyone has an opportunity to live long and well.  

There are complex challenges to navigate as we engage in the work. For example, there are limited studies that address inequities and most of the evidence does not focus on the expected benefits and implications for marginalized groups. Our ability to draw conclusions about a strategy’s potential impact on inequity is limited by the research questions asked, the data collected, the way the data is analyzed, and the interpretation of findings. Research that doesn’t consider the barriers and opportunities for marginalized populations can lead to inaction and further perpetuate inequities across groups. There is room for innovation across the field as databases similar to WWFH generally do not systematically review evidence with an equity focus. We are excited to join others in pushing new ground! 

CHR&R sees an urgent need to support communities advancing an evidence-informed approach to achieving health equity. Over the next several months, CHR&R is engaging in a process to strengthen the disparity rating to help you find solutions that address inequities in your community.  

How do you use WWFH’s disparity rating? What have you found helpful about the rating and what other equity-related information do you need to further accelerate your work? Reach out to [email protected] to share your thoughts.