Summary
We count what matters. When it comes to equitable access to opportunities for health and wellness, what matters is measuring those determinants that shape health and safety, and can drive health equity. By doing so, we can determine priorities and take necessary actions to keep all Americans healthy, lower the cost of healthcare, and ensure that everyone has an equal opportunity to thrive and achieve his or her full potential.
In spring 2014, the Robert Wood Johnson Foundation (RWJF) commissioned Prevention Institute (PI) to develop a set of health equity metrics to inform its broader set of metrics for its Culture of Health. In order to develop the set of metrics, PI reviewed existing metrics, conducted interviews, and applied health equity principles and other considerations, to identify 35 recommended metrics for the determinants of health that could reflect progress toward achieving health equity. PI provided RWJF with the project research and findings to inform discussion around health equity metrics for the Foundation and the nation. PI modified the document slightly for broader dissemination, including adding an executive summary.
Measuring What Works to Achieve Health Equity: Metrics for the Determinants of Health provides a framework for understanding how disparities in health outcomes are produced and how health equity can be achieved, particularly by addressing the determinants of health. It lays out the determinants of health - structural drivers, community determinants, and healthcare - that must be improved to achieve health equity. It also describes the methods and criteria that Prevention Institute applied to identify health equity metrics. Finally, the paper delineates a set of metrics that could reflect progress toward achieving health equity.
The recommended metrics include existing indicators, indexes, and composite measures as well as those that could be developed, and consider the need for effective framing that communicates clear direction and spurs action.