Health Equity

Prevention Institute is working with the Robert Wood Johnson Foundation’s Achieving Health Equity Team to inform its grant making goals and strategies. Our analysis reveals that health inequities have been produced through policies and practices and that multiple sectors have a role to play in reversing the production and in supporting community transformation and health equity.

Advancing health equity is a central piece of our work in preventing violence, as we aim to address the underlying systems and conditions of inequity that create and perpetuate violence in the first place.  Our research and trainings in this area address land use practices; community trauma and resilience; early childhood development; and the critical role of urban youth in fostering safe communities.

In 2001-2003, we developed the Tool for Health and Resilience in Vulnerable Environments (THRIVE) for the U.S. Office of Minority Health. THRIVE is a framework for understanding how structural drivers play out at the community level to impact daily living conditions which, in turn, influence health, safety and health equity.

HEALU was formed in response to structural barriers to equity in Los Angeles’ land use arena, and in an effort to strategically and collaboratively promote systems change. HEALU augments the role of health in the land use sphere through training, capacity building, convening and proactively advancing key strategies to ensure a healthier, more equitable land use system.

Our approach to water equity connects a range of environmental and social issues whose challenges and solutions are interwoven, from drinking water quality and stormwater management to urban greening and fiscal equity.  It also recognizes the full spectrum of disparate environmental conditions that negatively impact the health of low-income communities of color—including air, soil and water pollution and disparities in natural and recreational amenities—and considers how system-level solutions may address or compound inequities.

Decisions about land use—like what projects get built and where, whose voices shape the process, and what supports are in place to ensure that existing residents benefit from new investments—directly impact community health. Through our local-level projects and policy work, we are building a model of how to embed health equity in all land use related decisions.

Drawing on interviews with grassroots leaders from across the country, this report explores how the political landscape, funding, staff skills, leadership, and partnerships influence the ability of community-based organizations to work effectively with public health agencies to address health inequities and racial injustices. 

Our approach to water equity connects a range of environmental and social issues whose challenges and solutions are interwoven, from drinking water quality and stormwater management to urban greening and fiscal equity.  It also recognizes the full spectrum of disparate environmental conditions that negatively impact the health of low-income communities of color—including air, soil and water pollution and disparities in natural and recreational amenities—and considers how system-level solutions may address or compound inequities.

Working as a thought-partner with the Robert Wood Johnson Foundation, PI conducted an analysis to determine the sectors and systems to engage for achieving health equity, and pinpointing the actions to accomplish to achieve equitable outcomes. The analysis resulted in Countering the Production of Inequities: A Framework of Emerging Systems to Achieve an Equitable Culture of Health. The framework underscores how historical and current policies and laws, practices and procedures produce inequities in health outcomes to inform a concrete understanding of how to begin to reverse or ameliorate the inequities and support communities in transforming to achieve an equitable culture of health.

This document outlines the development of THRIVE (Tool for Health and Resilience in Vulnerable Environments) and the concept of the social determinants of health (SDOH). By analyzing 22 SDOH frameworks in addition to THRIVE, we identify similarities and differences among the frameworks and highlight THRIVE’s unique contribution to the field. 

This paper 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 also delineates a set of metrics that could reflect progress toward achieving health equity.

Prevention Institute and Tony Iton, MD, prepared this report for the Institute of Medicine's Roundtable on Health Disparities to identify policy solutions at the community, regional, and state level to reduce inequities in health and safety.

In this article in the international journal Environment & Urbanization, Prevention Institute discusses how community prevention and health equity are global concerns, and outlines prevention-based approaches to improving health.

THRIVE is a tool for assessing the status of community conditions and prioritizing them for action to improve health, safety, and health equity.

This interactive collection of profiles showcases successful community initiatives to improve health equity.

Our free, interactive online primer helps practitioners build primary prevention and equity into community health. 

This Centers for Disease Control and Prevention guide, developed with help from Prevention Institute, helps public health practitioners advance health equity through community prevention strategies.

The staff of Public Health Institute brought THRIVE to Planada, California to engage youth to address pedestrian safety. After using Photovoice to assess community conditions related to pedestrian safety, the group decided to focus on promoting safe routes to school. To advance safe routes to school, the youth engaged in a multi-faceted campaign, including efforts to create policy change.

After the Louisiana Public Health Institute (LPHI) participated in a THRIVE training-of-trainers, LPHI staff applied the concepts of THRIVE to spark organizational change. They created a health equity workgroup and expanded the focus of their ongoing initiatives and coalition to include community environments. They trained community activists on THRIVE and saw quick outcomes with the development a community garden.  

The Fruitvale Transit Village Project is a community-centered transit oriented approach that connects the local transit station with the surrounding community of Fruitvale, a low-income, predominantly minority community in Oakland, California.

Over the course of a decade, stakeholders in the western unincorporated area of Alameda County (also called "The Eden Area") came together to identify, discuss, and debate the most important issues facing their communities. Collectively, they developed a vision of livable communities and a prioritized set of actions.