Centering Equity

The overarching goal of the Community Voices for Health program is to build stronger engagement infrastructure that involves a broader range of people—especially marginalized and underserved communities—so their voices are heard in health policy-making, their efforts to solve problems are supported, and their community networks are fortified.

This goal necessitates a solid relationship with marginalized and underserved communities and the shift of power toward those communities so that their challenges are addressed in health policy. Centering equity also requires a critical analysis of the roots of marginalization in health to ensure that new solutions and designs do not contribute to further marginalization.

Centering equity in community engagement is an iterative process. It demands constant reflection and table-setting as new ventures are undertaken and new people and organizations enter the fold.

Below are activities for creating shared definitions and understanding and for embedding equity in program design.

  1. Activity: Creating a shared understanding of equity

“Equity” is a commonly used word with varied definitions. To support the effective practice of equity, develop a shared understanding of what the term means and how it relates to your efforts. Below are a few prompts to guide conversations:

  1. Within your team, spend a few minutes unpacking personal definitions and experiences of equity:
    • What personal histories or aspects of our identities are alive when we think of our experiences with equity?
    • What differences exist in the group’s meaning and understanding of the term? What can we learn from that?
  2. Consider the following definitions of equity:

“Equity is when outcomes are not predictable based on someone’s identities.”

–Creative Reaction Lab

“Health equity is achieved when every person has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances. Health inequities are reflected in differences in length of life; quality of life; rates of disease, disability, and death; severity of disease; and access to treatment.”



  1. What might the differences in understanding of equity be between your definitions of equity and the definitions from Creative Reaction Lab and the CDC above?
  2. What are public health outcomes that the group is seeking? What are the connections between different identities and those health outcomes?
  3. What other information might the group need to learn about public health outcomes’ connection to identity?

Activity: Defining community

The lack of a strong infrastructure for engagement affects everyone, but historically marginalized and underserved communities the most. However, the people most affected by an issue are the best positioned to create solutions. They need to be centered in decision-making early on.

Often, the blanket term “the community” is used to describe the people who have less structural decision-making power in policymaking. It has a broad definition and is deeply nuanced depending on the context in which it’s used. Strong engagement approaches incorporate clear definitions about the communities of focus. Below are questions to guide discussions of community definition and engagement considerations:

  1. How does your organization define “community”? Be as specific as possible, beyond marginalized people. For example, “young people who are homeless in Las Vegas” is a specific community.
  2. What relationships does your organization currently have with that community?
  3. What is the history of the relationships between the community and your organization? Might there be tension or harm that needs to be addressed prior to engaging with the community?
  4. Which relationships are missing that need to be formed?

Activity: Embedding equity into program design

Questions in the framework below will help guide groups as they think about how to proactively incorporate equity-centered approaches into programming at every step:

  1. Community-based participatory research (often occurs prior to defining outcome goals.
    • What is the community’s history of engaging with research on this topic?
    • What community-led work has already been done?
    • How might you shift your plan based on the community history with the topic?
    • What community-identified needs are being incorporated into the research plan (e.g., needs regarding activity timing, content, language, and tech accessibility)?
    • How might community members provide input for the research methodologies and plan?
  2. Defining and refining the problem
    • Who ultimately has the power to decide what the challenge or focus will be?
    • Who should have more power to decide what the focus is?
    • Does the community have enough time to make decisions?
    • How might the program team clearly communicate the project focus to the community?
    • What opportunities for integrating feedback exist?
  3. Developing approaches to the problem
    • How are multiple engagement styles incorporated into brainstorming solutions?
    • Who is at the table? Who is not at the table? Who should be at the table?
    • Whose voices are most valued and why?
    • Whose voices are least valued and why?
  4. Executing on the approaches
    • How is the community included in program evaluation?
    • Is there ongoing evaluation throughout the program’s cycle?
    • Are there opportunities for real-time feedback and adjustment to ensure alignment with community needs?