Measuring What Works to Achieve Health Equity: Metrics for the Determinants of Health

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. Prevention Institute’s (PI) new paper on health equity metrics was commissioned by the Robert Wood Johnson Foundation (RWJF) to inform discussion on metrics for the Foundation and the nation. PI applauds RWJF's Culture of Health Action Framework, including their corresponding drivers and measures. The Action Framework reflects the Foundation’s commitment to achieving health equity and represents a significant step forward for the nation. PI is proud that Measuring What Works to Achieve Health Equity informed the Foundation’s thinking and direction. PI's paper draws on the Institute's health equity framework, and identifies the determinants of health that must be improved to achieve health equity – including structural drivers, community determinants, and healthcare. Within community determinants, PI addressed three interrelated community environments: the social-cultural environment, the physical/built environment, and the education/economic environment. PI reviewed existing metrics, conducted interviews, and applied health equity principles to develop selection criteria and identify 35 recommended metrics for the determinants of health 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. The metrics consider the need for effective framing to communicate clear direction and spur action. As the US shifts from a nation focused on disease to one based on prevention and population health, metrics are needed that measure the determinants of health and what works to achieve health equity. In this session, we will describe PI's research process and recommended health equity metrics, and discuss implications for future research and practice.