Equity, Diversity, and Inclusion in Public Health: Creating a Healthier Society

October 16, 2024 | Natalie S. Burke

Public health plays a vital role in ensuring the well-being of communities, addressing health inequities, and promoting population health. However, for public health leaders, initiatives, and organizations to be truly effective, it is essential to incorporate principles of equity, diversity, and inclusion (EDI). These three pillars are critical for building a healthier society in which all people have fair opportunities to achieve their best possible health. When EDI is present and active, health equity becomes possible.

Examining Equity

Health equity, as a fundamental principle in public health, seeks to ensure that everyone has a fair chance to achieve optimal health. Too often, people balk at the concept of fairness believing it to be subjective and immeasurable. In this instance, “fair” is best described as whatever is necessary to get a person, family, population, or community to the best possible outcome. It acknowledges that individuals have different health potential, needs, and experiences that must be addressed to create equal opportunities for health.

To that end, public health leaders must recognize and address social determinants of health, such as income, education, employment, transportation, structural racism, and housing, which all play important roles in the production of health outcomes. By identifying these underlying factors, public health initiatives can be tailored to meet the unique needs of marginalized communities and minoritized populations while reducing health inequities.

Understanding the Importance (and Differences) of Diversity and Inclusion

Diversity and inclusion are essential for building strong and effective public health systems. Diversity refers to the presence of a wide range of individuals from different identities, including race, ethnicity, gender, sexual orientation, socioeconomic status, and more. Inclusion, on the other hand, refers to creating an environment in which everyone is valued, respected, and empowered to contribute their unique perspectives and lived experiences. Think of inclusion as the muscle of diversity—many different types of people, engaged meaningfully.

A diverse public health workforce is crucial for addressing health inequities and meeting the needs of diverse populations. When public health professionals come from various backgrounds, they bring different perspectives, insights, and solutions to the table. This diversity of thought and experience leads to more impactful policies, programs, and practices that can better serve the entire population—particularly those with the greatest health needs.

In addition, inclusion ensures that all individuals have opportunities to participate in decision-making processes and shape public health policies. This approach engages levers of power within organizations and communities—power being the ability to define reality for yourself or others. By including the empowered voices of marginalized and minoritized people, public health initiatives become more responsive to their needs, ultimately leading to improved health outcomes and the elimination of health inequities.

Putting EDI into Action for the Greater Good

Together, equity, diversity, and inclusion are crucial for public health leaders, the workforce, and outcomes for several reasons:

1. Health Inequities: EDI helps to ensure that public health initiatives are designed to reach and serve all communities, especially those that have historically faced barriers to accessing healthcare and that are experiencing poorer health outcomes. By prioritizing EDI, public health leaders and the workforce can work towards achieving health equity.
2. Cultural Competence: The public health workforce and its leaders must respect a diversity of cultures and their values. Cultural competence allows public health professionals to engage successfully with different populations while effectively supporting them to achieve their best possible health. By embracing diversity and inclusion, the public health workforce can develop cultural competence, which will lead to better communication, trust, and collaboration with communities. People are more likely to trust and follow recommendations from professionals who understand their backgrounds and experiences.
3. Health Literacy: Efforts should be made to improve health literacy, especially among marginalized communities and minoritized populations. This involves providing accessible and culturally appropriate health information to empower individuals to make informed decisions about their health.
4. Innovation and Creativity: Diversity within the public health workforce brings together individuals with different perspectives, backgrounds, and experiences. This diversity of thought leads to innovative solutions and creative approaches to public health challenges. When people from different backgrounds come together, they bring unique insights and ideas that can enhance the effectiveness and impact of public health interventions.
5. Representation and Trust: The public health workforce should reflect the communities they serve. When individuals from marginalized communities and minoritized populations see themselves represented in the public health workforce, it creates a sense of trust and confidence in the initiatives implemented. Representation helps to break down barriers, reduce stigma, and improve the uptake of public health interventions.
6. Improved Decision-Making: Inclusive decision-making processes lead to better outcomes. When diverse voices are included in public health discussions and decision-making, a broader range of perspectives and experiences are considered. This ensures that policies and interventions are more comprehensive, responsive, and effective in meeting the needs of diverse populations.
7. Community Engagement and Collaboration: Building relationships with communities is essential for successful public health interventions. By embracing EDI, the public health workforce can engage communities in meaningful ways, ensuring that their voices are heard, their concerns are addressed, and their active participation in shaping public health initiatives and public policies that create opportunities for health. This collaboration and engagement foster trust, enhance the relevance of interventions, and increase their likelihood of success.
8. Eliminating the Impacts of Bias and Discrimination: Implicit and explicit biases can affect healthcare decisions and treatment outcomes. A diverse workforce can help reduce these biases and discrimination in healthcare delivery, ensuring that individuals receive equitable care.
9. Legal and Ethical Imperatives: In some jurisdictions, there are legal and ethical imperatives to promote EDI in the workplace. Violating these principles can lead to legal consequences, financial penalties, and damage to an organization's reputation.

EDI is vital for public health leaders seeking to promote health equity, innovation, representation, improved decision-making, and community engagement. By investing in self-mastery and professional development to become equitable leaders while also prioritizing these principles, public health leaders of all identities can better serve diverse populations, reduce health inequities, and create more inclusive and effective public health systems.