Background on Health and Racial Equity

Find information on health and racial equity terms and concepts. This includes helpful definitions and images. Use this information to gain an understanding of health and racial equity. This background is very important when looking at health data. It is also important in planning public health programs and policies.

Table of Contents

Health and Racial Equity Terms

Data Contextualization: Providing a narrative that describes the data and the root causes of inequities in the context of historical and current systems of oppression (e.g. racism, sexism). This must be done by engaging community partners and stakeholders in understanding and interpreting the data, and/or looking at quantitative data on individual and community experience.

Equity: Fairness; treating everyone in a way that produces just results.

Equity-centered: Incorporating equity principles in process; driven by a goal of achieving equity in outcomes.

Groundwater Approach: The applied practice of the groundwater metaphor, which is designed to help practitioners internalize the reality that we live in a racially structured society, and that that is what causes racial inequity. The metaphor is based on three observations: 1) racial inequity looks the same across systems, 2) socio-economic difference does not explain the racial inequity; and 3) inequities are caused by systems, regardless of people’s culture or behavior.

Health Disparity: Differences between the health of populations in measures of who gets disease, who has disease, who dies from disease, and other adverse health conditions.

Health Equality: Everyone is given the same health intervention without consideration of underlying needs.

Health Equity: Health equity is the opportunity for everyone to attain their highest level of health. No one is disadvantaged from achieving this potential because of his or her social position (e.g., class, socioeconomic status) or socially assigned circumstance (e.g., race, gender, ethnicity, religion, sexual orientation, geography).

Health Inequity: A health inequity is the unjust distribution of resources and power between populations which manifests in disparities. Health inequities are differences in health status and mortality rates across population groups that are systemic, avoidable, unfair, and unjust. These differences are rooted social and economic injustice, and are attributable to social, economic and environmental conditions in which people live, work, and play.

Implicit Bias: Also known as unconscious or hidden bias, a negative association that people unknowingly hold. It is often expressed automatically, without conscious awareness.

Institutional Racism: The discriminatory treatment, unfair policies and practices, and inequitable opportunities and impacts within organizations and institutions, based on race.

Internalized Racism: The set of private beliefs, prejudices, and ideas that individuals have about the superiority of whites and the inferiority of people of color. Among people of color, it manifests as internalized racial oppression. Among whites, it manifests as internalized racial superiority.

Interpersonal Racism: The expression of racism between individuals. These are interactions occurring between individuals that often take place in the form of harassing, racial slurs, or telling of racial jokes.

People of Color: A term that has been used in many different ways across time. In some contexts, it is being used as a way to express the dichotomies that exists based on designation of a person as white or non-white. It is not to be used to broadly classify all non-white populations or dismiss the varied history of discriminatory and violent policies against specific non-white groups.

Racial Equity: Acknowledging and accounting for past and current inequities, and providing all people, particularly those most impacted by racial inequities, the infrastructure needed to thrive. People, including people of color, are owners, planners, and decision-makers in the systems that govern their lives. Everyone benefits from a more just, equitable system.

Racial Equity Lens: Explicitly considering race, ethnicity, and racism in analyzing issues, looking for solutions and defining success. 

Racialize: The act or process of imbuing a racial characteristic to something (or someone). 

Social Determinants of Health (SDoH): Factors that contribute to an individual’s medical and behavioral health outcomes and to predicting population health (e.g., socioeconomic status, food access, education, and opportunity for employment). While structural inequities and prejudices such as homophobia, ableism, and xenophobia have impacts on SDOH, racism has been proven to also have a direct and harmful impact on health.

Structural Racism: Racial bias across institutions and society over time. It is the cumulative and compounded effects of an array of factors, such as public policies, institutional practices, cultural representations, and other norms that work in various, often reinforcing, ways to perpetuate racial inequity.

Health and Racial Equity Concepts

Bay Area Regional Health Inequities Initiative (BARHII) Framework

The BARHII framework is a nationally recognized model for understanding health inequites. It shows how some inequities and living conditions impact health behaviors and outcomes. Through the visuals, communities can understand where and how to focus public health programs and policies to reduce inequities.

Public health equity framework showing how social and institutional inequities as well as living conditions impact health outcomes.

Boston Public Health Commission (BPHC) Social Determinants of Health Framework

The BPHC works to protect and promote the health and well-being of it's residents. Their agency created a visual as part of it's Moving Equity Forward Together program. The graphic shows how systems of oppression influence the social determinants of health. It also shows how these systems and determinants then impact health outcomes.

A diagram showing how racism and other systems of oppression impacts health outcomes through social capital, education, transportation, employment, food access, health behaviors, socioeconomic status, environmental exposure, access to health services, housing, public safety, and more.

Additional Resources

Data definitions from the Massachusetts Department of Public Health Racial Equity Data Roadmap.

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