Educating and Training Staff on the Principles of Health Equity

Some rural providers and public health practitioners may benefit from opportunities to receive education and training on health equity. Education can focus on a range of topics, such as the historical basis of health inequities, implicit bias, cultural humility, culturally and linguistically appropriate services (CLAS), and strategies for engaging with communities that have experienced inequities, among many others. Training can focus on increasing knowledge, informing practices, and gaining tools and techniques to advance health equity. Training and education opportunities can support staff who directly engage with communities that experience health inequities.

Training can enable staff to:

• Learn from one another and reflect on health equity topics
• Explore how to talk about health equity, such as with colleagues, community members, and other collaborators
• Define key concepts of health equity — including any shared definitions for health equity used by the organization, partnership, coalition, or agency
• Understand the difference between health equity, health disparities, and the social determinants of health
• Increase awareness of the root causes of health equity and the unique factors driving inequities in the community
• Build capacity to engage with communities that experience health inequities
• Collect accurate data from patients, such as race, ethnicity, and language (REaL) data or social determinants of health assessments

One free resource is the Roots of Health Inequity training and online learning collaborative from the National Association of County and City Health Officials. The training offers individual and group learning opportunities for local public health practitioners.

Examples of Rural Communities Providing Training to Advance Health Equity

• In rural Minnesota, Rice County Public Health staff participated in training on cultural competency to learn how to better serve immigrant communities. After initial cultural competency training opened conversations about health equity in the department, Rice County Public Health offered additional staff training and coaching on health equity with grant funding from the Public Health National Center for Innovations.
• In rural Oregon, St. Charles Madras implemented a pilot project to better serve the needs of their American Indian and Latino patients. St. Charles Madras invited leaders from the Confederated Tribes of Warm Springs to speak about transcultural care and how inpatient providers can better care for American Indian patients. The hospital also made permanent changes to expectations around training by requiring participation in cultural competency activities in nursing job descriptions. The Critical Access Hospital funded its pilot with a Small Rural Hospital Improvement Project grant from the Oregon Office of Rural Health.
• The West Marion Inc. is working with local rural hospitals in North Carolina to offer training about diversity and inclusion.

Implementation Considerations

Open communication, transparency, and trust are necessary for productive conversations about health equity in the workplace. Staff members who have experienced inequities need to feel safe about sharing their lived experiences. Rural organizations may benefit from engaging an external trainer or consultant to help guide staff through education and training and to facilitate discussions about equity topics. The National Institutes of Health offers resources on navigating crucial conversations about race in the workplace.

Organizations may also consider opportunities to hold staff accountable for participating in training activities. For example, they can make health equity trainings part of the employee onboarding process or integrating health equity topics into existing organizational training requirements.

In addition to addressing general health equity topics like power and racism, trainings can focus on a wide range of communities that experience inequities. These could include people with disabilities, people who are experiencing homelessness, people with limited health literacy, and LGBTQI+ communities, among many others.

Questions for Consideration

• What do staff know about health equity?
• What are the training goals and needs of staff related to health equity?
• Where does training fit in the organization's overall goals for health equity? How will staff apply what they learn to their work?
• Who will deliver the training? What follow-up and support will be available to staff?
• How will staff be evaluated over time to assess how they are applying the training?

Program Clearinghouse Examples

• Rice County Public Health
• West Marion Inc.

Resources to Learn More

Health Equity and Social Justice 101 Online Training Series
Video/Multimedia
Provides a three-part video series that discusses issues like structural racism, intersectionality, and stories from the field.
Organization(s): National Association of County and City Health Officials
Date: 6/2017

Health Equity Training Modules
Website
Offers three modules on health equity that provide an introduction, a discussion of power, and suggestions for operationalizing health equity.
Organization(s): University of Wisconsin Population Health Institute

Training Spotlight: Diversity and Health Equity
Website
Provides trainings based on the four core factors of the Health Equity Framework: systems of power, relationships and networks, individual factors, and physiological pathways.
Organization(s): MCH Navigator, National Center for Education in Maternal and Child Health, Georgetown University