When you hear the word "equity" you probably think of "equality," but equity is a deeper and more complex concept. Equality is each of us getting the same, no matter where we are or where we want to go. Equity is each of us getting what we need, based on where we are and where we want to go.
Equity as a Skill: What Does That Really Mean?
Equity means that people have access to the opportunities, resources, networks and supports that they need to succeed. Healthcare equity is providing patients appropriate resources according to their need, and addressing differential treatment arising from both system and individual factors.
If a healthcare system is equitable, then no one is denied the right to be healthy. This means that there should be no differences in life expectancy or health outcomes across economic or ethnic groups. To achieve this, people of color and people from low-income communities need to be explicitly valued, and structural barriers to wellness removed.
Equity in practice means that you will seek to empower people who are members of marginalized groups and support them in building their own capacities, creating and utilizing discrimination-free resources for them. Someone using the skill of equity will respect diversity and seek inclusion for traditionally excluded groups.
Equity in a Professional Setting
In order to better understand how to perform well on equity metrics on CASPer, it is helpful to understand why this is being measured in the first place.
Why are medical schools and other health professions programs so interested in assessing equity?
Let's look at an example in a professional context for some insight. Below, we'll share a story an example of effective empathy in a family doctor's office
Chelsea and her daughter sâkowêw are making their third trip to their family doctor's office in as many months. Chelsea, a First Nations Cree woman, was diagnosed with type 2 diabetes after the birth of her daughter 18 years ago, and her blood sugar control had never been great. She also had high blood pressure, high cholesterol and diabetic foot ulcers.
Chelsea's family doctor had added an insulin injection along with a pill in an attempt to improve her sugars, which hadn't helped. He had also arranged an appointment for health behavior teaching with the clinic's diabetes nurse, which hadn't helped either. He told Chelsea in no uncertain terms that she would destroy her feet unless she improved her sugar control.
Chelsea's family doctor was unsure of what to do next, and decided to read through the Truth and Reconcilation Report for ideas. He read more articles, learning about the concepts of cultural safety and cultural humility for his Indigenous patients and engaged in critical self-reflection. He hadn't realized that his implicit biases were destabilizing his clinical relationship with Chelsea or that he had been unknowingly using language rooted in racism and oppression.
He discovered that when he used his authority as a doctor to tell Chelsea how to manage her diabetes, he was re-enacting the legacy of colonization with its uneven and damaging relationships between Indigenous and non-Indigenous people.
Chelsea and sâkowêw noticed that their doctor acted differently this visit. He focused on sharing and connectedness as well as used a more indirect and nonconfrontational approach to discuss Chelea's health issues. He acknowledged the connection between Chelsea's adverse life experiences and her capacity to manage her diabetes.
For the first time, Chelsea felt safe and acknowledged at her family doctor's office instead of powerless and reprimanded.
As you can see from this example, equity is a skill which involves not only addressing the differential treatment of marginalized groups in society, but also acknowledging your privilege and reflecting on how you interact with members of these groups.
Chelsea's health was set on the path to improvement without any changes in medication-what she needed for equity was a doctor who created a safe and stable clinical relationship through understanding Indigenous practices and acknowledging the historical and social context of Chelsea's health.
Healthcare systems in Canada and in countries around the world are working to address the social determinants of health, structural barriers to care, and achieve health equity for whole populations. Medical schools are interested in people who promote equity, as physicians are active participant-architects within the health care system and are key to its improvement.
Given this example, you can understand why medical schools and other health professions programs are so interested in asking applicants to demonstrate equity.
So How Does CASPer Evaluate You on this Skill?
CASPer poses common scenarios and reflective questions aimed to determine if you possess the People Skills that you will eventually require to be a successful professional. Start Practicing