Health Equity Resources

Find more information in our Health Equity Training Journal.


Ableism is a set of beliefs or practices that devalue and discriminate against people with physical, intellectual, or psychiatric disabilities and often rests on the assumption that disabled people need to be ‘fixed’ in one form or the other.


Bias is an inclination of temperament or outlook. Bias is also a personal and sometimes unreasoned judgment.


Classism is differential treatment based on social class or perceived social class. Classism is the systematic oppression of subordinated class groups to advantage and strengthen the dominant class groups. It’s the systematic assignment of characteristics of worth and ability based on social class.

Downstream Strategies

Downstream strategies are interventions which often involve individual-level behavioral approaches for prevention or disease management.


Elitism is when a group of individuals who may be of higher intellect, wealth, power, and/or special skills and experiences higher influence in society.


Ethnicity is a state of belonging to a social group that has a common national or cultural tradition.


Fair is marked by impartiality and honesty: free from self-interest, prejudice or favoritism.


Genderism is the systematic belief that people need to conform to their gender assigned at birth in a gender-binary system that includes only female and male.

Health Disparity

Health disparities are differences in health among groups of people that are linked to social, economic, geographic, and/or environmental disadvantage.

Health Equity

Health equity is when everyone has the opportunity to be as healthy as possible.

Health Inequity

Health inequities are systematic differences to opportunities leading to unfair and avoidable differences in health outcomes.


Heterosexism is prejudice against any non-heterosexual form of behavior, relationship, or community, particularly the denigration of lesbians, gay men, and those who are bisexual or transgender. Whereas homophobia generally refers to an individual’s fear or dread of gay men or lesbians, heterosexism denotes a wider system of beliefs, attitudes, and institutional structures that attach value to heterosexuality and disparage alternative sexual behavior and orientation.

Implicit Bias

Implicit bias is unconscious, automatic, and relies on associations that we form over time. We can form bias toward groups of people based on what we see in the media, our background, and experiences. Our biases reflect how we internalize messages about our society rather than our intent.


Intersectionality is the interconnected nature of social categorizations such as race, class, and gender, regarded as creating overlapping and interdependent systems of discrimination or disadvantage.


It is acting or being in conformity with what is morally upright or good.


Oppression is the systematic subjugation of one social group by a more powerful social group for the social, economic, and political benefit of the more powerful social group.

Oppression = Power + Prejudice


Power is a special right, advantage, or immunity granted or available only to a particular person or group.


Privilege refers to certain social advantages, benefits, or degrees of prestige and respect that an individual has by virtue of belonging to certain social identity groups.


In practice, the designation of race is based on socially defined visual traits as seen through the filter of individual and social perspective, while ethnicity is a category determined by genes, culture, and social class, a product of social evolution.


Racism is a system consisting of structures, policies, practices, and norms that assigns value and determines opportunity based on the way people look or the color of their skin. This results in conditions that unfairly advantage some and disadvantage others throughout society.

Racism is not just the discrimination against one group based on the color of their skin or their race or ethnicity, but the structural barriers that impact racial and ethnic groups differently to influence where a person lives, where they work, where their children play, and where they gather in community.


Sizeism is prejudice or discrimination on the grounds of a person’s size or weight.

Social Construct

A social construct is an idea that has been created and accepted by the people in a society.

Social Determinants of Equity

The social determinants of equity are quality experiences in the early years, education and building personal and community resilience, good quality employment and working conditions, having sufficient income to lead a healthy life, healthy environments, and priority public health conditions.

Social Determinants of Health

The social determinants of health are the non-medical factors that influence health outcomes. Social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels. The state social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries.

Social Identity

Social identity is a person’s sense of who they are based on their group membership. The groups that people belong to can be a source of pride and self-esteem.

Systemic Racism

Systemic racism is what happens when cultural institutions and systems reflect that individual racism.

Unearned Access

Unearned access is access based on an identity someone holds traditionally associated with privilege.

Upstream Strategies

Upstream interventions involve policy approaches that can affect large populations through regulation, increased access, or economic incentives. For example, increasing tobacco taxes is an effective method for controlling tobacco-related diseases (7). Midstream interventions occur within organizations. Downstream interventions would be the rate of self-reported exposure to secondhand smoke (downstream).


Xenophobia is fear of people from another country or group.

  1. Declaring Racism, a Public Health Emergency: What does that mean?— NACDD webinar
  2. The Skin You’re In
  3. Racism as a Cost for Everyone TEDTalk by Heather C. McGhee
  4. CDC Director Dr. Rochelle Walensky Addresses the Community Preventive Services Task Force
  5. Director’s Commentary by Dr. Rochelle Walensky, MD, MPH, Director of CDC
  6. Racism and Health: Racism is a Serious Threat to the Public’s Health –
  7. TIME 100 Talks Health Summit: CDC Director Dr. Rochelle Walensky on Health Equity
  8. Impact of Racism on our Nation’s Health—CDC
  9. Race Equity and Public HealthAmerican Public Health Association
  10. Racism: The Ultimate Underlying Condition—American Public Health Association
  11. Race Toward Health: How Race is the Greatest Predictor of Health with Dr. Thomas LaVeist—NACDD podcast
  12. Race Toward Health: What is a ‘Racial Equity Culture’? with Dr. Kristine Andrews—NACDD podcast
  13. Race Toward Health: The Political Determinants of Health with Daniel Dawes—NACDD podcast
  14. Levels of Racism: A Theoretic Framework and a Gardener’s Tale by Dr. Camara Phyllis Jones
  15. How Racism Makes Us Sick by David R. Williams
  16. If Racism is a Public Health Crisis, What Does that Mean for My Work? by Dr. Camara Phyllis Jones
  1. How Do We Overcome Our Biases—Walk Boldly Towards Them by Verna Myers
  2. Harvard Implicit Association Test
  3. Unpacking the Invisible Knapsack of Privilege by Peggy McIntosh
  4. University of Central Arkansas (UCA) Privilege Exercise Worksheet  
  5. Kimberlé Crenshaw: What is Intersectionality?
  6. Kimberlé Crenshaw at Ted + Animation
  7. Intersectionality and Health Explained—Sociological Studies Sheffield
  8. The Urgency of Intersectionality by Kimberlé Crenshaw
  9. Kimberlé Williams Crenshaw: Structural & Political Intersectionality
  10. Be an Ally—NIH Office of Equity, Diversity, and Inclusion
  11. I Grew Up in Poverty. Here’s Why I Recognize my White Privilege by Tom Rietz
  1. Does My Neighborhood Determine My Future?
  2. Where You Live Has a Huge Impact on Your Health
  3. Segregated by Design
  4. Health to be Determined: Using Built Environment to Relieve Communities from Arrested Mobility with Charles T. Brown, MPA—NACDD podcast
  5. Why the Built Environment? by Dr. Matthew Trowbridge
  6. Downstream, Upstream, Mainstream: Getting to Equity with Dr. Renée Canady—NACDD webinar
  7. How We in State Health Departments Can Support Active People, Healthy Nation—NACDD webinar
  8. Insights Magazine: Socially Determined – A Call to Action—NACDD report
  9. Complete Streets Webinar by Public Health Partners—NACDD webinar
  10. Health: To Be Determined—NACDD Podcast Series
  11. Deliberate Practice: Programs-Level Approaches to Address Upstream Factors—NACDD webinar
  12. Upstream Factors: From What and Why to How—NACDD webinar
  13. Community IS Medicine – an “Rx” for Eating, Exercise, Sleep and Community—NACDD webinar
  14. Building the Public Narrative to Address Root Causes for Health Disparities & State Examples—NACDD webinar
  15. The Color of Law: The Forgotten History of How Our Government Segregated America Webinar and Q&A with author Richard Rothstein, NACDD consultant Robyn Taylor, and NACDD Board Past President Dr. Susan Kansagra—NACDD webinar
  1. Health Equity Guiding Principles for Inclusive Communication—CDC
  2. Educating and Communicating about Breast and Cervical Cancer in the Community—Innovating Health International
  3. Health Equity Toolkit—Campaign for Action
  4. Advancing Health Equity: Key Questions for Assessing Policy, Processes, and Assumptions—Minnesota Department of Health
  5. Breast Cancer Disparities Online Toolkit—ASTHO
  6. Disparities Impact Statement—Centers for Medicaid and Medicare Services
  7. Plan of Action for Cervical Cancer Prevention and Control 2018-2030—PAHO
  8. Compilation of Resources on Health Equity to Accelerate Population Health–NACDD
  9. Social Vulnerability Index—CDC
  1. National LGBT Cancer Network website—National LGBT Cancer Network
  2. Vanessa Goes to the Doctor—National LGBT Cancer Network
  3. What Goes Unsaid—National LGBT Cancer Network
  4. The Southern LGBTQ Health Survey Report (2019) —Southern LGBTQ Health Initiative–FullReport.pdf
  5. Latinx LGBT Adults in the US—UCLA School of Law, Williams Institute
  6. Increasing Access for the LGBTQ+ Population—National LGBT Cancer Network/CDC
  7. Effects of gender discrimination on health
  1. Impact of Unresolved Trauma on American Indian Health Equity
  2. American Indian Health Equity/Disparities—Center for American Indian Resilience
  3. Native Americans and Health Equity—NIHCM
  4. Communities in Action: Pathways to Health Equity. Chapter 2: The State of Health Disparities in the United States.
  5. Racialization as a Barrier to Achieving Health Equity for Native Americans
  1. How Do We Advance Equity for Asian Americans? —RWJF
  2. Asian Americans and Pacific Islanders Heritage
  3. Asian Americans and Health Equity: Dismantling Stereotypes and Changing the Narrative by Dr. Simona C. Kwon
  4. Anti-Asian American Racism: A Wake-Up Call for Population Based Cancer Research
  1. Using Data to Promote Equity in Policy and Programming—NACDD
  2. #Ableism—Center for Disability Rights
  3. What is Classism? —Class Action
  4. Health inequalities by class and race in the US: What can we learn from the patterns?
  5. Awake to Woke to Work: Building a Race Equity Culture — Equity in the Center
  6. Measuring the Impact of Public Health Policy—CDC
  1. Breast cancer statistics. Centers for Disease Control and Prevention. Updated June 8, 2020. Accessed July 15, 2020.
  2. Breast cancer basic information. Centers for Disease Control and Prevention. Updated July 26, 2019.
  3. Cancer disparities. National Cancer Institute. Updated March 11, 2019. Accessed July 17, 2020.
  4. Yedjou CG, Sims JN, Miele L, et al. Health and racial disparity in breast cancer. Adv Exp Med Biol. 2019;1152:31-49. doi:10.1007/978-3-030-20301-6_3
  5. Yi H, Xiao T, Thomas PS, et al. Barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. AMIA Annual Symposium Proceedings Archive. 2015; 1352-1360.
  6. Lunsford NB, Sapsis KF, Smither B, Reynolds J, Wilburn B, Fairley T. Young women’s perceptions regarding communication with healthcare providers about breast cancer, risk, and prevention. J Women’s Health (Larchmt). 2018;27(2):162-170. doi:10.1089/jwh.2016.6140
  7. Sutton AL, He J, Edmonds MC, Sheppard VB. Medical mistrust in black breast cancer patients: acknowledging the roles of the trustor and the trustee. J Cancer Educ. 2019;34:600-607. doi:10.1007/s13187-018-1347-3
  8. White-Means SI, Osmani AR. Racial and ethnic disparities in patient-provider communication with breast cancer patients: evidence from 2011 MEPS and experiences with cancer supplement. Inquiry. 2017;54:1-17. doi:10.1177/0046958017727104
  9. Abittan B, Herman S, Herman J. Provider-patient communication of personal breast cancer risk (bcr): providers’ beliefs [18M]. Obstet Gynecol. 2018;131 Suppl 1:145S-145S.doi:10.1097/01.AOG.0000533074.18359.7c
  10. Breast cancer in young women. Centers for Disease Control and Prevention. Updated July 9, 2019. Accessed July 21, 2020.
  11. Joseph-Williams N, Elwyn G, Edwards A. Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making. Patient Educ Couns. 2014;94(3):291-309. doi:10.1016/j.pec.2013.10.031 
  12. Davio K. African American women are at a disadvantage in preventing breast cancer. The American Journal of Managed Care. Published January 16, 2019. 
  13. Vraga EK, Stefanidis A, Lamprianidis G, et al. Cancer and social media: a comparison of traffic about breast cancer, prostate cancer, and other reproductive cancers on Twitter and Instagram. J Health Commun. 2018;23(2):181-189. doi:10.1080/10810730.2017.1421730 
  14. Black KZ, Eng E, Schaal JC, et al. The other side of through: young breast cancer survivors’ spectrum of sexual and reproductive health needs. Qual Health Res. June, 2020. doi:10.1177/1049732320929649
  15. Underwood JM, Townsend JS, Stewart SL, et al. Surveillance of demographic characteristics and health behaviors among adult cancer survivors – Behavioral Risk Factor Surveillance System, United States, 2009. Morbidity and Mortality Weekly Report. 2012;61(SS01):1-23. 
  16. Shea-Budgell MA, Kostaras X, Myhill KP, Hagen NA. Information needs and sources of information for patients during cancer follow-up. Curr Oncol. 2014;21(4):165-73. doi:10.3747/co.21.1932 
  17. Husson O, Mols F, van de Poll-Franse L V. The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: A systematic review. Ann Oncol. 2010;22:761-772. doi:10.1093/annonc/mdq413
  18. Institute of Medicine. Delivering high-quality cancer care: charting a new course for a system in crisis. The National Academies Press. doi:10.17226/18359 
  19. Peppercorn J: Need to improve communication in breast cancer care [Editorial]. J Clin Oncol. 2012;30(15):1744-1746. doi:10.1200/jco.2011.41.3195 
  20. Brown M, McElroy JA. Sexual and gender minority breast cancer patients choosing bilateral mastectomy without reconstruction: “I now have a body that fits me.” Women & Health. 2016;58(4):403-418. doi:10.1080/03630242.2017.1310169 
  21. Rubin LR, Tanenbaum M. “Does that make me a woman?” breast cancer, mastectomy, and breast reconstruction decisions among sexual minority women. Psychol Women Q. 2011;35(3):401-414. doi:10.1177/0361684310395606

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