{"id":4857,"date":"2026-05-01T09:31:52","date_gmt":"2026-05-01T09:31:52","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=4857"},"modified":"2026-05-01T10:15:14","modified_gmt":"2026-05-01T10:15:14","slug":"mind-the-gap-embedding-equity-in-everyday-practice","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/id\/2026\/05\/mind-the-gap-embedding-equity-in-everyday-practice\/","title":{"rendered":"Mind the Gap: Embedding Equity in Everyday Practice"},"content":{"rendered":"<p><strong>By Amanda O\u2019Connor, Claire Blewitt and Helen Skouteris, Monash University, Melbourne, Australia.<\/strong><\/p>\n<p><a href=\"https:\/\/impsciuw.org\/implementation-science\/learn\/equitable-implementation-science\/\"><span style=\"font-weight: 400;\">Health equity<\/span><\/a><span style=\"font-weight: 400;\"> means that everyone has a fair and just opportunity to achieve good health, regardless of socioeconomic position, ethnicity, gender, or other social conditions. Yet, current global trends show widening health gaps. Differences in life expectancy between countries, often driven by structural weaknesses in health systems, systemic racism and bias, and unequal social, economic, and environmental conditions, can <\/span><a href=\"https:\/\/www.who.int\/news\/item\/06-05-2025-health-inequities-are-shortening-lives-by-decades#:~:text=Although%20data%20is%20scarce%2C%20there,Breaking%20the%20cycle\"><span style=\"font-weight: 400;\">exceed three decades<\/span><\/a><span style=\"font-weight: 400;\">, and inequalities within countries are also increasing between social groups.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These root causes can feel far removed from our daily work. However, health care professionals <\/span><a href=\"https:\/\/practicalhealthpsychology.com\/2022\/08\/make-or-break-the-importance-of-breaks-in-healthcare\/\"><span style=\"font-weight: 400;\">often work under time pressure<\/span><\/a><span style=\"font-weight: 400;\">, resource constraints, and strict protocols. It may seem that equity is mainly a policy or system-level issue. Nonetheless, equity is also shaped in everyday healthcare encounters, in how services are organised, <\/span><a href=\"https:\/\/practicalhealthpsychology.com\/2022\/08\/2526\/\"><span style=\"font-weight: 400;\">how communication happens<\/span><\/a><span style=\"font-weight: 400;\">, how decisions are made, and which patients are able to benefit from available care.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Every consultation, care pathway, and service improvement effort <\/span><a href=\"https:\/\/practicalhealthpsychology.com\/2025\/02\/making-every-health-care-consultation-count-promoting-physical-activity-in-health-care-settings\/\"><span style=\"font-weight: 400;\">functions as a small intervention<\/span><\/a><span style=\"font-weight: 400;\">. Choices about appointment systems, referral routes, patient education materials, digital tools, and follow-up procedures can either reduce or widen gaps. When equity is not considered explicitly, standard procedures often work best for already advantaged groups. When equity is considered from the start, routine care becomes more accessible, more acceptable, and more effective for a wider range of patients.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">An equity-centred approach in healthcare begins with intentional reflection and planning. <\/span><a href=\"https:\/\/www.monash.edu\/medicine\/sphpm\/health-and-social-care\/research\/sempre\/our-research\"><span style=\"font-weight: 400;\">Teams<\/span><\/a><span style=\"font-weight: 400;\"> should make their understanding of equity explicit and discuss what fair access and fair outcomes mean in their specific service context. This includes identifying which patient groups are less likely to attend, adhere, or benefit, and examining practical barriers such as language, health literacy, transport, digital access, cost, stigma, or prior negative experiences with healthcare. Planning for equity also means recognising patient and community strengths, not only risks and deficits, and learning from past improvement efforts. For<\/span><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC11795705\/\"><span style=\"font-weight: 400;\"> example<\/span><\/a><span style=\"font-weight: 400;\">, access to care for children living with obesity in regional and rural areas may be improved by telemedicine, the expansion of nursing roles in primary care, and community health worker models.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Another core principle is valuing <\/span><a href=\"https:\/\/www.monash.edu\/medicine\/sphpm\/health-and-social-care\/research\/sempre\/valued-individuals-living-and-learning-about-growing-equity\"><span style=\"font-weight: 400;\">lived experience<\/span><\/a><span style=\"font-weight: 400;\">. Patients are experts in navigating their own conditions and circumstances. Their experiences with services reveal barriers and opportunities that clinical indicators alone cannot show. Healthcare professionals can strengthen equity by creating structured and ongoing ways to hear patient perspectives, through patient partners (i.e., patients or carers who are formally invited to collaborate with staff in service design, evaluation, or governance based on their lived experience), advisory groups, feedback systems, and co-design activities, and by ensuring this input meaningfully influences service delivery and communication approaches. <\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0149718924001150?via%3Dihub\"><span style=\"font-weight: 400;\">For instance<\/span><\/a><span style=\"font-weight: 400;\">, working with young people with lived experience of mental illness has led to a road map for the youth mental health sector in supporting collaborative service design, implementation, and evaluation of a community-based psychosocial service.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Reflective practice is also essential. Power differences are built into healthcare relationships through professional authority, institutional roles, and knowledge asymmetries. Clinicians and service teams need regular opportunities to reflect on how assumptions, stereotypes, and time pressures shape their judgments and interactions. Structured reflection, team dialogue, and feedback from diverse patients and colleagues help uncover blind spots and reduce the risk that bias influences care decisions. Reflection should be continuous and built into quality improvement routines. This is <\/span><a href=\"https:\/\/link.springer.com\/article\/10.1007\/s12310-024-09674-6#Sec28\"><span style=\"font-weight: 400;\">highlighted<\/span><\/a><span style=\"font-weight: 400;\"> in the work we do with early childhood organisations. To support children impacted by trauma effectively, we collaborate across disciplines and sectors and encourage deep and ongoing reflection on what practices and policies are needed to support health and wellbeing equity for these children.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Equity-centred care is strengthened by using appropriate conceptual lenses. Frameworks addressing social determinants of health, intersectionality, structural discrimination, and culturally grounded care help translate equity from an abstract value into practical decisions. These perspectives guide how professionals interpret non-adherence, missed appointments, communication difficulties, and risk behaviours, shifting the focus from \u201cnon-compliant patients\u201d to mismatched systems and contexts.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Health inequities are produced by large systems, but they are also reinforced or reduced through the many daily actions in healthcare settings. Putting equity first is therefore not separate from good clinical care; it is part of it.<\/span><\/p>\n<p><strong>Practical recommendations<\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><strong>Keep your eyes and mind open<\/strong>.<span style=\"font-weight: 400;\"> Build your understanding of health inequities and their structural drivers. <\/span><a href=\"https:\/\/www.nationalequityproject.org\/frameworks\/implicit-bias-structural-racialization#:~:text=Implicit%20bias%20(also%20referred%20to,we%20make%20available%20to%20patients.\"><span style=\"font-weight: 400;\">Reflect<\/span><\/a><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\"> on your own professional position, assumptions, and possible implicit biases, and consider how these may affect communication, clinical judgment, and expectations of patients. Make short reflective moments part of routine practice and team meetings.<\/span><\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><strong>Actively seek and listen to diverse patient voices<\/strong><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">. Go beyond standard satisfaction surveys. Create simple, repeated opportunities to hear from different patient groups, especially. Work especially with those who attend less often or discontinue care to understand the barriers that are preventing their holistic care. Work with patient representatives and community organisations and show clearly how their feedback is highly valued and leads to service adjustments.<\/span><\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><strong>Think critically about the tools and procedures you use.<\/strong><span style=\"font-weight: 400;\"> Clinical pathways, educational materials, digital portals, and behaviour change tools are often designed for highly literate and well-resourced patients. Review whether your materials and processes are understandable, culturally appropriate, and accessible. Adapt language and delivery formats where needed. Familiarize and engage for example with <\/span><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8564233\/#:~:text=The%20framework%20defines%20%E2%80%9Chealth%20equity,from%20achieving%20optimal%20health%20outcomes.\"><span style=\"font-weight: 400;\">equity frameworks<\/span><\/a><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">\u00a0 and theories from the outset.<\/span><\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><strong>Be prepared to challenge inequitable routines and structures<\/strong><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">. Notice patterns in who misses appointments, who gets referred, and who benefits least. Raise these observations with your team and ask them and the patients why these inequitable routines might be occurring. Advocate for the needs of these patients as expressed by them. This might involve flexible scheduling, interpreter access, outreach approaches, and resource allocation that supports.<\/span><\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><strong>Value multiple forms of evidence<\/strong><b>.<\/b><span style=\"font-weight: 400;\"> Combine clinical guidelines and quantitative indicators with patient stories, frontline staff insights, and community knowledge. Different evidence sources together give a more accurate picture of what works for whom in real-world care.<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>By Amanda O\u2019Connor, Claire Blewitt and Helen Skouteris, Monash University, Melbourne, Australia. Health equity means that everyone has a fair and just opportunity to achieve good health, regardless of socioeconomic position, ethnicity, gender, or other social conditions. Yet, current global [&hellip;]<\/p>\n","protected":false},"author":9,"featured_media":4861,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[28,13,43,16,56],"tags":[],"class_list":["post-4857","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-communication","category-interventions","category-patient-engagement","category-planning","category-public-health"],"translation":{"provider":"WPGlobus","version":"3.0.2","language":"id","enabled_languages":["en","id","my","bg","zh","hr","cz","da","de","es","fr","gr","he","it","ja","kr","lv","lt","hu","nl","no","pl","pt","ro","ru","sk","fi","sv","tr","uk"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"id":{"title":false,"content":false,"excerpt":false},"my":{"title":false,"content":false,"excerpt":false},"bg":{"title":false,"content":false,"excerpt":false},"zh":{"title":false,"content":false,"excerpt":false},"hr":{"title":true,"content":true,"excerpt":false},"cz":{"title":true,"content":true,"excerpt":false},"da":{"title":false,"content":false,"excerpt":false},"de":{"title":false,"content":false,"excerpt":false},"es":{"title":false,"content":false,"excerpt":false},"fr":{"title":false,"content":false,"excerpt":false},"gr":{"title":false,"content":false,"excerpt":false},"he":{"title":false,"content":false,"excerpt":false},"it":{"title":true,"content":true,"excerpt":false},"ja":{"title":false,"content":false,"excerpt":false},"kr":{"title":false,"content":false,"excerpt":false},"lv":{"title":true,"content":true,"excerpt":false},"lt":{"title":false,"content":false,"excerpt":false},"hu":{"title":false,"content":false,"excerpt":false},"nl":{"title":true,"content":true,"excerpt":false},"no":{"title":false,"content":false,"excerpt":false},"pl":{"title":true,"content":true,"excerpt":false},"pt":{"title":false,"content":false,"excerpt":false},"ro":{"title":false,"content":false,"excerpt":false},"ru":{"title":true,"content":true,"excerpt":false},"sk":{"title":true,"content":true,"excerpt":false},"fi":{"title":true,"content":true,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":true,"content":true,"excerpt":false},"uk":{"title":true,"content":true,"excerpt":false}}},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/practicalhealthpsychology.com\/id\/wp-json\/wp\/v2\/posts\/4857","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/practicalhealthpsychology.com\/id\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/practicalhealthpsychology.com\/id\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/id\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/id\/wp-json\/wp\/v2\/comments?post=4857"}],"version-history":[{"count":15,"href":"https:\/\/practicalhealthpsychology.com\/id\/wp-json\/wp\/v2\/posts\/4857\/revisions"}],"predecessor-version":[{"id":4886,"href":"https:\/\/practicalhealthpsychology.com\/id\/wp-json\/wp\/v2\/posts\/4857\/revisions\/4886"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/id\/wp-json\/wp\/v2\/media\/4861"}],"wp:attachment":[{"href":"https:\/\/practicalhealthpsychology.com\/id\/wp-json\/wp\/v2\/media?parent=4857"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/id\/wp-json\/wp\/v2\/categories?post=4857"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/practicalhealthpsychology.com\/id\/wp-json\/wp\/v2\/tags?post=4857"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}