THE ISSUE: Equity

The Issue is a series of articles on Healthy Community issues and topics, written by BC Healthy Communities Staff.

What is the issue? 

Equity and its meaning in both public health and planning.

 

Why is it important?

Equity means providing support and resources based on an individual’s level of need, instead of providing everyone with the same level of support. In both community planning and public health, equity is rooted in social justice and the desire for fairness and equal opportunities for all community members.

On the other hand, health equity means that all people can reach their full health potential and should not be disadvantaged from attaining it because of their race, ethnicity, religion, gender, age, social class, socioeconomic status or other socially determined circumstance. In the field of public health, community planning is seen as a tool to address the social determinants of health – primarily those related to the physical spaces in which we live, learn, work and play. In community planning, local government policies and in B.C., equity is often included as a component of sustainability.  

Within these two fields, there is a long history of overlap, and it is generally well understood that planners can influence the health and well-being of their communities. Public health professionals have advocated for the incorporation of health into all plans and policies, but there has been a strong focus on the built environment.

 

What does this mean for local governments/health authorities?

When incorporating health into policy and decision-making, local governments can get hung up on the development of a healthy built environment based on “ideal” principles of what a healthy community looks like. This can result in community infrastructure that does not necessarily meet the needs of all community members. For example, compact, complete communities contribute to improved public health outcomes – but during the COVID-19 pandemic, we have seen that not all density is equal, and there are broader social issues that influence an individual’s opportunity to be healthy and well. 

In both fields, colonialist frameworks of land governance and systemic racism have pathologized Black, Indigenous, and people of colour (BIPOC) and denied communities access to basic services influential to their health and well-being. In the current context of the COVID-19 pandemic and Black Lives Matter movements, we see how the design of space and place created without the voices of all community members involved can perpetuate place-based differences in health and well-being, and have been reminded of the importance of the social justice foundation on which equity in planning and public health both rely. 

Social justice is: “a process process, not an outcome, which (1) seeks fair (re)distribution of resources, opportunities, and responsibilities; (2) challenges the roots of oppression and injustice; (3) empowers all people to exercise self-determination and realize their full potential; (4) and builds social solidarity and community capacity for collaborative action.” 

 

What does this look like in practice?

Current planners are professionals who deal with the physical form and function of cities: streets, parks, land use and development, and zoning regulations. These are important in promoting public health, but when we talk about the inclusion of health and equity in all policies and processes, it is important to recognize the opportunities for community planning and equity planning to influence the social and economic conditions of a community.  

Planning for Equity means applying an equity lens – for just and fair inclusion into a society in which all can participate, prosper, and reach their full potential – to everything planners do. From the way planners work with community members creating a shared vision for their neighbourhoods to advocating for policies that connect people to opportunities at the local, state, and federal levels, planning for equity is planning for all.” 

When considering equity, it can be helpful to consider the framework of distributional, procedural, and historical/contextual equity.

Distributional Equity: Often considered the economic dimension of equity, this encompasses the distribution of costs, risks and benefits of policies, provision of key services and infrastructure, and provision of funding. In community planning, it might be related to the spatial distribution of resources.
Example: The City of Vancouver Park Provision Study (2016). 

Procedural Equity: This dimension addresses fairness in the political or decision-making processes that govern the allocation of resources and the resolution of disputes. In both public health and planning, this considers who is involved in decision-making, and whose voices and needs are prioritized in the information shared with decision-makers. It also looks at how we collect and report on differences in health outcomes, and how planning processes build the capacity of the communities they serve.
Example: Strathcona Community Health Network Housing Needs Assessment 

Historical/Contextual Equity: This considers pre-existing social, political, economic and environmental conditions affecting people or a community’s ability to participate in procedural processes and to benefit from distribution of resources. In our world today, this is about seeking to understand the systemic injustices that have affected our communities in order to actively reduce inequities. In planning, this is about speaking truth to power and striving to challenge the roots of oppression and injustice.
Example: Hogan’s Alley Society MVRD Black Experience Project

As planners and public health professionals work together towards the development of healthy and equitable communities, they should remember that planning is more than a tool to influence the built environment. The way in which planners gather and synthesize information can frame recommendations to decision-makers and community leaders that support equitable policies and contribute to the overall well-being of individuals and the public. 

 

Where can I go to learn more?

More about the links between Planning and Public Health:

 

More about Equity in Planning:

Emily Johnson is BC Healthy Communities’ Healthy Community Planner.

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