CDE Appendix 1 Literature Review - Central East Local Health ...

The Culture, Diversity and Equity Project: Literature Review
GEGA’s work places health squarely within a larger framework of social justice, focusing on health inequalities that
are “avoidable and associated with unjust social constructs” (GEGA, 2009). More positively, GEGA describes its
goal and perspective as “striving towards a world in which disadvantaged population groups (whether defined
by age, gender, race-ethnicity, socio-economic class or residence) can better achieve their full health potential,
as indicated by the health standards of those groups in society who are most advantaged” (ibid.). In this effort
GEGA calls for “affirmative and preferential action to improve the health of those with the poorest health when they
face unjust obstacles to achieving that potential” (ibid.).
GEGA describes an equity gauge as “a health development project that uses an active approach to monitoring and
addressing inequity in health and health care” in a manner that “moves beyond a mere description or passive
monitoring of equity indicators to a set of concrete actions designed to effect real and sustained change in reducing
unfair disparities in health and health care” (ibid.).
The Equity Gauge framework is explicitly based on 3 broad spheres (called ‘pillars’) of action which are each
accorded equal importance in ensuring a successful outcome. These three pillars are:
1. Assessment and Monitoring: Research and monitoring to measure and describe inequities
2. Advocacy and public participation to promote the use of information to effect change involving a broad range
of stakeholders from civil society working together in a movement for equity
3. Community empowerment and involvement: to involve the poor and marginalized as active participants rather
than passive recipients.
The Ottawa Equity Gauge adds and emphasizes a fourth 'Intervention" pillar to the Global Equity Gauge based upon
‘Cochrane and Campbell systematic reviews’ 3 of the evidence-base around the impact of specific interventions
(Tugwell et al., 2006).
Figure 2.11 below represents the Ottawa Equity Gauge, as applied to the study of food security in Ottawa (see next
page):
3 The Campbell Collaboration (named after Donald Campbell, an American psychologist and thinker) is a sibling organisation to The Cochrane
Collaboration which has been formed “to prepare, maintain and promote the accessibility of systematic reviews in areas such as education,
criminal justice, social policy and social care”, and, most recently, health equity (Retrieved March 9, 2009 form
http://www.cochrane.org/docs/campbell.htm).
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