Health Equity Foundation
Reflect on the systems and biases that shape care experiences, and how we can create more equitable care.
Estimated time for completion: ~1.5 to 2 hours
A foundation for care that is equitable, inclusive and reflective
Why this matters
In Canada and around the world, some people experience poorer health because of barriers built into our systems — including in healthcare — which can worsen inequities. Barriers like racism and other forms of discrimination create avoidable and unfair differences in access to care, poorer healthcare experiences and outcomes. This affects many people, such as First Nations, Inuit and Métis, Black and racialized communities, 2S/LGBTQIA+ communities, lower-income people and families, people with disabilities, newcomers, people across various ages and many other communities facing systemic barriers.
Overview
This foundation is designed to be a welcoming and reflective space, no matter where you are in your understanding of health equity or the systems that create inequities in care.
Using HEC’s Health Equity Framework, you’ll explore actions that support equity-oriented approaches to safe and high-quality care. The framework is a tool to help you reflect on your own identity, role and relationships within the health system, and to identify equity-oriented approaches to shift how care is delivered and experienced.
You’ll be encouraged to recognize systems of inequity through an intersectional lens and to choose one specific action from the framework that you can begin applying or strengthening in your work.
Throughout this foundation, we invite you to build what we call good habits of mind. This means approaching learning with openness, curiosity and a willingness to reflect, learn and unlearn. We learned about the phrase “good habits of mind” from our collaborative work with Tecumseh and Stephanie Nixon. It was inspired by Tecumseh’s sharing of Haudenosaunee teachings about the “good mind”, a mindset rooted in gratitude and respect for the Creator and all of creation for their continued support to our lives.
There is no need to rush. Move through the material with care and kindness and pause often to consider how what you are learning connects to your daily work and the people you serve.
Some activities are meant to be completed individually, while others are designed for team reflection and discussion.
Learning objectives
General objective
Learn about HEC’s Health Equity Framework as a resource to enable equity-oriented care.
After completing this foundation, you will be able to:
- Understand the role of self-reflection in promoting safe, high-quality and equitable care
- Recognize systems of inequity through an intersectional lens
- Identify and reflect on one action from HEC’s Health Equity Framework to apply or strengthen in your work
Before you begin
Before diving in, take a moment to gather what you need for this foundation.
You’ll be asked to reflect on your own, and at times, to engage in discussion with your team. Some activities can be done individually, but others work best when shared and discussed with others in your organization and community.
Here’s what we suggest having on hand:
- A quiet space for personal reflection (pen and paper or a blank document might be helpful)
- Access to the HEC Health Equity Framework
- Time set aside to watch a short video to understand our social location and where we may have privilege
- A plan to connect with your team or colleagues to reflect and explore next steps together
You can move through the material at your own pace. What matters most is creating space for honest reflection, meaningful conversation and the possibility of action.
Individual learning
Understanding self and our role in promoting equity-oriented practice
We live in a world shaped by systems that create unfair differences in healthcare and other areas of life. These systems advantage some people and create barriers for others. Because they are so embedded in daily life, we often do not notice how they shape our behaviours and decisions, or how they can make it harder to deliver good care or feel a sense of belonging at work.
None of us created these systems, but we have all inherited them. The good news is that by learning how they work, we can take steps to change them.
To begin this exploration, we introduce the analogy of “What is water?” Think of how a fish does not notice the water it swims in. Systems of inequity can be just as invisible to us. They surround us, shape our assumptions and behaviours, and often go unnoticed.
Individual activity – What is water?
Take a few minutes to reflect on the following:
- Think about a time when you became aware of something significant about your world that you had not noticed before
- What sparked this realization?
- How did it make you feel?
- Did it lead to any changes in your behaviour?
Keep this reflection in mind as you continue through this foundation. Building equity-oriented practice starts with awareness of ourselves, the systems we work within and the experiences of those around us.
Watch: How does privilege have a direct impact on our actions to promote health equity?
Watch this 10-minute video (available in English and French) to explore the concept of privilege and how it affects our work in healthcare.
What is privilege?
Privilege refers to unearned advantages that some people hold while others face barriers or disadvantages. These advantages are often built into the systems around us. Recognizing them is an essential part of advancing equity.
Reflection questions:
- What new insights are landing for me?
- What do I feel during this learning and unlearning?
- What new questions am I beginning to see as important?
- What possibilities for equity-oriented action are coming to light?
These questions will support your equity journey and help you approach the rest of the activities with curiosity and self-awareness.
Want to learn more?
- Equity, Diversity and Inclusion Virtual Learning Exchange (EDI-VLE): A webinar series to help build inclusive, equity-oriented practices when working with people with lived and living experiences. Recordings are available.
- Unpacking Privilege: An introduction to anti-oppression using the coin model (English only): A self-paced learning module that introduces the coin model of anti-oppression. Learn how to identify your social location and take one personal anti-oppressive action.
Duration: 30 minutes
Individual and team activity
Applying the framework
This activity is designed to be completed in two parts: first individually, then as a team.
Step 1 – Individual reflection
Start by reading the HEC Health Equity Framework. This resource was co-developed with people navigating and working within health systems and offers practical ways to advance equity and improve care.
The framework encourages us to move away from thinking of equity as simply helping others. Instead, it challenges us to reflect on our own roles, identities and positions within the system, and to consider how we may contribute to or disrupt inequities.
It reminds us that inequities are:
- Structural, human-made and historically rooted
- Intersecting and power-driven
- Unfair and ultimately harmful to everyone
As you read, reflect on the following questions individually or as a team:
- Which of the guiding commitments in the framework resonate with you?
- How would you describe systems of inequity after reading this resource? Where have you noticed these systems of inequity in everyday life?
- Which actions in the framework feel most important or promising for the work you are doing?
- In what ways do you engage people & communities in identifying the priorities and actions that will make the biggest difference?
Step 2 – Team discussion
After completing the individual reflection, gather as a team to discuss what emerged.
It may be helpful to return to these guiding questions:
- What new insights are landing for me?
- What do I feel during this learning and unlearning?
- What new questions am I coming to see as important?
- What possibilities for equity-oriented action are coming to light?
This step is an opportunity to learn from one another, surface patterns, or bring light to things we have not noticed before and start imagining what collective action could look like in your setting.
Final team activity
As a team, choose one action from the Health Equity Framework to explore more deeply. This might be:
- An area where your team or organization has already done some work
- A new action that feels timely and important for your initiative
Over the next few weeks, engage in conversations with colleagues, patients, caregivers and community members. Ask how this action could be activated in your work and what changes it might lead to. Focus on listening, learning and planning together.
Final reflection and next steps
As you wrap up this foundation, take time to reflect:
- What new or existing questions are coming up for me around health equity?
- How does equity intersect with the other foundations of patient safety, cultural safety and engagement?
Health equity is deeply connected to how care is delivered, who is included in decisions and how systems respond to people’s needs. Keep reflecting, questioning and applying what you have learned in your everyday practice.
Recommended resources and programs
Want to go further? Join us for a live session of the equity, diversity and inclusion virtual learning exchange (EDI-VLE), launching in early 2026. This session will focus on practical applications of the Health Equity Framework and share new implementation tools.
The session will include:
- Case examples of how the framework is being used in healthcare settings
- A preview of new implementation supports to guide equity-oriented action
Registration opening soon
