Science of Health Equity Learning Lab & Assistant Professor, School of Nursing, University of British Columbia ART360, 1147 Research Road, Kelowna, BC, Canada.
Science of Health Equity Learning Lab School of Nursing, University of British Columbia, Kelowna, BC, Canada.
BMC Public Health. 2023 May 15;23(1):890. doi: 10.1186/s12889-023-15709-5.
Collective agreement about the importance of centering equity in health research, practice, and policy is growing. Yet, responsibility for advancing equity is often situated as belonging to a vague group of 'others', or delegated to the leadership of 'equity-seeking' or 'equity-deserving' groups who are tasked to lead systems transformation while simultaneously navigating the violence and harms of oppression within those same systems. Equity efforts also often overlook the breadth of equity scholarship. Harnessing the potential of current interests in advancing equity requires systematic, evidence-guided, theoretically rigorous ways for people to embrace their own agency and influence over the systems in which they are situated. ln this article, we introduce and describe the Systematic Equity Action-Analysis (SEA) Framework as a tool that translates equity scholarship and evidence into a structured process that leaders, teams, and communities can use to advance equity in their own settings.
This framework was derived through a dialogic, critically reflective and scholarly process of integrating methodological insights garnered over years of equity-centred research and practice. Each author, in a variety of ways, brought engaged equity perspectives to the dialogue, bringing practical and lived experience to conversation and writing. Our scholarly dialogue was grounded in critical and relational lenses, and involved synthesis of theory and practice from a broad range of applications and cases.
The SEA Framework balances practices of agency, humility, critically reflective dialogue, and systems thinking. The framework guides users through four elements of analysis (worldview, coherence, potential, and accountability) to systematically interrogate how and where equity is integrated in a setting or object of action-analysis. Because equity issues are present in virtually all aspects of society, the kinds of 'things' the framework could be applied to is only limited by the imagination of its users. It can inform retrospective or prospective work, by groups external to a policy or practice setting (e.g., using public documents to assess a research funding policy landscape); or internal to a system, policy, or practice setting (e.g., faculty engaging in a critically reflective examination of equity in the undergraduate program they deliver).
While not a panacea, this unique contribution to the science of health equity equips people to explicitly recognize and interrupt their own entanglements in the intersecting systems of oppression and injustice that produce and uphold inequities.
越来越多的人认识到，在健康研究、实践和政策中以公平为中心的重要性。然而，推进公平的责任通常被认为属于一个模糊的“他人”群体，或者被委托给“寻求公平”或“值得公平”的群体的领导层，他们的任务是领导系统变革，同时在同一系统内驾驭压迫的暴力和伤害。公平工作也常常忽略了公平奖学金的广度。利用当前推进公平的兴趣潜力，需要系统地、以证据为指导、从理论上严格的方式，让人们接受自己对所处系统的影响力。在本文中，我们介绍并描述了系统公平行动分析（SEA）框架，作为一种将公平奖学金和证据转化为领导者、团队和社区可以在自己的环境中推进公平的结构化过程的工具。
该框架是通过对话、批判性反思和学术性的综合方法得出的，该方法整合了多年来以公平为中心的研究和实践中获得的方法学见解。每位作者都以各种方式将积极参与的公平视角带入对话，将实践和生活经验带入对话和写作。我们的学术对话基于批判性和关系性视角，从广泛的应用和案例中综合了理论和实践。
SEA 框架平衡了代理、谦逊、批判性反思对话和系统思维的实践。该框架通过四个分析要素（世界观、一致性、潜力和问责制）引导用户系统地询问在一个设置或行动分析对象中公平是如何以及在哪里被整合的。由于公平问题存在于社会的几乎所有方面，框架可以应用于的“事物”种类仅受其用户想象力的限制。它可以为回顾性或前瞻性工作提供信息，这些工作可以由政策或实践环境之外的团体进行（例如，使用公共文件评估研究资助政策的前景）；也可以由系统、政策或实践环境内部进行（例如，教师对他们提供的本科课程中的公平进行批判性反思）。
虽然不是万能的，但这一对健康公平科学的独特贡献使人们能够明确认识到并打断自己在产生和维持不平等的交叉压迫和不公正系统中的纠缠。
